TY - JOUR T1 - Upper airway symptoms associate with the eosinophilic phenotype of COPD JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00184-2021 SP - 00184-2021 AU - Nicolai Obling AU - Vibeke Backer AU - John R Hurst AU - Uffe Bodtger Y1 - 2021/01/01 UR - http://openres.ersjournals.com/content/early/2021/06/17/23120541.00184-2021.abstract N2 - Background There is growing evidence that upper airway symptoms coexist with lower airway symptoms in Chronic Obstructive Pulmonary Disease (COPD). Still, the prevalence and impact of upper airway disease on the nature and course of COPD remain unclear. We aimed to describe this in a cross-sectional study.Methods We examined a cohort of COPD patients with pulmonary function tests, induced sputum, blood eosinophils, atopy tests, CT of the paranasal sinuses. Lower airway symptoms were assessed using the COPD assessment test (CAT), and upper airway symptoms were assessed using the nasal subdomain of the 22-item Sino Nasal Outcome Test (SNOT22nasal). We recruited patients from five sites in Denmark and Sweden. We excluded patients with a history of asthma.Findings In total, 180 patients (female 55%, age 67 (±8) years, FEV1% 52.4 (±16.6), GOLD stage: A:18%, B:54%, C:3%, D:25%) were included in the study. Seventy-four patients (41%) reported high upper airway symptoms (high UAS defined as SNOT22nasal≥6) with a median score of 10 (IQR 8–13). Patients with high UAS reported higher CAT scores (17.4 (±7.5) versus 14.9 ±6.6, p<0.05) and displayed higher fractions of eosinophils in blood (median 3.0% (IQR 1.6–4.2%) versus 2.3% (IQR 1.4–3.1), p<0.05) and in induced sputum (median 1.8% (IQR 0.3–7.1%) versus median 0.5% (IQR 0–1.7%), p<0.05). No differences in atopy, CT findings or exacerbation rates were observed.Conclusion COPD patients with upper airway disease showed increased evidence of eosinophilic disease and increased lower airway symptom burden.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. 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 ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Dr. Obling has nothing to disclose.Conflict of interest: Dr. Backer has nothing to disclose.Conflict of interest: J.R. Hurst reports support to attend meetings, and payment to himself and his employer (UCL) for educational and advisory work from pharmaceutical companies that make medicines to treat COPD, outside the submitted work.Conflict of interest: Dr. Bodgter has nothing to disclose. ER -