Colds as predictors of the onset and severity of COPD exacerbations

• Published in: International journal of chronic obstructive pulmonary disease 2017-01, Vol.12, p.839-848
• Main Authors: Johnston, Neil W, Olsson, Marita, Edsbäcker, Staffan, Gerhardsson de Verdier, Maria, Gustafson, Per, McCrae, Christopher, Coyle, Peter V, McIvor, R Andrew
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Care and treatment; Causes of; Chronic obstructive lung disease; Chronic obstructive pulmonary disease; Colds; Common cold; Common Cold - diagnosis; Common Cold - physiopathology; Common Cold - virology; Complications and side effects; COPD epidemiology; COPD exacerbations; Data collection; Development and progression; Diagnosis; Diaries; Disease Progression; Electronic Health Records; Female; Humans; Lung - physiopathology; Lung - virology; Male; Middle Aged; Nurses; Original Research; Physicians; Prognosis; Prospective Studies; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary Disease, Chronic Obstructive - virology; Questionnaires; Respiratory Infection; Risk Factors; Severity of Illness Index; Smartphones; Spirometry
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/COPD.S127146

Common colds are associated with acute respiratory symptom exacerbations in COPD patients. To determine exacerbation risk and severity in COPD patients with/without coincident self-reported colds. Global initiative for chronic Obstructive Lung Disease stage I-IV COPD patients electronically transmitted respiratory symptom diaries to research staff daily between December 2006 and April 2009. Respiratory symptom worsening prompted contact by a study nurse and patient assessment to determine if a cold was present or an exacerbation underway. A composite daily symptom score was derived for each subject from diarized symptom data. The exacerbation/cold/virus relation was examined using a Poisson regression model, the relation of colds to respiratory symptom severity using generalized estimating equation models. Daily diary transmission compliance of >97% enabled detection of all possible exacerbations. Among 262 exacerbations meeting Anthonisen criteria, 218 (83%) had cold-like symptoms present at their inception, but respiratory viruses were detected in only 106 (40%). Within-subject exacerbation risk was 30 times (95% confidence interval [CI]: 20, 47;