Gómez-García Rosa María, De-Miguel-Díez Javier, López-de-Andrés Ana, Hernández-Barrera Valentín, Jimenez-Sierra Ana, Cuadrado-Corrales Natividad, Zamorano-León José J, Carabantes-Alarcón David, Bodas-Pinedo Andrés, Jiménez-García Rodrigo
Respiratory Care Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), 28007 Madrid, Spain.
Department of Public Health & Maternal and Child Health, Faculty of Pharmacy, Universidad Complutense de Madrid, 28040 Madrid, Spain.
Diseases. 2025 Jan 20;13(1):23. doi: 10.3390/diseases13010023.
Respiratory syncytial virus (RSV) infection is a common cause of hospital admission. The association between chronic obstructive pulmonary disease (COPD) exacerbation and RSV infection is not well studied.
To analyze the hospitalizations of patients with COPD and RSV infection in Spain between 2018 and 2022.
The data used were obtained from the Spanish Hospital Discharge Database. We selected subjects aged ≥40 years diagnosed with COPD, admitted to the hospital from 1 January 2018 to 31 December 2022. The COPD population that met the selection criteria was subdivided based on the presence of an ICD-10 code for RSV infection. To obtain comparable populations, for each subject with COPD and RSV infection, a subject without an RSV code was selected, with the COPD code in the same diagnostic position (1 to 20), as well as the same year of admission, sex, and age.
Among subjects aged ≥40 years, 1,429,288 were identified as having COPD, of whom 5673 also had RSV infection. The number of hospitalizations with COPD and RSV infection increased during the study period. The proportion of RSV infection among patients admitted for COPD increased significantly over time, from 0.32% in 2018 to 0.65% in 2022, < 0.001. In-hospital mortality (IHM) increased over time, but the differences were not significant (6.23% in 2018 vs. 6.79% in 2022). Patients with COPD and RSV infection had, compared with those without RSV infection, a higher use of mechanical ventilation, both invasive (3.44% vs. 1.34%, < 0.001) and noninvasive (8.09% vs. 4.51%, < 0.001) and a higher proportion of intensive care unit (ICU) admission (7.21% vs. 3.9%, < 0.001). After multivariate adjustment, a significant increase in IHM was found from 2018 to 2022 in subjects with and without RSV infection. The presence of RSV infection was associated with a higher mortality (OR 1.22; 95% CI 1.01-1.46).
The proportion of RSV infection among patients admitted for COPD increased significantly over time. Patients with COPD and RSV infection had, compared with those without RSV infection, a higher severity, a higher use of mechanical ventilation, and a higher proportion of ICU admission. The presence of RSV infection was associated with IHM. These results can help to identify patients at higher risk and make decisions to avoid the increased risk of hospitalization and mortality in this population.
呼吸道合胞病毒（RSV）感染是住院治疗的常见原因。慢性阻塞性肺疾病（COPD）急性加重与RSV感染之间的关联尚未得到充分研究。
分析2018年至2022年西班牙COPD合并RSV感染患者的住院情况。
所使用的数据来自西班牙医院出院数据库。我们选取了年龄≥40岁、2018年1月1日至2022年12月31日期间入院且被诊断为COPD的患者。符合入选标准的COPD患者群体根据是否存在RSV感染的ICD-10编码进行细分。为了获得可比人群，对于每一位患有COPD且合并RSV感染的患者，选取一位没有RSV编码、COPD编码处于相同诊断位置（1至20）、入院年份、性别和年龄相同的患者。
在年龄≥40岁的患者中，有1429288人被确定患有COPD，其中5673人同时合并RSV感染。在研究期间，COPD合并RSV感染的住院人数有所增加。因COPD入院患者中RSV感染的比例随时间显著增加，从2018年的0.32%增至2022年的0.65%，P<0.001。住院死亡率（IHM）随时间增加，但差异不显著（2018年为6.23%，2022年为6.79%）。与未感染RSV的患者相比，COPD合并RSV感染的患者机械通气的使用更多，包括有创通气（3.44%对1.34%，P<0.001）和无创通气（8.09%对4.51%，P<0.001），且重症监护病房（ICU）入院比例更高（7.21%对3.9%，P<0.001）。多因素调整后，2018年至2022年期间，感染和未感染RSV的患者IHM均显著增加。RSV感染的存在与更高的死亡率相关（OR 1.22；95%CI 1.01-1.46）。
因COPD入院患者中RSV感染的比例随时间显著增加。与未感染RSV的患者相比，COPD合并RSV感染的患者病情更严重，机械通气使用更多，ICU入院比例更高。RSV感染的存在与IHM相关。这些结果有助于识别高危患者，并做出决策以避免该人群住院和死亡风险的增加。
