title: Viral Etiology of Chronic Obstructive Pulmonary Disease Exacerbations during the A/H1N1pdm09 Pandemic and Postpandemic Period.
abstract: Viral infections are one of the main causes of acute exacerbations of chronic obstructive pulmonary disease (AE-COPD). Emergence of A/H1N1pdm influenza virus in the 2009 pandemic changed the viral etiology of exacerbations that were reported before the pandemic. The aim of this study was to describe the etiology of respiratory viruses in 195 Spanish patients affected by AE-COPD from the pandemic until the 2011-12 influenza epidemic. During the study period (2009-2012), respiratory viruses were identified in 48.7% of samples, and the proportion of viral detections in AE-COPD was higher in patients aged 30-64 years than ≥65 years. Influenza A viruses were the pathogens most often detected during the pandemic and the following two influenza epidemics in contradistinction to human rhino/enteroviruses that were the main viruses causing AE-COPD before the pandemic. The probability of influenza virus detection was 2.78-fold higher in patients who are 30-64 years old than those ≥65. Most respiratory samples were obtained during the pandemic, but the influenza detection rate was higher during the 2011-12 epidemic. There is a need for more accurate AE-COPD diagnosis, emphasizing the role of respiratory viruses. Furthermore, diagnosis requires increased attention to patient age and the characteristics of each influenza epidemic.
authors.affiliation: Valladolid National Influenza Centre, Avenida Ramón y Cajal No. 7, 47005 Valladolid, Spain ; Microbiology and Immunology Service, University Clinic Hospital of Valladolid, Avenida Ramón y Cajal s/n, 47005 Valladolid, Spain.
authors.forename: Ivan
authors.initials: I
authors.lastname: Sanz
authors.affiliation: Consejería de Sanidad, Junta de Castilla y León, Paseo de Zorrilla No. 1, 47007 Valladolid, Spain.
authors.forename: Sonia
authors.initials: S
authors.lastname: Tamames
authors.affiliation: Valladolid National Influenza Centre, Avenida Ramón y Cajal No. 7, 47005 Valladolid, Spain ; Microbiology and Immunology Service, University Clinic Hospital of Valladolid, Avenida Ramón y Cajal s/n, 47005 Valladolid, Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: Rojo
authors.affiliation: Microbiology and Immunology Service, University Clinic Hospital of Valladolid, Avenida Ramón y Cajal s/n, 47005 Valladolid, Spain.
authors.forename: Mar
authors.initials: M
authors.lastname: Justel
authors.affiliation: Consejería de Sanidad, Junta de Castilla y León, Paseo de Zorrilla No. 1, 47007 Valladolid, Spain.
authors.forename: José Eugenio
authors.initials: JE
authors.lastname: Lozano
authors.affiliation: Pulmonology Service, University Clinic Hospital of Valladolid, Avenida Ramón y Cajal s/n, 47005 Valladolid, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Disdier
authors.affiliation: Consejería de Sanidad, Junta de Castilla y León, Paseo de Zorrilla No. 1, 47007 Valladolid, Spain.
authors.forename: Tomás
authors.initials: T
authors.lastname: Vega
authors.affiliation: Valladolid National Influenza Centre, Avenida Ramón y Cajal No. 7, 47005 Valladolid, Spain ; Microbiology and Immunology Service, University Clinic Hospital of Valladolid, Avenida Ramón y Cajal s/n, 47005 Valladolid, Spain.
authors.forename: Raúl
authors.initials: R
authors.lastname: Ortiz de Lejarazu