Prevalence of Respiratory Syncytial Virus in Patients with Chronic Obstructive Pulmonary Disease and Its Impact on Exacerbation Rates

COPD is a prevalent respiratory ailment ranking as the third leading cause of mortality globally. Its clinical trajectory, characterized by unpredictable exacerbations (AECOPD), significantly impacts patient morbidity and mortality. Viral respiratory tract infections are identified as the predominant risk factor for AECOPD. This study aims to examine the impact of Respiratory Syncytial Virus (RSV) on AECOPD, particularly in the context of emerging preventive measures like RSV vaccinations. Utilizing data from the PREVENT-Study, an investigator-initiated and driven, double-blind randomized multinational trial encompassing 450 COPD patients observed over an average of 27 months, this investigation analyzed virus detection rates across distinct clinical states: stable periods (n=1909), upper respiratory tract infection (URTI) onset (n=391), URTI follow-up (n=356), and AECOPD (n=177). During the study duration, a total of 3478 visits were conducted, resulting in 3274 PCR tests, with 432 (13.1%) yielding virus detection, among which RSV accounted for 6.94% (n=30) of cases. Notably, RSV detection rates varied across clinical states: 2.8% during stable visits, 7.8% during URTI visits, 5.4% during URTI follow-up visits, and 8.6% during AECOPD visits. RSV infection showed no significant influence on hospitalization rates during exacerbations. Additionally, there was no apparent association observed between reduced FEV1 levels (baseline 1.3L/51%) and the probability of developing an RSV infection when contrasting RSV-induced exacerbations with the non-RSV infection cohort.