Association between respiratory viruses and exacerbation of COPD: a case-control study

Background: Respiratory viral infection is the main cause of exacerbations of chronic obstructive pulmonary disease (COPD) in all age groups. The present study aimed to find out the association between viral infection in exacerbated and stable patients with COPD as well as evaluating the frequency of respiratory viruses in the Iranian exacerbated patients. Methods: The study included 170 patients as the sample group with acute exacerbations and a control group consisting of 96 stable patients over a period of 3 years. Reverse transcription-nested polymerase chain reaction (RT-nested PCR) and nested PCR methods were used to diagnose the presence of 16 respiratory viruses. Results: Viral infection was detected in 81 (47.6%) exacerbations and 24 (25%) stable patients (p < 0.05). Adenovirus was more frequent among the exacerbated patients than the stable patients (p < 0.05). Furthermore, influenza virus, respiratory syncytial virus, and enterovirus turned out to be the most common viruses in both groups. Moreover, respiratory viral co-infection has a possible role in exacerbation, severity, and longer hospitalization. Muscle pain and fever were found as significant symptoms in the infected patients with exacerbations. Conclusions: The current study investigated the probable roles of the respiratory viruses, and dual infections during acute exacerbations of COPD. Since climate-dependent respiratory viral incidence patterns in Iran are often dissimilar, preparing a comprehensive global model of respiratory infections with seasonal details in different geographical zones might decrease the morbidity and mortality rate in exacerbations of COPD.