Scabies increased the risk and severity of COPD: a nationwide population-based study.
BACKGROUND
Scabies is a common parasitic infectious disease, and COPD is a major pulmonary disease. However, there have been no previous studies that have investigated the relationship between scabies and COPD.


METHODS
This nationwide population-based study included a total of 3,568 patients with scabies as the study group and 14,255 patients as a control group. We followed up patients in both groups for a 5-year period to identify any new diagnoses of COPD. We then followed them up for an additional 2-year period to determine the severity of any newly diagnosed cases of COPD as indicated by acute respiratory events. Cox proportional hazard regression analyses were performed to calculate the hazard ratio (HR) of COPD during the 5-year follow-up period and COPD complication during the additional 2-year follow-up period.


RESULTS
Of the 17,823 patients in the study, 2,765 (15.5%) were newly diagnosed with COPD during the 5-year follow-up period; 904 (32.7%) were from the scabies group; and 1,861 (67.3%) were from the control group. Compared to the patients without scabies, the adjusted HR (aHR) for COPD for the subjects with scabies was 1.72 (95% CI: 1.59-1.87) during the 5-year follow-up period. For those newly diagnosed with COPD, the aHR for COPD with acute exacerbation was 1.85 (95% CI: 1.67-2.06), the aHR for COPD with pneumonia was 3.29 (95% CI: 2.77-3.92), the aHR for COPD with acute respiratory failure was 4.00 (95% CI: 3.08-5.19), and the aHR for COPD with cardiopulmonary arrest was 3.95 (95% CI: 2.25-6.95) during the additional 2-year follow-up period.


CONCLUSIONS
The results of this study indicate a 72% increased risk for COPD among patients with scabies. The results also reveal an increased risk of severe COPD complications such as acute respiratory failure, cardiopulmonary arrest, pneumonia, and acute exacerbation among patients with scabies. This useful information may help physicians in treating scabies and remaining alert to the potential development of COPD and its severe complications.
Division of Chest Medicine, Department of Internal Medicine, E-DA Hospital, I-Shou University, Kaohsiung.
Jung-Yueh
JY
Chen
Division of Urology, Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan.
Jui-Ming
JM
Liu
Department of Obstetrics & Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei.
Fung-Wei
FW
Chang
Division of Thoracic Surgery, Department of Surgery, Taichung Armed Forces General Hospital, Taichung; Department of Physiology, National Defense Medical Center.
Hung
H
Chang
Graduate Institute of Food Science and Technology, National Taiwan University; Institute of Biotechnology, National Taiwan University.
Kuan-Chen
KC
Cheng
Division of Urology, Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan.
Chia-Lun
CL
Yeh
Division of Chest Medicine, Department of Internal Medicine, E-DA Hospital, I-Shou University, Kaohsiung.
Yu-Feng
YF
Wei
Graduate Institute of Life Sciences, National Defense Medical Center; Department of Pathology, Graduate Institute of Pathology and Parasitology, Tri-Service General Hospital, National Defense Medical Center; Biobank Management Center, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Ren-Jun
RJ
Hsu
National Health Insurance Research Database; chronic obstructive pulmonary disease; scabies
Diabetes Care. 2010 Jan;33(1):55-60
19808918
Am Heart J. 2002 Mar;143(3):412-7
11868045
Thorax. 2002 Oct;57(10):847-52
12324669
Chest. 2005 May;127(5):1544-52
15888826
J Microbiol Immunol Infect. 2012 Aug;45(4):276-80
22444547
Respir Med. 2013 Sep;107(9):1376-84
23791463
Am J Respir Crit Care Med. 1996 Feb;153(2):530-4
8564092
Health Aff (Millwood). 2015 Mar;34(3):502-10
25732502
Am J Respir Crit Care Med. 2012 Jul 15;186(2):155-61
22561964
Lancet. 2005 Nov 26;366(9500):1875-81
16310554
Epidemiol Infect. 2005 Dec;133(6):985-91
16274495
Am J Trop Med Hyg. 2003 Dec;69(6):652-6
14740884
Parasite Immunol. 2010 Aug;32(8):532-40
20626808
Parasite Immunol. 2014 Nov;36(11):594-604
25040151
Thorax. 2013 Aug;68(8):788-90
23604380
Eur Respir J. 2003 Oct;22(4):672-88
14582923
N Engl J Med. 2006 Apr 20;354(16):1718-27
16625010
Curr Probl Dermatol. 1995;22:105-11
7587311
PLoS One. 2011;6(5):e20333
21647421
Epidemiol Infect. 1999 Jun;122(3):471-7
10459652
Lancet. 2009 Aug 29;374(9691):733-43
19716966
Clin Microbiol Infect. 2012 Apr;18(4):313-23
22429456
Int J Chron Obstruct Pulmon Dis. 2015 Nov 11;10:2459-67
26648708
Curr Opin Pulm Med. 1999 Mar;5(2):93-9
10813258
Eur Respir J. 2008 Oct;32(4):962-9
18579551
J Allergy Clin Immunol. 2000 Jan;105(1 Pt 1):143-9
10629464
Am J Respir Crit Care Med. 2015 Jun 1;191(11):1213-4
26029829
Eur Respir J. 2006 Sep;28(3):523-32
16611654
MMWR Surveill Summ. 2002 Aug 2;51(6):1-16
12198919