• Omar Kherad, Pierre-Olivier Bridevaux, Laurent Kaiser, Jean-Paul Janssens, and Olivier T Rutschmann.
• Department of Internal Medicine and University of Geneva, La Tour Hospital, Geneva, Switzerland.
• Open Respir Med J. 2014 Jan 1;8:18-21.

BackgroundThere is a growing interest in better defining risk factors associated with increased susceptibility to exacerbation in patients with COPD.IntroductionThe aim of the study was to determine whether identification of a respiratory virus during a severe acute exacerbation of COPD (AECOPD) increases the risk of subsequent exacerbations and mortality during a one-year followup.MethodsSecondary analysis of 86 COPD patients admitted for AECOPD between June 2007 and December 2008 at Geneva's University Hospital who were followed up for 1 year. Fifty-one percent of index AECOPD were related to viral infection. Rate of AECOPD, time to next AECOPD, and all-cause mortality were compared between patients with vs without viral index AECOPD.ResultsEighty-one cases were included in this secondary follow-up analysis. Mean exacerbation rate was 1.9 AECOPD per person-year for patients with viral index AECOPD vs 4.0 AECOPD per person year for those with non-viral index AECOPD. Incidence rate ratio (IRR) for subsequent AECOPD during one year follow up was lower for patients with viral index AECOPD (IRR 0.57; [CI 95% 0.39-0.84]), after controlling for previous exacerbations, and was strongly associated with the number of exacerbations in the year preceding the index AECOPD. During the one-year follow-up period, 16 patients (19%) died. In a Cox regression model, patients with a proven viral infection did not have a higher mortality (HR 0.56 [CI 95% 0.20 -1.58]).ConclusionViral AECOPD was not associated with a higher rate of subsequent exacerbations or mortality during the following year.

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