Abstract
Objective: To explore impact of Candida on the acute exacerbation of chronic obstructive pulmonary disease (AECOPD) outcome.Methods: A retrospective, multi-center, case-control study was performed. Patients hospitalized for AECOPD in 25 centers during Jan 2011–Dec 2016 were enrolled. Data were collected, including demographic information, conditions during the stable phase of COPD, clinical characteristics of AECOPD, and follow-up information within 1 year after discharge. Univariate analysis and binary logistic regression were applied, and p < 0.05 was regarded as significant.Results: Totally 1,103 patients were analyzed, with 644 lower respiratory airway (LTR) Candida positive cases and 459 Candida negative controls. Long-term prognosis was significantly different between Candida positive and negative group, including the recurrent AECOPD within 180 days (75.5 vs. 6.6%, p < 0.001) and mortality within 1 year (6.9 vs. 0.4%, p < 0.001). Univariate logistic analysis showed that LTR Candida isolation was related to higher recurrence rate of AECOPD within 180 days and mortality within 1 year. Binary logistic regression analysis demonstrated that LTR Candida isolation was independently associated with recurrence of AECOPD within 180 days.Conclusions: LTR Candida isolation was associated with worse long-term prognosis of AECOPD and independently related to higher risks of recurrent AECOPD within 180 days.
Highlights
Chronic obstructive pulmonary disease (COPD) is one of the most common chronic diseases with high morbidity and mortality
Long-term prognosis was significantly different between Candida positive and negative group, including the recurrent Acute exacerbation of COPD (AECOPD) within 180 days (75.5 vs. 6.6%, p < 0.001) and mortality within 1 year (6.9 vs. 0.4%, p < 0.001)
Univariate logistic analysis showed that lower respiratory airway (LTR) Candida isolation was related to higher recurrence rate of AECOPD within 180 days and mortality within 1 year
Summary
Chronic obstructive pulmonary disease (COPD) is one of the most common chronic diseases with high morbidity and mortality. According to the 2019 global initiative for COPD (GOLD) report, COPD is the fourth leading cause of death in the world. According to the Global Burden of Disease Study data, COPD is the third leading cause of death in China, and the mortality rate is increasing (Wang, 2017). Acute exacerbation of COPD (AECOPD) is the most important acute event in the disease course of COPD, leading to disease progression and poor outcome. The most common causes of AECOPD were viruses and bacterial infections (Aaron, 2014; Cai et al, 2014). Co-infection of viruses and bacteria has been detected in 25% of exacerbations (Sethi and Murphy, 2008)
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