RSV-related Community COPD Exacerbations and Novel Diagnostics: A Binational Prospective Cohort Study

RESCEU investigators, Dexter J Wiseman, Ryan S Thwaites, Andrew I Ritchie, Lydia Finney, Mairi Macleod, Faisal Kamal, Hassan Shahbakhti, Lisa H van Smoorenburg, Huib A Kerstjens, Joanne Wildenbeest, Deniz Öner, Jeroen Aerssens, Guy Berbers, Rutger Schepp, Ashley Uruchurtu, Benedikt Ditz, Louis Bont, James P Allinson, Maarten van den BergeGavin C Donaldson, Peter J Openshaw*, Jadwiga Wedzicha*

*Bijbehorende auteur voor dit werk

OnderzoeksoutputAcademicpeer review

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Samenvatting

RATIONALE: Respiratory syncytial virus (RSV) is a common global respiratory virus increasingly recognized as a major pathogen in frail older adults and as a cause of chronic obstructive pulmonary disease (COPD) exacerbations. There is no single test for RSV in adults with acceptable diagnostic accuracy. Trials of RSV vaccines have recently shown excellent safety and efficacy against RSV in older adults; defining the frequency of RSV-related community infections and COPD exacerbations is important for vaccine deployment decisions.

OBJECTIVES: This prospective study aimed to establish the frequency of outpatient-managed RSV-related exacerbations of COPD in two well-characterized patient cohorts using a combination of diagnostic methods.

METHODS: Participants were recruited at specialist clinics in London, UK and Groningen, NL from 2017 and observed for three consecutive RSV seasons, during exacerbations and at least twice yearly. RSV infections were detected by reverse transcription-polymerase chain reaction (RT-PCR) and serologic testing.

MEASUREMENTS AND MAIN RESULTS: 377 patients with COPD attended 1,999 clinic visits and reported 310 exacerbations. There were 27 RSV-related exacerbations (8·7% of total); of these, seven were detected only on PCR, 16 only on serology and 4 by both methods. Increases in RSV specific N-protein antibody were as sensitive as antibody to pre-F or post-F for serodiagnosis of RSV related exacerbations.

CONCLUSIONS: RSV is associated with 8.7% of outpatient managed COPD exacerbations in this study. Antibodies to RSV-N protein may have diagnostic value, potentially important in a vaccinated population. The introduction of vaccines that prevent RSV is expected to benefit patients with COPD.

Originele taal-2English
TijdschriftAmerican Journal of Respiratory and Critical Care Medicine
DOI's
StatusE-pub ahead of print - 19-mrt.-2024

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