Respiratory Pathogens of Patients With Asthma and COPD Exacerbations

Objective: Chronic obstructive pulmonary disease (COPD) and asthma exacerbations both contribute to significant health care burden. Viral infections are important cause of acute exacerbation of COPD and asthma. Hypothesis to be tested: 1. Assess infective etiologies by Multiplex Molecular Detection of nasopharyngeal aspirate (NPA) of patients with acute exacerbation of COPD and asthma; 2. Identify the human rhinovirus (HRV) (the commonest virus causing exacerbations) subtypes involved; 3.Assess if the infective etiologies have associations with clinical outcome of the patients. Design and subjects: Prospective observational study. Patients admitted to hospital for acute exacerbation of COPD and asthma. Stable COPD and asthma patients will be recruited as controls. Study instruments: Multiplex Molecular Detection of respiratory pathogens from NPA. Clinical data of the patient will be collected and spirometry will be performed. Interventions: NPA collection from subjects. Main outcome measures: Primary aim is assessment of the prevalence of different viruses in relation to acute exacerbation of asthma and COPD. Secondary aim is to assess if a certain pathogen is associated with clinical outcomes including duration of hospitalization and 30 and 60 day readmissions and mortality Data analysis: Data will be analyzed by the Statistical Package of the Social Science Statistical software for Window, Version 22 (IBM SPSS Inc, IL, USA). Statistical methods including chi-square test, student t test and ANOVA will be used as appropriate. Expected results: Understanding the epidemiology of respiratory viruses in COPD and asthma exacerbations allows further investigations of treatment options and gives information about the prognosis.