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Am. J. Respir. Crit. Care Med., Volume 162, Number 1, July 2000, 167-173

Respiratory Viral Infections in Adults With and Without Chronic Obstructive Pulmonary Disease

STEPHEN B. GREENBERG, MARTHA ALLEN, JOAN WILSON, and ROBERT L. ATMAR

Departments of Medicine and Microbiology and Immunology, Baylor College of Medicine, Houston, Texas

A longitudinal cohort study of older adults with chronic obstructive pulmonary disease (COPD) who were stratified by FEV1 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 (~ 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 FEV1 >=  50% predicted) had few emergency-center visits or hospitalizations. Approximately half of COPD subjects with moderate/severe COPD (baseline FEV1 < 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.




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