Chronic obstructive pulmonary disease is the leading cause of fatality. The course of COPD is followed by episodes of acute deterioration in respiratory health, referred as 'exacerbations'. Acute exacerbations of COPD contribute substantially to the morbidity and mortality due to number of infectious agents including bacteria, viruses, or both. Therefore, we planned a case control study to know the association of respiratory viruses especially HRSV genotype with acute exacerbation of COPD, if any.
This is a prospective case-control study with two groups of patients (AECOPD and stable COPD). Nasopharyngeal aspirate were tested for the detection of Human Respiratory Syncytial Virus; Influenza Viruses; Human Metapneumovirus; Adeno Virus; Human Boca Virus and Parainfluenza Virus 1,2,3,4 by real time PCR.
Respiratory viruses are more often found in case group (AECOPD patients) 45/ 234 patients (19.23%) than in control group (stable COPD), 8/100 patients (8%; P=0.0330). In case group HRSV was detected in 7.6% (18/234) and was most commonly detected virus followed by INFV-A (11/234; 4.7%), INFV-B (10/234; 4.2%), HMPV (2/234; 0.8%), and ADV (4/234; 1.7%). In control group INFV-A was most commonly detected (4/100, 4%), followed by ADV (2/100, 2%) and HRSV (1/100, 1%). No patient tested positive for more than one virus.
Among respiratory viruses, HRSV-A is the most prominent group associated with AECOPD patients. Present study concluded that respiratory viruses play an important role in exacerbation.