title: Respiratory viral infections in adults with and without chronic obstructive pulmonary disease.
abstract: A longitudinal cohort study of older adults with chronic obstructive pulmonary disease (COPD) who were stratified by FEV(1) at enrollment was done to define the etiology, frequency, severity, and medical-care impact of respiratory tract viral infections (RTVIs). Controls consisted of a group of subjects of comparable age with the patients. RTVIs were documented in 44% of observed acute respiratory illnesses in control subjects and in 27% of COPD subjects, who were followed for mean periods of 35 and 26 mo, respectively. In this heavily influenza-vaccinated cohort ( approximately 90% vaccinated each year), picornaviruses, parainfluenza viruses, and coronaviruses were most commonly identified. Mean time to return to clinical baseline was approximately 2 wk in each group. Control and COPD subjects with mild airways obstruction (baseline FEV(1) >/= 50% predicted) had few emergency-center visits or hospitalizations. Approximately half of COPD subjects with moderate/severe COPD (baseline FEV(1) < 50% predicted) had at least one emergency-center visit and/or hospitalization for acute respiratory illness. RTVIs were documented in 23% of hospitalizations and in 45% of patients admitted between December and March. RTVIs have a major impact on utilization of health care resources for COPD patients with moderate/severe airways obstruction.
authors.affiliation: Departments of Medicine and Microbiology and Immunology, Baylor College of Medicine, Houston, Texas 77030, USA. stepheng@bcm.tmc.edu
authors.forename: S B
authors.initials: SB
authors.lastname: Greenberg
authors.forename: M
authors.initials: M
authors.lastname: Allen
authors.forename: J
authors.initials: J
authors.lastname: Wilson
authors.forename: R L
authors.initials: RL
authors.lastname: Atmar
mesh_terms: D000368:Aged; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007252:Influenza Vaccines; D008137:Longitudinal Studies; D008173:Lung Diseases, Obstructive / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012140:Respiratory Tract Diseases / Q000150:complications* / Q000453:epidemiology / Q000517:prevention & control / Q000821:virology*; D013997:Time Factors; D014777:Virus Diseases / Q000150:complications* / Q000453:epidemiology
chemical_list: D007252:Influenza Vaccines