Characteristics of respiratory viral infections in patients with acute exacerbation of chronic obstructive pulmonary disease and correlation with inflammatory cytokines

Abstract

Objective To investigate the characteristics of respiratory viral infections, and correlation between inflammatory cytokines and respiratory virus infections in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Methods One hundred and ninety-six patients with AECOPD admitted to Fuyang Hospital Affiliated to Anhui Medical University from July 2017 to February 2019 were analyzed retrospectively. The respiratory viruses and peripheral blood inflammatory cytokines were detected. The difference of clinical features and inflammatory cytokines between viral positive patients and viral negative patients were compared, and the risk factors of respiratory viral infection in patients were analyzed by multivariate Logistic regression. Results Sixty-seven cases (34.2%, 67/196) were positive for viral detection. Among them, the positive rate of influenza A virus was the highest (37.3%, 25/67), followed by rhinovirus (34.3%, 23/67). Compared with those in negative group, fever, inhaled glucocorticoid, diabetes mellitus increased: 55.2% (37/67) vs. 12.4% (16/129), 59.7% (40/67) vs. 35.7% (46/129), 29.9% (20/67) vs. 11.6% (15/129), hospital stay and CAT score in stable stage increased: (12.9 ± 3.2) d vs. (10.1 ± 2.6) d, (29.6 ± 3.2) scores vs. (22.6 ± 3.6) scores, CD8+ cells decreased: 0.191 ± 0.063 vs. 0.254 ± 0.076, and the levels of interferon-inducible protein-10, tumor necrosis factor-alpha (TNF-α), and C-reactive protein increased in positive group: (132.4 ± 21.6) ng/L vs. (53.1 ± 12.4) ng/L, (39.2 ± 2.5) ng/L vs. (16.6 ± 2.3) ng/L, (40.3 ± 4.2) mg/L vs. (12.0 ± 1.1) mg/L. The differences were statistically significant (P < 0.05). Multifactor Logistic regression analysis showed that, fever, CAT score in stable stage, serum interferon-inducible protein (IP)- 10 and TNF-α levels were correlated with respiratory viral infections in patients with AECOPD (OR = 18.013, 1.233, 1.021 and 1.083; P < 0.05). Conclusions Respiratory viral infections are common in AECOPD. Influenza A virus and rhinovirus are the two most common viruses. Fever is a common symptom. Patients with severe respiratory symptoms at stable stage are susceptible to viral infection. Viral infection is associated with an increase in serum IP-10 and TNF-α levels. Key words: Pulmonary disease, chronic obstructive; Respiratory tract infection; Acute exacerbation; Inflammatory cytokines