1
|
Al Wachami N, Guennouni M, Iderdar Y, Boumendil K, Arraji M, Mourajid Y, Bouchachi FZ, Barkaoui M, Louerdi ML, Hilali A, Chahboune M. Estimating the global prevalence of chronic obstructive pulmonary disease (COPD): a systematic review and meta-analysis. BMC Public Health 2024; 24:297. [PMID: 38273271 PMCID: PMC10811845 DOI: 10.1186/s12889-024-17686-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 01/05/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a major public health problem. The present study aims to provide a global and regional estimate of the prevalence of COPD based on spirometry according to the two most widely used diagnostic criteria of COPD: fixed ratio (FR) and lower limit of normal (LLN). METHODS We conducted a systematic review of the literature according to PRISMA guidelines. MEDLINE, Web of Sciences, and Scopus databases were searched to identify studies on the spirometry-based prevalence of COPD in individuals aged 40 years and older. The meta-analysis was performed using MedCalc 19 software. RESULTS In total, 42 of the 3393 studies reviewed were eligible for inclusion. The overall prevalence of COPD in people aged 40 years and older was 12.64% (95% CI 10.75%-14.65%) and 7.38% (95% CI 5.47% - 9.55%) based on FR and LLN criteria, respectively. By gender, men had a higher prevalence of COPD compared to women (15.47%; 95% CI 12.22%-19.02% for men versus 8.79%; 95% CI 6.94%-10.82% for women). Using the LLN criteria, the prevalence of COPD in both sexes was almost identical (8.67%; 95% CI 8.44%- 8.90% for men and 8.00%; 95% CI 6.42% - 9.73% for women). We reported a high prevalence of COPD among smokers and the elderly by both definitions of airway obstruction. Regional prevalence estimates using the FR definition indicate that the highest COPD prevalence was recorded in the Americas and the lowest was recorded in the Eastern Mediterranean region. Using the LLN definition, the highest prevalence was recorded in the Southeast Asian region and the lowest prevalence was recorded in the American region. The most common COPD stage was stage II, with a prevalence of 50.46%. The results indicate a huge lack of prevalence data in the African and Eastern Mediterranean region. The results were given using a random-effect model due to the high heterogeneity between studies. CONCLUSION Results show that the prevalence of COPD differs according to the diagnostic criteria used. In addition, management and prevention strategies targeting risk factors for COPD are certainly needed to reduce the global burden of this chronic respiratory disease.
Collapse
Affiliation(s)
- Nadia Al Wachami
- Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Hassan First University of Settat, 26000, Settat, Morocco.
| | - Morad Guennouni
- Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Hassan First University of Settat, 26000, Settat, Morocco
- Higher School of Education and Training, Chouaîb Doukkali University of El Jadida, El Jadida, Morocco
| | - Younes Iderdar
- Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Hassan First University of Settat, 26000, Settat, Morocco
| | - Karima Boumendil
- Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Hassan First University of Settat, 26000, Settat, Morocco
| | - Maryem Arraji
- Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Hassan First University of Settat, 26000, Settat, Morocco
| | - Yassmine Mourajid
- Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Hassan First University of Settat, 26000, Settat, Morocco
| | - Fatima Zahra Bouchachi
- Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Hassan First University of Settat, 26000, Settat, Morocco
| | - Mohamed Barkaoui
- Higher Institute of Sport, Laboratory of Sciences and Health Technologies, Hassan First University of Settat, 26000, Settat, Morocco
| | | | - Abderraouf Hilali
- Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Hassan First University of Settat, 26000, Settat, Morocco
| | - Mohamed Chahboune
- Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Hassan First University of Settat, 26000, Settat, Morocco
| |
Collapse
|
2
|
Chaudhary N, Khan UH, Shah TH, Shaheen F, Mantoo S, Qadri SM, Mehfooz N, Shabir A, Siraj F, Shah S, Koul PA, Jan RA. Prevalence and predictors of pulmonary embolism in patients with acute exacerbation of chronic obstructive pulmonary disease. Lung India 2021; 38:533-539. [PMID: 34747735 PMCID: PMC8614611 DOI: 10.4103/lungindia.lungindia_79_21] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background: The prevalence of pulmonary embolism (PE) in patients of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) varies over a wide range. Early detection and treatment of PE in AECOPD is a key to improve patient outcome. The purpose of the study was to investigate the prevalence and predictors of PE in patients of AECOPD in a high burden region of North India. Materials and Methods: This prospective study included patients of AECOPD with no obvious cause of exacerbation on initial evaluation. Apart from routine workup, the participants underwent assessment of D-dimer, compression ultrasound and venous Doppler ultrasound of the lower limbs and pelvic veins, and a multidetector computed tomography pulmonary angiography. Results: A total of 100 patients of AECOPD with unknown etiology were included. PE as a possible cause of AE-COPD was observed in 14% of patients. Among the participants with PE, 63% (n = 9) had a concomitant presence of lower extremity deep venous thrombosis. Hemoptysis and chest pain were significantly higher in patients of AECOPD with PE ([35.7% vs. 7%, P = 0.002] and [92.9% vs. 38.4%, P = 0.001]). Likelihood of PE was significantly higher in patients who presented with tachycardia, tachypnea, respiratory alkalosis (PaCO2 <45 mmHg and pH >7.45), and hypotension. No difference was observed between the two groups in terms of in-hospital mortality, age, sex distribution, and risk factors for embolism except for the previous history of venous thromboembolism (35.7% vs. 12.8% P = 0.03). Conclusion: PE was probably responsible for AECOPD in 14% of patients with no obvious cause on initial assessment. Patients who present with chest pain, hemoptysis, tachypnea, tachycardia, and respiratory alkalosis should be particularly screened for PE.
Collapse
Affiliation(s)
- Nasir Chaudhary
- Department of Cardiology, GMC, Jammu, Jammu and Kashmir, India
| | - Umar Hafiz Khan
- Department of Geriatric Medicine, Sher E Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Tajamul Hussain Shah
- Department of Pulmonary Medicine, Sher E Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Feroze Shaheen
- Department of Radiology, Sher E Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Suhail Mantoo
- Department of Internal Medicine, Sher E Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Syed Mudasir Qadri
- Department of Internal Medicine, Sher E Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Nazia Mehfooz
- Department of Pulmonary Medicine, Sher E Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Afshan Shabir
- Department of Geriatric Medicine, Sher E Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Farhana Siraj
- Department of Internal Medicine, Sher E Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Sonaullah Shah
- Department of Internal and Pulmonary Medicine, Sher E Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Parvaiz A Koul
- Department of Internal and Pulmonary Medicine, Sher E Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Rafi Ahmed Jan
- Department of Internal and Pulmonary Medicine, Sher E Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| |
Collapse
|
3
|
Daniel RA, Aggarwal P, Kalaivani M, Gupta SK. Prevalence of chronic obstructive pulmonary disease in India: A systematic review and meta-analysis. Lung India 2021; 38:506-513. [PMID: 34747730 PMCID: PMC8614617 DOI: 10.4103/lungindia.lungindia_159_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background and Objective: The prevalence of chronic obstructive pulmonary disease (COPD) is increasing worldwide. There is a lack of national-level estimates on the magnitude of COPD in India. Hence, we estimated the prevalence of COPD among adults in India. Methods: We searched PubMed, Embase, Cochrane Library, Google Scholar, and Scopus and included community-based cross-sectional studies reporting data on the prevalence of COPD among adults based on spirometry. A random-effects model was used to estimate the pooled prevalence of COPD. Results: In the eight identified studies, (pooled sample of 8,569 individuals), the estimated prevalence was 7.4% (95% confidence interval: 5.0%–9.8%), I2 = 95.4% (P < 0.001). The prevalence was higher among males, in the urban area, and the northern region. Conclusion: Adequate training and resources should be provided to diagnose COPD at primary health care level for early management. A nationwide population-based survey is indicated to provide reliable estimates of the burden to inform evidence-based community-based interventions.
Collapse
Affiliation(s)
- Roy Arokiam Daniel
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Praveen Aggarwal
- Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Mani Kalaivani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjeev Kumar Gupta
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
4
|
Verma A, Gudi N, Yadav UN, Roy MP, Mahmood A, Nagaraja R, Nayak P. Prevalence of COPD among population above 30 years in India: A systematic review and meta-analysis. J Glob Health 2021; 11:04038. [PMID: 34484706 PMCID: PMC8397327 DOI: 10.7189/jogh.11.04038] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background By 2030, Sustainable Development Goal 3.4 aims to reduce the premature mortality caused by non-communicable diseases through prevention and treatment. Chronic obstructive pulmonary disease is the second leading cause of mortality and disability-adjusted life years in India. This review was conducted to estimate the prevalence of COPD using systematic review and meta-analysis technique. Method Search was conducted using six databases for studies on COPD among population above 30 years in India between years 2000 to 2020. Cross-sectional and cohort studies reporting prevalence of COPD and associated risk factors were included in the present review. Screening and data extraction was done by two authors independently. Studies were appraised for quality using the modified New Castle Ottawa scale and reporting quality was assessed using STROBE guidelines. Result Our search returned 8973 records, from which 23 records fulfilled the eligibility criteria. Overall, the prevalence of COPD among population aged 30 years and above in India was 7%. Risk factors like active and passive smoking, biomass fuel exposure, environmental tobacco smoke, occupational exposure to dust, indoor and outdoor pollution, and increasing age were reported to have a significant association with COPD among Indian population. Conclusion Our findings suggest the need for a multicentric national-level research study to understand COPD burden and its contributing risk factors. The findings also suggest the need for COPD sensitive health literacy program focused on early screening and primary prevention of risk factors for COPD, which may help early initiation of self-management practices, that are crucial for better quality of life.
Collapse
Affiliation(s)
- Ashwani Verma
- Evidence Synthesis Specialist, Campbell South Asia, New Delhi, India.,DIT University, Dehradun, Uttarakhand, India
| | - Nachiket Gudi
- Department of Health Policy, Prasanna School of Public Health, Manipal Academy of Higher Education, India
| | - Uday N Yadav
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia.,Center for Research, Policy, and Implementation, Biratnagar, Nepal.,Department of Public Health, Torrens University, Sydney, Australia
| | - Manas Pratim Roy
- Deputy Assistant Director General, Directorate General of Health Services, Nirman Bhawan, New Delhi, India
| | - Amreen Mahmood
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Karnataka, India
| | - Ravishankar Nagaraja
- Department of Biostatistics, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
| | - Pradeepa Nayak
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| |
Collapse
|
5
|
Mir H, Koul PA, Bhat D, Shah ZA. A case-control study of tumor necrosis factor-alpha promoter polymorphism and its serum levels in patients with chronic obstructive pulmonary disease in Kashmir, North India. Lung India 2020; 37:204-209. [PMID: 32367841 PMCID: PMC7353946 DOI: 10.4103/lungindia.lungindia_477_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Aim: Data about polymorphism in tumor necrosis factor-alpha (TNF-α) and its serum levels in chronic obstructive pulmonary disease (COPD) are conflicting. We aimed to evaluate the association of TNF-α-308 G > A polymorphism in patients with COPD in Kashmir (North India), a high burden area and also determined the serum TNF-α levels in these patients. Materials and Methods: One hundred spirometrically confirmed COPD patients and 163 controls resident from Kashmir valley (North India) were recruited. Genotyping of the promoter region of TNF-α was carried out using polymerase chain reaction-restriction fragment length polymorphism. The serum TNF-α was quantified using the Cytometric Bead Array flex system by flow cytometry. Results were subjected to appropriate statistical treatment and P < 0.05 was considered statistically significant. Results: Ninety-one COPD patients (91%) had G/G (wild homozygous) genotype and nine patients (9%) had G/A (heterozygous) genotype. Among the control population, 150 (92%) had G/G genotype and 13 (8%) had G/A genotype. The variant allele “A” was not detected in either of the two groups. Serum levels of TNF-α were significantly higher in patients compared to control group (8.0 ± 10.1 pg/ml vs. 3.3 ± 0.42 pg/ml, respectively, P = 0.0001). Conclusion: While serum levels of TNF-α are higher in COPD patients compared to the controls, there was no difference in the prevalence of TNF-α-308 polymorphism in the ethnic Kashmiri population with COPD.
Collapse
Affiliation(s)
- Hyder Mir
- Department of Biotechnology, Mewar University, Chittorgarh, Rajasthan, India
| | - Parvaiz Ahmad Koul
- Department of Internal and Pulmonary Medicine, Sheri Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Dilafroze Bhat
- Department of Clinical Biochemistry, Sheri Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Zaffar Amin Shah
- Department of Immunology and Molecular Medicine, Sheri Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| |
Collapse
|
6
|
Pratiti R, Mukherjee D. Epidemiology and Adverse Consequences of Hookah/Waterpipe Use: A Systematic Review. Cardiovasc Hematol Agents Med Chem 2019; 17:82-93. [PMID: 31483237 DOI: 10.2174/1871525717666190904151856] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/15/2019] [Accepted: 08/15/2019] [Indexed: 06/10/2023]
Abstract
Hookah smoking is becoming a popular trend globally. Waterpipe smoking is the second most prevalent form of alternate tobacco products. The rapid increase in hookah use is because of the misconception prevalent in society that hookah smoking is less harmful than cigarette smoking. Smoking ban policies had given impetus of switching from cigarette smoking to alternate tobacco products like waterpipe. Hookah users regard hookah to be more socially acceptable, less stigmatizing with flavors and to alleviate cigarette craving symptoms. Newer basic science research on animal models and human cells has shown consistently mutagenic, oxidative, and inflammatory changes that could cause possible health effects of premalignant oral lesion and chronic diseases like atherosclerosis and chronic obstructive pulmonary disease. Studies on the chemistry of waterpipe smoke had shown alarming results with the smoke containing seven carcinogens, 39 central nervous system depressants, and 31 respiratory irritants. Enormous data exist showing waterpipe smoking causing various health effects. Hookah smoking effects on cardiovascular disease is additive with hookah containing a significant amount of nicotine, tar, and heavy metals causing both acute and chronic effects on the cardiovascular system. These effects include increased heart rate, blood pressure, prevalence of coronary heart disease, heart failure, ST-segment elevation myocardial ischemia, recurrent ischemia, and worse outcomes including mortality related to these diseases. The objectives of the review are to assess the factor associated with the increasing use of hookah, its health effects, options for hookah smoking cessation, and public health policy initiatives to mitigate waterpipe use.
Collapse
Affiliation(s)
- Rebecca Pratiti
- McLaren HealthCare, G-3245 Beecher Rd, Flint, MA 48532, United States
| | - Debabrata Mukherjee
- Texas Tech University Health Science Center, Department of Internal Medicine, El Paso, TX 79905, United States
| |
Collapse
|
7
|
Zhang H, Dong L, Kang YK, Lu Y, Wei HH, Huang J, Wang X, Huang K. Epidemiology of chronic airway disease: results from a cross-sectional survey in Beijing, China. J Thorac Dis 2018; 10:6168-6175. [PMID: 30622788 DOI: 10.21037/jtd.2018.10.44] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Although the epidemiology of chronic airway disease (CAD) has been investigated in several population-based studies, the findings of these studies are diverse. We aimed to investigate the prevalence of CAD and its associated factors in urban northern China. Methods A cross-sectional study was conducted among 29,359 Chinese adults aged ≥20 years. All participants were randomly recruited from two urban communities in Beijing and asked to complete a self-administered questionnaire that enquired about the demographic characteristics as well as the diagnosis of CAD and CAD-related symptoms. Results In all, 26,166 participants completed the questionnaire, with the response rate being 89.1%. The prevalence of diagnosed CAD was 9.0% among men and 7.2% among women, with a total prevalence of 8.1%. Furthermore, 11.5% of the investigated subjects had CAD-related symptoms. Women had a lower risk of developing wheezing, cough, dyspnea, and diagnosed CAD than men (P<0.05). The frequency of CAD-related symptoms and diagnosed CAD was greater among elderly persons than among those who were younger (P<0.01). Subjects with a smoking habit were more susceptible to CAD-related symptoms and diagnosed CAD (P<0.01). Additionally, individuals with CAD-related symptoms were more likely to be diagnosed with CAD, compared to those without these symptoms (P<0.01). Conclusions CAD is a common respiratory disease in urban northern China. Female gender might be a protective factor against CAD, while age and smoking are risk factors for the disease.
Collapse
Affiliation(s)
- Hong Zhang
- Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Department of Pulmonary and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.,Beijing Institute of Respiratory Medicine, Beijing 100020, China
| | - Li Dong
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Yi-Kun Kang
- Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Department of Pulmonary and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.,Beijing Institute of Respiratory Medicine, Beijing 100020, China
| | - Yong Lu
- Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Department of Pulmonary and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.,Beijing Institute of Respiratory Medicine, Beijing 100020, China
| | - Hui-Hong Wei
- Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Department of Pulmonary and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.,Beijing Institute of Respiratory Medicine, Beijing 100020, China
| | - Jie Huang
- Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Department of Pulmonary and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.,Beijing Institute of Respiratory Medicine, Beijing 100020, China
| | - Xue Wang
- Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Department of Pulmonary and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.,Beijing Institute of Respiratory Medicine, Beijing 100020, China
| | - Kewu Huang
- Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Department of Pulmonary and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.,Beijing Institute of Respiratory Medicine, Beijing 100020, China
| |
Collapse
|
8
|
Koul PA, Mir H, Akram S, Potdar V, Chadha MS. Respiratory viruses in acute exacerbations of chronic obstructive pulmonary disease. Lung India 2017; 34:29-33. [PMID: 28144057 PMCID: PMC5234194 DOI: 10.4103/0970-2113.197099] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) cause significant morbidity, mortality, and an inexorable decline of lung function. Data from developed countries have shown viruses to be important causes of AECOPD, but data from developing countries like India are scant. We set out to determine the contribution of viruses in the causation of hospitalized patients with AECOPD. Methods: Twin nasopharyngeal/oropharyngeal swabs collected from 233 patients admitted with an acute AECOPD and tested for respiratory viruses including respiratory syncytial virus A and B, parainfluenza were (PIV) 1, 2, 3, and 4, human metapneumovirus (hMPV) A and B, influenza A and B, enterovirus, corona NL65, OC43, and 229E viruses, adenovirus 2 and 4, rhinovirus, and bocavirus, by duplex real time reverse-transcription polymerase chain reaction (qRT-PCR) using CDC approved primers and probes. Samples positive for influenza A were subtyped for A/H1N1pdm09 and A/H3N2 whereas influenza B samples were subtyped into B/Yamagata and B/Victoria subtypes, using primers and probes recommended by CDC, USA. Results: Respiratory viruses were detected in 46 (19.7%) cases, influenza A/H3N2 and rhinoviruses being the most common viruses detected. More than one virus was isolated in four cases consisting of hMPV-B + adeno-2 + Inf-B; rhino + H3N2, PIV-1 + rhino; and PIV-1+ hMPV-B in one case each. Ancillary supportive therapeutic measures included bronchodilators, antibiotics, steroids, and ventilation (noninvasive in 42 and invasive in 4). Antiviral therapy was instituted in influenza-positive patients. Three patients with A/H3N2 infection died during hospitalization. Conclusions: We conclude that respiratory viruses are important contributors to AECOPD in India. Our data calls for prompt investigation during an exacerbation for viruses to obviate inappropriate antibiotic use and institute antiviral therapy in viral disease amenable to antiviral therapy. Appropriate preventive strategies like influenza vaccination also need to be employed routinely.
Collapse
Affiliation(s)
- Parvaiz A Koul
- Department of Internal and Pulmonary Medicine, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Hyder Mir
- Department of Internal and Pulmonary Medicine, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Shabir Akram
- Department of Internal and Pulmonary Medicine, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Varsha Potdar
- National Institute of Virology, Pune, Maharashtra, India
| | | |
Collapse
|
9
|
Koul PA, Dar HA, Jan RA, Shah S, Khan UH. Two-year mortality in survivors of acute exacerbations of chronic obstructive pulmonary disease: A North Indian study. Lung India 2017; 34:511-516. [PMID: 29098995 PMCID: PMC5684807 DOI: 10.4103/lungindia.lungindia_41_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES Data about long-term mortality of Indian patients following acute exacerbation of chronic obstructive pulmonary disease (AECOPD) are scant. We set out to study the 2-year mortality in north Indian patients following discharge after AECOPD. MATERIALS AND METHODS One hundred and fifty-one (96 male) patients admitted for AECOPD and discharged were followed for 2 years at 3, 6, 12, 18, and 24 months for mortality. Statistical analysis was performed to identify risk factors associated with mortality. RESULTS Sixty (39.7%) of the 151 recruited died during the 24 months of follow-up, 30 (19.8%) at 3-month, 43 (28.5%) at 6-month, 49 (32.4%) at 1-year, 55 (36.4%) at 18-month, and 60 (39.7%) at 2 years. There was no mortality in Global Initiative for Chronic Obstructive Lung Disease (GOLD) Stage I (0 of 6 cases), whereas it was 12.3% (n = 8 of 65 patients) in GOLD Stage II, 41.7% (n = 15 of 36 cases), in GOLD Stage III, and 84.1% (n = 37 of 4 cases), of patients with GOLD Stage IV. Mortality was associated with 6-min walk distance, oxygen saturation, low body mass index, history of congestive heart failure, and St. George Respiratory Questionnaire score. CONCLUSION Indian patients discharged after AECOPD have a high 2-year mortality. Measures to reduce the frequency of exacerbations need to be routinely adopted in patients with COPD.
Collapse
Affiliation(s)
- Parvaiz A Koul
- Department of Internal and Pulmonary Medicine, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Hilal A Dar
- Department of Internal and Pulmonary Medicine, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Rafi A Jan
- Department of Internal and Pulmonary Medicine, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Sanaullah Shah
- Department of Internal and Pulmonary Medicine, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Umar Hafiz Khan
- Department of Internal and Pulmonary Medicine, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| |
Collapse
|