Viral respiratory infections in elderly patients and patients with chronic obstructive pulmonary disease

Abstract

Patients with chronic obstructive pulmonary disease (COPD) and elderly individuals are prone to the development of significant lower respiratory tract symptoms from colds caused by viral respiratory pathogens. Longitudinal surveillance studies conducted to assess the impact of viral respiratory tract pathogens on morbidity and mortality in each of these at-risk populations demonstrate that there is a substantial burden of disease from viral respiratory infection (VRI), including rhinovirus infections, with respect to utilization of health-care resources. Despite a similar rate of occurrence of VRI among subjects with COPD and the control group, a cohort with moderate to severe COPD had a 2-fold increase in medical resource utilization, including clinician visits, emergency center visits, and hospitalizations. In surveillance studies of respiratory viruses in the elderly, regular seasonal infections with rhinoviruses cause substantial morbidity, which has been largely underappreciated and underreported.

Figure 1

Seasonal variation of viral respiratory infections by month. Hatched squares = controls; open squares = COPD; A = adenovirus; C = coronavirus; CMV = cytomegalovirus; E = enterovirus; F = influenza virus A or B; P = parainfluenza virus type 1, 2, or 3; R = rhinovirus; RS = respiratory syncytial virus. Dual viral infections are designated with backslash (/). Circles signify hospitalizations. (Reprinted with permission from Am J Respir Crit Care Med.6)