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Epidemiological relationships between the common cold and exacerbation frequency in COPD
J R Hurst1, G C Donaldson, T M A Wilkinson
1Academic Unit of Respiratory Medicine, Royal Free and University College Medical School, Hampstead, London, NW3 2QG, UK.
The European Respiratory Journal
|November 3, 2005
Summary
Frequent exacerbations in chronic obstructive pulmonary disease (COPD) are linked to catching more colds, not increased susceptibility. This suggests managing cold frequency may help reduce COPD exacerbations.
Area of Science:
- Respiratory Medicine
- Pulmonology
- Epidemiology
Background:
- Chronic obstructive pulmonary disease (COPD) exacerbations significantly impact lung function and quality of life.
- The precise mechanisms driving COPD exacerbation susceptibility are not fully understood.
- Common cold viruses are often implicated in COPD exacerbations.
Purpose of the Study:
- To investigate the relationship between exacerbation frequency and cold acquisition in COPD patients.
- To determine if frequent exacerbators acquire more colds or are more likely to exacerbate after a cold.
- To identify factors associated with frequent colds in COPD.
Main Methods:
- 150 COPD patients recorded daily symptoms and peak expiratory flow for a median of 1,047 days.
- Annual cold and exacerbation incidence rates were calculated.
- Statistical analysis explored the association between cold frequency, exacerbation frequency, and smoking history.
Main Results:
- Frequent exacerbators experienced significantly more colds annually (1.73 vs. 0.94 colds/year).
- The likelihood of exacerbation during a cold was independent of exacerbation frequency.
- Patients with frequent colds had higher cumulative cigarette smoke exposure (46 vs. 33 pack-years).
Conclusions:
- COPD exacerbation frequency is associated with a higher incidence of acquiring common colds.
- Increased propensity to exacerbate after a cold does not explain frequent exacerbations.
- Reducing cold acquisition may be a strategy to decrease exacerbation frequency in COPD.