Predictors of influenza PCR positivity in acute exacerbations of chronic obstructive pulmonary disease
Purpose: Influenza infection is an important cause of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Clinical features predicting influenza PCR positivity are unknown. We aim to identify predictors of influenza PCR positivity in AECOPD. Patients and Methods: A retrospective st...
| Main Authors: | , , , |
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| Other Authors: | |
| Format: | Journal Article |
| Language: | English |
| Published: |
2022
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| Online Access: | https://hdl.handle.net/10356/161295 |
| _version_ | 1811693150779998208 |
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| author | Chen, Calvin You Jia Yew, Min Sen Abisheganaden, John Arputhan Xu, Huiying |
| author2 | Lee Kong Chian School of Medicine (LKCMedicine) |
| author_facet | Lee Kong Chian School of Medicine (LKCMedicine) Chen, Calvin You Jia Yew, Min Sen Abisheganaden, John Arputhan Xu, Huiying |
| author_sort | Chen, Calvin You Jia |
| collection | NTU |
| description | Purpose: Influenza infection is an important cause of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Clinical features predicting influenza PCR positivity are unknown. We aim to identify predictors of influenza PCR positivity in AECOPD. Patients and Methods: A retrospective study of AECOPD cases admitted between 1st January 2016 to 30 June 2017 with combined nasal/throat swabs sent for influenza PCR (Xpert Xpress Flu/RSV) within 24 hours of admission was performed. Clinical parameters and investigations within 24 hours of admission were retrieved from electronic medical records. Results: Influenza PCR were sent for 925 AECOPD cases (mean age 75 years, 87.9% male). There were 90 PCR positive cases (68 Influenza A, 22 Influenza B). Influenza PCR positive cases had higher temperatures, higher heart rates, lower white cell and lower eosinophil counts. Age, gender, COPD severity, comorbidities and smoking status were similar in both groups. There were no differences in blood pressure, oxygen status, neutrophil or lymphocyte counts, C reactive protein, procalcitonin or chest X-ray consolidation between groups. Higher temperature, higher heart rate, white cell count in the lowest quartile (Q1 < 8.1 x109 /L) and non-eosinophilic exacerbations predicted influenza PCR positivity on univariate logistic regression and these factors remained significant after multivariate adjustment (temperature adjusted odds ratio [adj OR] 1.324 [1.009–1.737], p = 0.043; heart rate adj OR 1.017 [1.004–1.030], p = 0.011; white cell count Q1 adj OR 3.330 [1.690–6.562], p = 0.001; eosinophilic exacerbations adj OR 0.390 [0.202–0.756], p = 0.005). Conclusion: Higher temperature, higher heart rate, low white cell count (especially when < 8.1 x109 /L) and non-eosinophilic exacerbations are independent predictors of influenza PCR positivity in AECOPD cases. |
| first_indexed | 2024-10-01T06:47:07Z |
| format | Journal Article |
| id | ntu-10356/161295 |
| institution | Nanyang Technological University |
| language | English |
| last_indexed | 2024-10-01T06:47:07Z |
| publishDate | 2022 |
| record_format | dspace |
| spelling | ntu-10356/1612952023-03-05T16:54:47Z Predictors of influenza PCR positivity in acute exacerbations of chronic obstructive pulmonary disease Chen, Calvin You Jia Yew, Min Sen Abisheganaden, John Arputhan Xu, Huiying Lee Kong Chian School of Medicine (LKCMedicine) Science::Medicine Chronic Obstructive Pulmonary Disease Exacerbation Purpose: Influenza infection is an important cause of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Clinical features predicting influenza PCR positivity are unknown. We aim to identify predictors of influenza PCR positivity in AECOPD. Patients and Methods: A retrospective study of AECOPD cases admitted between 1st January 2016 to 30 June 2017 with combined nasal/throat swabs sent for influenza PCR (Xpert Xpress Flu/RSV) within 24 hours of admission was performed. Clinical parameters and investigations within 24 hours of admission were retrieved from electronic medical records. Results: Influenza PCR were sent for 925 AECOPD cases (mean age 75 years, 87.9% male). There were 90 PCR positive cases (68 Influenza A, 22 Influenza B). Influenza PCR positive cases had higher temperatures, higher heart rates, lower white cell and lower eosinophil counts. Age, gender, COPD severity, comorbidities and smoking status were similar in both groups. There were no differences in blood pressure, oxygen status, neutrophil or lymphocyte counts, C reactive protein, procalcitonin or chest X-ray consolidation between groups. Higher temperature, higher heart rate, white cell count in the lowest quartile (Q1 < 8.1 x109 /L) and non-eosinophilic exacerbations predicted influenza PCR positivity on univariate logistic regression and these factors remained significant after multivariate adjustment (temperature adjusted odds ratio [adj OR] 1.324 [1.009–1.737], p = 0.043; heart rate adj OR 1.017 [1.004–1.030], p = 0.011; white cell count Q1 adj OR 3.330 [1.690–6.562], p = 0.001; eosinophilic exacerbations adj OR 0.390 [0.202–0.756], p = 0.005). Conclusion: Higher temperature, higher heart rate, low white cell count (especially when < 8.1 x109 /L) and non-eosinophilic exacerbations are independent predictors of influenza PCR positivity in AECOPD cases. Published version 2022-08-24T04:20:32Z 2022-08-24T04:20:32Z 2022 Journal Article Chen, C. Y. J., Yew, M. S., Abisheganaden, J. A. & Xu, H. (2022). Predictors of influenza PCR positivity in acute exacerbations of chronic obstructive pulmonary disease. International Journal of Chronic Obstructive Pulmonary Disease, 17, 25-32. https://dx.doi.org/10.2147/COPD.S338757 1178-2005 https://hdl.handle.net/10356/161295 10.2147/COPD.S338757 35023911 2-s2.0-85123459678 17 25 32 en International Journal of Chronic Obstructive Pulmonary Disease © 2022 Chen et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). application/pdf |
| spellingShingle | Science::Medicine Chronic Obstructive Pulmonary Disease Exacerbation Chen, Calvin You Jia Yew, Min Sen Abisheganaden, John Arputhan Xu, Huiying Predictors of influenza PCR positivity in acute exacerbations of chronic obstructive pulmonary disease |
| title | Predictors of influenza PCR positivity in acute exacerbations of chronic obstructive pulmonary disease |
| title_full | Predictors of influenza PCR positivity in acute exacerbations of chronic obstructive pulmonary disease |
| title_fullStr | Predictors of influenza PCR positivity in acute exacerbations of chronic obstructive pulmonary disease |
| title_full_unstemmed | Predictors of influenza PCR positivity in acute exacerbations of chronic obstructive pulmonary disease |
| title_short | Predictors of influenza PCR positivity in acute exacerbations of chronic obstructive pulmonary disease |
| title_sort | predictors of influenza pcr positivity in acute exacerbations of chronic obstructive pulmonary disease |
| topic | Science::Medicine Chronic Obstructive Pulmonary Disease Exacerbation |
| url | https://hdl.handle.net/10356/161295 |
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