Department of Internal Medicine, Chi Mei Medical Center, Chiali, Taiwan.
School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan.
Int J Chron Obstruct Pulmon Dis. 2022 Sep 14;17:2253-2261. doi: 10.2147/COPD.S378034. eCollection 2022.
Chronic obstructive pulmonary disease (COPD) is a common disease and is preventable and treatable. A previous study showed that influenza virus infections were also associated with the risk of acute exacerbation in patients with COPD, and other studies showed that the influenza virus might increase the risk of stroke. However, studies on the influence of influenza infection among COPD patients are limited. In this study, we review the role of influenza infection in contributing to mortality, pneumonia, respiratory failure, COPD acute exacerbation, and ischemic stroke among COPD patients.
We performed a population-based cohort study of COPD patients using data from Taiwan between January 1, 2011, and December 31, 2019. We excluded patients with lung cancer, lung transplantation and asthma. We also excluded patients who lacked COPD medication prescriptions and those treated with anti-influenza drugs without flu diagnosis records. Patients with missing or incomplete data were also excluded from the study cohort.
After 1:1 matching by age, sex, COPD duration, diagnosed years and comorbidities, we enrolled 10,855 cases and controls for further analysis. The risks of pneumonia, respiratory failure, COPD acute exacerbation, and ischemic stroke were 1.770 (95% CI=1.638-1.860; P<0.0001), 1.097 (95% CI=1.008-1.194; P=0.0319), 1.338 (95% CI=1.248-1.435; P<0.0001), and 1.134 (95% CI=1.039-1.239, P=0.0051), respectively, in the influenza infection group compared with COPD patients without influenza infection.
Influenza infections are linked to an increased risk of ischemic stroke, pneumonia, respiratory failure, and COPD acute exacerbation among COPD patients. In conclusion, patients with COPD need to be closely monitored after having an influenza infection.
慢性阻塞性肺疾病(COPD)是一种常见疾病,可预防且可治疗。先前的一项研究表明,流感病毒感染也与 COPD 患者急性加重的风险相关,其他研究表明流感病毒可能会增加中风的风险。然而,关于 COPD 患者流感感染影响的研究有限。在这项研究中,我们回顾了流感感染在 COPD 患者中的作用,包括导致死亡率、肺炎、呼吸衰竭、COPD 急性加重和缺血性中风的作用。
我们使用 2011 年 1 月 1 日至 2019 年 12 月 31 日台湾的数据,进行了一项基于人群的 COPD 患者队列研究。我们排除了肺癌、肺移植和哮喘患者。我们还排除了缺乏 COPD 药物处方且没有流感诊断记录而接受抗流感药物治疗的患者,以及数据缺失或不完整的患者。
经过年龄、性别、COPD 持续时间、诊断年限和合并症的 1:1 匹配,我们纳入了 10855 例病例和对照进行进一步分析。肺炎、呼吸衰竭、COPD 急性加重和缺血性中风的风险分别为 1.770(95%CI=1.638-1.860;P<0.0001)、1.097(95%CI=1.008-1.194;P=0.0319)、1.338(95%CI=1.248-1.435;P<0.0001)和 1.134(95%CI=1.039-1.239,P=0.0051),在流感感染组中高于无流感感染的 COPD 患者。
流感感染与 COPD 患者缺血性中风、肺炎、呼吸衰竭和 COPD 急性加重的风险增加有关。总之,患有 COPD 的患者在感染流感后需要密切监测。