PT - JOURNAL ARTICLE AU - Daiana Stolz AU - Eleni Papakonstantinou AU - Leticia Grize AU - Daniel Schilter AU - Werner Strobel AU - Renaud Louis AU - Christian Schindler AU - Hans H. Hirsch AU - Michael Tamm TI - Time-course of upper respiratory tract viral infection and COPD exacerbation AID - 10.1183/13993003.00407-2019 DP - 2019 Oct 01 TA - European Respiratory Journal PG - 1900407 VI - 54 IP - 4 4099 - http://erj.ersjournals.com/content/54/4/1900407.short 4100 - http://erj.ersjournals.com/content/54/4/1900407.full SO - Eur Respir J2019 Oct 01; 54 AB - Viral respiratory tract infections have been implicated as the predominant risk factor for acute exacerbations of chronic obstructive pulmonary disease (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 from 450 COPD patients (Global Initiative for Chronic Obstructive Lung Disease stages 2–4) who were followed for a mean of 27 months. Swabs were taken during stable periods (n=1909), at URTI onset (n=391), 10 days after the URTI (n=356) and during an AECOPD (n=177) and tested using a multiplex nucleic acid amplification test.Evidence of at least one respiratory virus was significantly higher at URTI onset (52.7%), 10 days after the URTI (15.2%) and during an AECOPD (38.4%), compared with the stable period (5.3%, p<0.001). During stable visits, rhinovirus accounted for 54.2% of all viral infections, followed by coronavirus (20.5%). None of the viruses were identified in two consecutive stable visits. Patients with a viral infection at URTI onset did not have a higher incidence of exacerbation than patients without viral infection (p=0.993). Τhe incidence of any viral infection during an 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 onset and during an AECOPD. Detection of parainfluenza 3 at URTI onset was associated with a higher risk of an AECOPD (p=0.003). Rhinovirus and coronavirus were the most frequently detected viruses during AECOPD visits, accounting for 35.7% and 25.9% of all viral infections, respectively.The prevalence of viral infection during the stable period of COPD was 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.The presence of viruses in patients with stable COPD is rare. URTI viruses were not per se associated with an increased risk of exacerbation. URTI is associated with worsening of quality of life and lung function independently of exacerbation. http://bit.ly/30jGm5N