Viruses in bronchiectasis

Bronchiectasis is a chronic respiratory condition characterised by irreversible dilation of the bronchi, leading to recurrent respiratory infections and chronic inflammation. Bacterial infections have been well-recognised as contributors to disease progression as well as potent inducers of exacerbations for decades. However, recent studies have indicated that viruses are present in up to 50% of exacerbations, raising questions over the role viruses may play in bronchiectasis. Despite the evidence of their presence, the role of viral infections in bronchiectasis remains largely underexplored. Understanding how viruses impact bronchiectasis is crucial in providing patients with better care and treatment strategies. Given the persistent threat of viral infections, as highlighted by the coronavirus disease 2019 (COVID-19) pandemic, this review aims to provide an overview of the current knowledge surrounding viruses in bronchiectasis, how they may trigger exacerbations and insights from other chronic respiratory conditions where the role of viruses is better understood.