RT Journal Article
SR Electronic
T1 Time-course of upper respiratory tract viral infection and COPD exacerbation
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1900407
DO 10.1183/13993003.00407-2019
A1 Daiana Stolz
A1 Eleni Papakonstantinou
A1 Leticia Grize
A1 Daniel Schilter
A1 Werner Strobel
A1 Renaud Louis
A1 Christian Schindler
A1 Hans H. Hirsch
A1 Michael Tamm
YR 2019
UL http://erj.ersjournals.com/content/early/2019/07/03/13993003.00407-2019.abstract
AB Viral respiratory tract infections have been implicated as the predominant risk factor for acute exacerbations of COPD (AECOPD). We aimed to evaluate, longitudinally, the association between upper respiratory tract infections (URTI) caused by viruses and AECOPD.Detection of 18 viruses was performed in naso- and orοpharyngeal swabs in 450 COPD patients (GOLD 2–4), followed for a mean of 27 months, at stable periods (n=1909), at URTI onset (n=391), 10 days after the URTI (n=356) and at AECOPD (n=177) using a multiplex nucleic acid amplification testing.Evidence of at least one respiratory virus was significantly higher at URTI onset (52.7%), at 10 days following a URTI (15.2%) and at exacerbation (38.4%), compared with the stable period (5.3%, p<0.001). At stable visits rhinovirus accounted for 54.2% of all viral infections, followed by coronavirus (20.5%). None of the viruses could be identified in two consecutive stable visits. Patients with viral infection at URTI onset did not have a higher incidence of exacerbation, compared with patients without viral infection (p=0.993). Τhe incidence of any viral infection at AECOPD was similar between URTI-related AECOPD and non-URTI-related AECOPD (p=0.359). Only 24% of the patients that had a URTI-related AECOPD had the same virus at URTI and AECOPD. Detection of parainfluenza 3 at URTI onset was associated with higher risk of AECOPD (p=0.003). Rhinovirus and coronavirus were the most frequently detected viruses at AECOPD visits accounting for 35.7% and 25.9% of all viral infections, respectively.The prevalence of viral infection at the stable period of COPD is low. The risk of exacerbation following the onset of URTI symptoms depends on the particular virus associated with the event and was significant only for parainfluenza 3.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Stolz has nothing to disclose.Conflict of interest: Dr. Papakonstantinou has nothing to disclose.Conflict of interest: Dr. Grize has nothing to disclose.Conflict of interest: Dr. Schilter has nothing to disclose.Conflict of interest: Dr. Strobel has nothing to disclose.Conflict of interest: Dr. Louis has nothing to disclose.Conflict of interest: Dr. Schindler has nothing to disclose.Conflict of interest: Dr. Hirsch has nothing to disclose.Conflict of interest: Dr. Tamm has nothing to disclose.