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Impact of respiratory viral infections on mortality and critical illness among hospitalized patients with chronic obstructive pulmonary disease.
Mulpuru, Sunita; Andrew, Melissa K; Ye, Lingyun; Hatchette, Todd; LeBlanc, Jason; El-Sherif, May; MacKinnon-Cameron, Donna; Aaron, Shawn D; Alvarez, Gonzalo G; Forster, Alan J; Ambrose, Ardith; McNeil, Shelly A.
  • Mulpuru S; Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
  • Andrew MK; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
  • Ye L; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
  • Hatchette T; Department of Medicine (Geriatrics), Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
  • LeBlanc J; Canadian Center for Vaccinology (CCfV), IWK Health Center, Nova Scotia Health, Halifax, Nova Scotia, Canada.
  • El-Sherif M; Canadian Center for Vaccinology (CCfV), IWK Health Center, Nova Scotia Health, Halifax, Nova Scotia, Canada.
  • MacKinnon-Cameron D; Department of Medicine (Infectious Diseases), Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
  • Aaron SD; Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
  • Alvarez GG; Canadian Center for Vaccinology (CCfV), IWK Health Center, Nova Scotia Health, Halifax, Nova Scotia, Canada.
  • Forster AJ; Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
  • Ambrose A; Canadian Center for Vaccinology (CCfV), IWK Health Center, Nova Scotia Health, Halifax, Nova Scotia, Canada.
  • McNeil SA; Canadian Center for Vaccinology (CCfV), IWK Health Center, Nova Scotia Health, Halifax, Nova Scotia, Canada.
Influenza Other Respir Viruses ; 16(6): 1172-1182, 2022 11.
Article in English | MEDLINE | ID: covidwho-2052631
ABSTRACT

BACKGROUND:

Seasonal respiratory viral infections are associated with exacerbations and morbidity among patients with COPD. The real-world clinical outcomes associated with seasonal viral infections are less well established among hospitalized patients. RESEARCH QUESTION To estimate the association between seasonal respiratory viral infections, 30-day mortality, and intensive care unit (ICU) admission among hospitalized COPD patients. STUDY DESIGN AND

METHODS:

We conducted an analysis of a national prospective multicenter cohort of COPD patients hospitalized with acute respiratory illness during winter seasons (2011-2015) in Canada. Nasopharyngeal swabs were performed on all patients at the onset of hospital admission for diagnosis of viral infection. Primary outcomes were 30-day mortality and ICU admissions. Secondary outcomes included invasive/non-invasive ventilation use.

RESULTS:

Among 3931 hospitalized patients with COPD, 28.5% (1122/3931) were diagnosed with seasonal respiratory viral infection. Viral infection was associated with increased admission to ICU (OR 1.5, 95% CI 1.2-1.9) and need for mechanical ventilation (OR 1.9, 95% CI 1.4-2.5), but was not associated with mortality (OR 1.1, 95% CI 0.8-1.4). Patients with respiratory syncytial virus (RSV) were equally likely to require ICU admission (OR 1.09, 95% CI 0.67-1.78), and more likely to need non-invasive ventilation (OR 3.1; 95% CI 1.8-5.1) compared to patients with influenza.

INTERPRETATION:

Our results suggest COPD patients requiring hospitalization for respiratory symptoms should routinely receive viral testing at admission, especially for RSV and influenza, to inform prognosis, clinical management, and infection control practices during winter seasons. Patients with COPD will be an important target population for newly developed RSV therapeutics. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov ID NCT01517191.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Tract Infections / Respiratory Syncytial Virus, Human / Respiratory Syncytial Virus Infections / Pulmonary Disease, Chronic Obstructive / Influenza, Human Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Humans Language: English Journal: Influenza Other Respir Viruses Journal subject: Virology Year: 2022 Document Type: Article Affiliation country: Irv.13050

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Tract Infections / Respiratory Syncytial Virus, Human / Respiratory Syncytial Virus Infections / Pulmonary Disease, Chronic Obstructive / Influenza, Human Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Humans Language: English Journal: Influenza Other Respir Viruses Journal subject: Virology Year: 2022 Document Type: Article Affiliation country: Irv.13050