Physician-authored summaries and commentary on the most important medical research, provided by the NEJM Group, a division of the Massachusetts Medical Society.
© Massachusetts Medical SocietyJanuary/February 2025
In an observational study, 9% of outpatient COPD exacerbations were caused by RSV infections.
How often respiratory syncytial virus (RSV) triggers outpatient exacerbations of chronic obstructive pulmonary disease (COPD) is an interesting question, given the recent availability of an RSV vaccine. In this prospective cohort study from the UK and the Netherlands, researchers followed 377 patients with COPD to determine the frequency and severity of outpatient RSV-related COPD exacerbations compared with exacerbations that were triggered by other infections. Patients were recruited and monitored during three years prior to the COVID-19 pandemic; 303 patients completed follow up.
Among 310 COPD exacerbations, 9% were caused by RSV detected by reverse transcription polymerase chain reaction (RT-PCR) or a fourfold rise in serological titre. Other common infective agents included rhinovirus, influenza virus and bacteria. Compared with other infective causes, RSV-related COPD exacerbations were significantly shorter in duration but were no different in symptom severity.
Comment: Understanding and mitigating the causes of outpatient COPD exacerbations is vital to help keep patients out of the hospital and to prevent chronic decline in pulmonary function. These results reinforce the importance of recommending the RSV vaccine to help prevent COPD exacerbations in this highly vulnerable patient population (NEJM JW Gen Med Sep 15 2024 and MMWR Morb Mortal Wkly Rep 2024; 73: 696-702).
David S. Weisman, DO, FACP, Associate Professor of Medicine Clinician Educator, Georgetown University Medical Center, Washington, DC; Associate Program Director in Internal Medicine, MedStar Health, Baltimore, USA.
Wiseman DJ, et al. Respiratory syncytial virus-related community chronic obstructive pulmonary disease exacerbations and novel diagnostics: a binational prospective cohort study. Am J Respir Crit Care Med 2024; 210: 994-1001.
Baraldi F, et al. The convoluted journey to unveil the respiratory syncytial virus in chronic obstructive pulmonary disease exacerbations: old paths and new traces. Am J Respir Crit Care Med 2024; 210: 967-969.
This summary is taken from the following Journal Watch titles: General Medicine, Ambulatory Medicine, Hospital Medicine.