Identifying viral infections in vaccinated Chronic Obstructive Pulmonary Disease (COPD) patients using clinical features and inflammatory markers

• Published in: Influenza and other respiratory viruses 2010-01, Vol.4 (1), p.33-39
• Main Authors: Hutchinson, Anastasia F., Black, Jim, Thompson, Michelle A., Bozinovski, Steven, Brand, Caroline A., Smallwood, David M., Irving, Louis B., Anderson, Gary P.
• Format: Article
• Language: English
• Subjects: Aged; Biomarkers - blood; Chronic obstructive pulmonary disease; Diagnosis, Differential; diagnostic test accuracy; Early Diagnosis; exacerbations of COPD; Female; Humans; inflammatory markers; Influenza Vaccines - immunology; Interleukin-6 - blood; Male; Original; Pharyngitis - virology; Picornavirus; Pulmonary Disease, Chronic Obstructive - blood; Pulmonary Disease, Chronic Obstructive - virology; Sensitivity and Specificity; Serum Amyloid A Protein - analysis; Vaccination; Virus Diseases - blood; Virus Diseases - complications; Virus Diseases - diagnosis
• ISSN: 1750-2640; 1750-2659
• DOI: 10.1111/j.1750-2659.2009.00113.x

Background  Known inflammatory markers have limited sensitivity and specificity to differentiate viral respiratory tract infections from other causes of acute exacerbation of COPD (AECOPD). To overcome this, we developed a multi‐factorial prediction model combining viral symptoms with inflammatory markers. Methods  Interleukin‐6 (IL‐6), serum amyloid A (SAA) and viral symptoms were measured in stable COPD and at AECOPD onset and compared with the viral detection rates on multiplex PCR. The predictive accuracy of each measure was assessed using logistic regression and receiver operating characteristics curve (ROC) analysis. Results  There was a total of 33 viruses detected at the onset of 148 AECOPD, the majority 26 (79%) were picornavirus. Viral symptoms with the highest predictive values were rhinorrhoea [Odds ratio (OR) 4·52; 95% CI 1·99–10·29; P