Abstract
Background: Acute exacerbations of chronic obstructive pulmonary disease are a major cause of morbidity and mortality worldwide. Most acute exacerbations are triggered by community-acquired respiratory infections.Influenza vaccines are currently recommended for all persons with COPD. Aim: To determine the effectiveness of influenza vaccination on influenza-related acute respiratory illness (ARI) and overall ARI in patients with COPD. Methods: A case control study was conducted on 90 elderly patients with COPD (58 years and older) recruited from the outpatient geriatric clinic of Ain shams university hospital. 90 patients with COPD were classified based on their FEV1 as having mild, moderate, and severe COPD. They were classified into two groups; 45 COPD patients (cases) who received the influenza vaccine & 45 COPD patients (controls) who refused to receive the influenza vaccine. We compared the two groups as regard exacerbation rates, hospitalizations, mortality, lung function and adverse effects. Results: Inactivated vaccine in COPD patients resulted in a significant reduction in the total number of exacerbations per vaccinated subject (1.8 i?½ 1.3)compared with those who did not receive the influenza vaccine(3.0i?½1.9).The exacerbations rate were (2.1i?½2.2), (3.2i?½1.9), and (3.7i?½1.2) in the patients with mild, moderate, and severe COPD, respectively in non-vaccinated group, and (1.6i?½1.4), (2.0i?½1.2), and (2.3i?½1.4) in the patients with mild, moderate, and severe COPD, respectively in the vaccinated group. The hospitalization rate was Lower in vaccinated subjects (44.4%) than non-vaccinated group (75.6%) p value 0.002 .Also mortality rate was lower in vaccinated subject (11.1%) than non-vaccinated group (26.7%). Conclusions: Influenza vaccination is highly effective in the prevention of influenza-related acute respiratory illness (ARI) regardless of the severity of COPD. Influenza vaccination should be recommended to all patients with COPD.
Highlights
Chronic obstructive pulmonary disease (COPD) is currently the fourth leading cause of mortality worldwide [1]
A case control study was conducted on 90 elderly patients with COPD (58 years and older) recruited from the outpatient geriatric clinic of Ain shams university hospital. 90 patients with COPD were classified based on their FEV1 as having mild, moderate, and severe COPD
Influenza vaccination is highly effective in the prevention of influenza-related acute respiratory illness (ARI) regardless of the severity of COPD
Summary
Chronic obstructive pulmonary disease (COPD) is currently the fourth leading cause of mortality worldwide [1]. By 2020, it is predicted that COPD will have risen to be the third leading cause of mortality [2]. The estimated annual cost of COPD is $32.1. Billion worldwide and 70% of these costs are related to acute exacerbations that require hospitalization [3,4]. In Egypt, COPD is a rising significant health problem, data on its prevalence, morbidity, and mortality are still lacking and have to be estimated [5]. A recent prospective study of COPD exacerbations [8] demonstrated an in-hospital mortality rate of 8% and a 1-year mortality rate of 23%. Acute exacerbations of chronic obstructive pulmonary disease are a major cause of morbidity and mortality worldwide. Influenza vaccines are currently recommended for all persons with COPD
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