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Longitudinal profiling of viral infections in COPD patients and their implication to exacerbations

Viral respiratory tract infections have been associated with acute exacerbations of COPD (AECOPD). We evaluated longitudinally the incidence of viral infections and their association to AECOPD. We followed 450 patients with stable, moderate to very severe COPD, for 27 months. Detection of 18 viruses (adenovirus, influenza A-B, H1-H3, parainfluenza 1-4, RSV A-B, rhinovirus (RV)/enterovirus, coronavirus NL63, -OC43, -229E, -HKU1, bocavirus and metapneumovirus) was performed in naso- and orοpharyngeal swabs collected at URTI onset (n=391), 10 days thereafter (n=356), at AECOPD (n=177) and stable periods (n=1909) using multiplex nucleic acid amplification testing (50’000 PCRs). Evidence for at least 1 respiratory virus was more common at AECOPD (39.0%, P The prevalence of viral infection at the stable period of COPD is low. The risk of AECOPD following the onset of URTI symptoms depends on the particular virus associated with the URTI.