Abstract
Background The burden of COPD in the Asia-Pacific region is projected to increase. Data from other regions show bacterial and viral infections can trigger acute exacerbations of COPD (AECOPD).
Methods This 1-year, prospective, epidemiological study (NCT03151395) of patients with moderate to very severe COPD in Hong Kong, the Philippines, South Korea and Taiwan assessed the prevalence in sputum samples (by culture and PCR) of bacterial and viral pathogens during stable COPD and AECOPD. The odds of experiencing an exacerbation was evaluated for pathogen presence, acquisition and apparition. Health-related quality of life (HRQOL) was assessed.
Results 197 patients provided 983 sputum samples; 226 during exacerbation episodes. The mean yearly AECOPD incidence rate was 1.27 per patient. The most prevalent bacteria by PCR at exacerbation were Haemophilus influenzae (Hi) and Moraxella catarrhalis (Mcat); Mcat prevalence was higher at exacerbation than at stable-state. Virus prevalence was low, other than for human rhinovirus (HRV: 8.1%, stable-state; 16.6%, exacerbation). The odds ratio for an exacerbation (versus stable state) was statistically significant for presence, acquisition and apparition of Hi (2.20 [95% CI: 1.26–3.89]; 2.43 [1.11–5.35]; 2.32 [1.20–4.46], respectively), Mcat (2.24 [1.30–3.88]; 5.47 [2.16–13.86]; 3.45 [1.71–6.98], respectively) and HRV (2.12 [1.15–3.91]; 2.22 [1.09–4.54]; 2.09 [1.11–3.91], respectively). HRQOL deteriorated according to number of exacerbations experienced.
Conclusion In patients with COPD in the Asia-Pacific region, the presence of Hi, Mcat or HRV in sputum samples significantly increased the odds of an exacerbation, providing further evidence of potential roles in triggering AECOPD.
Footnotes
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Conflict of interest: Laura Taddei, Ludovic Malvaux and Ashwani Kumar Arora are employed by the GSK group of companies. Laura Taddei and Ludovic Malvaux hold shares in the GSK group of companies. Lucio Malvisi was employed by the GSK group of company at the time the study was conducted. Laura Taddei, Ludovic Malvaux, Ashwani Kumar Arora and Lucio Malvisi declare no other financial and non-financial relationships and activities. David Hui, Ronnie Z. Samoro, Sang Haak Lee, Yiu Cheong Yeung and Yu-Chih Liu declare no financial and non-financial relationships and activities and no conflicts of interest.
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- Received November 30, 2021.
- Accepted June 10, 2022.
- Copyright ©The authors 2022
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