Viral Profile of COPD Exacerbations According to Patients§



G. Dimopoulos1, S. Tsiodras2, M. Lerikou*, 3, Aik Chranioti4, E. Perros5, U. Anagnostopoulou3, P. Karakitsos4, A. Armaganidis1
1 Department of Critical Care, University Hospital, ATTIKON, Medical School, University of Athens, Greece
2 4th Department of Internal Medicine, University Hospital, ATTIKON, Medical School, University of Athens, Greece
3 8th Department of Pulmonary Medicine, Athens Chest Hospital, SOTIRIA, Greece
4 2nd Department of Cytology, University Hospital, ATTIKON, Medical School, University of Athens, Athens, Greece
5 Department of Pneumonology, General Hospital Nikaias, Piraeus, Athens, Greece


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© Dimopoulos et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the 8th Pulmonary Department, SOTIRIA Athens Chest Hospital, 48, Rodopis Str, Glyfada, 16675, Athens, Greece; Tel/Fax: +30.210.8104592; E-mail: mlerikou@yahoo.gr
§ Part of this article has been previously published in Pulmonary Pharmacology & Therapeutics; Volume 25, Issue 1, February 2012, Pages 12-18.


Abstract

Background :

To compare the differences between elderly and non-elderly patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) due to viral infections.

Methods :

Patients with chronic obstructive pulmonary disease (COPD) exacerbation were recruited and classified as elderly (>65 years) and non-elderly (≤ 65 years). Sputum and oropharyngeal samples were assessed, PCR for respiratory viruses and cultures for common pathogens were performed.

Results :

247 patients (median age: 69.3±9.5 years) were recruited and categorized into group A: non-elderly patients [n=81 (32.8%), median age 58±5.99] and group B: elderly patients [n=166 (67.2%), median age 74.8±4.8] years. In 133 (53.8%) patients a viral infection was identified and in 34 (13.8%) a bacterial pathogen was isolated from cultures. In 18 (7.3%) patients a double infection (bacterial+viral) was identified. In group B, the presence of cardiac failure (46.6% vs 28.3%, p<0.001), renal failure (10.5% vs 4%, p=0.03), bacterial co-infection (13.8% vs 7.4%, p=0.04), influenza vaccination rates (45.5% vs 215, p<0.001), and longer hospital stay (8.4±4.4 vs 7.5±3.2 days, p=0.02) were higher than group A. The overall rate of viral infections did not differ according to age. A trend to higher rates of infection with parainfluenza 3 [19 (20%) patients in group B vs3 (7.5%) patients in group A, p=0.04] was observed in older patients.

Conclusion :

No differences on the rate and type of viral infections were noted for elderly vs non elderly patients. However, they tended to have more bacterial co-infections that led to AECOPD and longer hospitalization stays compared to non-elderly patients.

Keywords: COPD exacerbations, elderly, PCR, viruses..