Different pattern of viral infections and clinical outcomes in patient with acute exacerbation of chronic obstructive pulmonary disease and chronic obstructive pulmonary disease with pneumonia
Identifieur interne : 001000 ( Istex/Corpus ); précédent : 000F99; suivant : 001001Different pattern of viral infections and clinical outcomes in patient with acute exacerbation of chronic obstructive pulmonary disease and chronic obstructive pulmonary disease with pneumonia
Auteurs : Ho-Cheol Kim ; Sang-Ho Choi ; Jin-Won Huh ; Heungsup Sung ; Sang Bum Hong ; Chae-Man Lim ; Younsuck KohSource :
- Journal of Medical Virology [ 0146-6615 ] ; 2016-12.
Abstract
Respiratory viruses are well‐known causes of acute exacerbation of chronic obstructive pulmonary disease (AE‐COPD) and also important pathogens for concomitant pneumonia in COPD (CP‐COPD). However, the differences in a viral infection pattern and clinical impacts of respiratory viruses between the two groups have not been well investigated. The clinical and microbiological data from COPD patients admitted with AE‐COPD (n = 281) or CP‐COPD (n = 284) between January 2010 and December 2012 were reviewed. After excluding 88 patients (40 with AE‐COPD and 48 with CP‐COPD) who did not undergo a multiplex RT‐PCR test for respiratory viruses, the demographic characteristics, identified viruses, and clinical outcomes of the AE‐COPD and CP‐COPD groups were compared. Respiratory viruses were identified in 41.9% of AE‐COPD group and 33.5% of the CP‐COPD groups. The most common virus was influenza virus in the AE‐COPD group (33.7%) versus human coronavirus (24.1%) in the CP‐COPD group. Influenza virus was significantly more common in the AE‐ACOPD group than in the CP‐COPD group (P < 0.01). In‐hospital mortality of AE‐COPD and CP‐COPD were 1.2% and 12.3%, respectively (P < 0.01). Among CP‐COPD patients, in‐hospital mortality of patients with only viral infection group, only bacterial infection group, and viral‐bacterial co‐infection were 2.6%, 25.8%, and 17.5%, respectively (P = 0.01). Respiratory viruses were commonly identified in both AE‐COPD and CP‐COPD, influenza virus and human coronavirus were the most common viruses identified in AE‐COPD and CP‐COPD patients, respectively. The mortality rates of only viral infection group was significantly lower than only bacterial infection or viral‐bacterial co‐infection group in CP‐COPD patients. J. Med. Virol. 88:2092–2099, 2016. © 2016 Wiley Periodicals, Inc.
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DOI: 10.1002/jmv.24577
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E‐mail:</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: yskoh@amc.seoul.kr</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:171F61613DEA3A0304A5EC3C0896E4928BDA9AB9</idno><date when="2016" year="2016">2016</date><idno type="doi">10.1002/jmv.24577</idno><idno type="url">https://api.istex.fr/ark:/67375/WNG-4B28NBXV-6/fulltext.pdf</idno><idno type="wicri:Area/Istex/Corpus">001000</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">001000</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main">Different pattern of viral infections and clinical outcomes in patient with acute exacerbation of chronic obstructive pulmonary disease and chronic obstructive pulmonary disease with pneumonia</title><author><name sortKey="Kim, Ho Heol" sort="Kim, Ho Heol" uniqKey="Kim H" first="Ho-Cheol" last="Kim">Ho-Cheol Kim</name><affiliation><mods:affiliation>Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea</mods:affiliation></affiliation></author><author><name sortKey="Choi, Sang O" sort="Choi, Sang O" uniqKey="Choi S" first="Sang-Ho" last="Choi">Sang-Ho Choi</name><affiliation><mods:affiliation>Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea</mods:affiliation></affiliation></author><author><name sortKey="Huh, Jin On" sort="Huh, Jin On" uniqKey="Huh J" first="Jin-Won" last="Huh">Jin-Won Huh</name><affiliation><mods:affiliation>Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea</mods:affiliation></affiliation></author><author><name sortKey="Sung, Heungsup" sort="Sung, Heungsup" uniqKey="Sung H" first="Heungsup" last="Sung">Heungsup Sung</name><affiliation><mods:affiliation>Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea</mods:affiliation></affiliation></author><author><name sortKey="Hong, Sang Bum" sort="Hong, Sang Bum" uniqKey="Hong S" first="Sang Bum" last="Hong">Sang Bum Hong</name><affiliation><mods:affiliation>Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea</mods:affiliation></affiliation></author><author><name sortKey="Lim, Chae An" sort="Lim, Chae An" uniqKey="Lim C" first="Chae-Man" last="Lim">Chae-Man Lim</name><affiliation><mods:affiliation>Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea</mods:affiliation></affiliation></author><author><name sortKey="Koh, Younsuck" sort="Koh, Younsuck" uniqKey="Koh Y" first="Younsuck" last="Koh">Younsuck Koh</name><affiliation><mods:affiliation>Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: yskoh@amc.seoul.kr</mods:affiliation></affiliation><affiliation><mods:affiliation>Correspondence to: Younsuck Koh, MD, PhD, Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic‐ro 43‐gil, Songpa‐gu, Seoul 05505, South Korea. E‐mail:</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: yskoh@amc.seoul.kr</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Journal of Medical Virology</title><title level="j" type="alt">JOURNAL OF MEDICAL VIROLOGY</title><idno type="ISSN">0146-6615</idno><idno type="eISSN">1096-9071</idno><imprint><biblScope unit="vol">88</biblScope><biblScope unit="issue">12</biblScope><biblScope unit="page" from="2092">2092</biblScope><biblScope unit="page" to="2099">2099</biblScope><biblScope unit="page-count">8</biblScope><date type="published" when="2016-12">2016-12</date></imprint><idno type="ISSN">0146-6615</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0146-6615</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Respiratory viruses are well‐known causes of acute exacerbation of chronic obstructive pulmonary disease (AE‐COPD) and also important pathogens for concomitant pneumonia in COPD (CP‐COPD). However, the differences in a viral infection pattern and clinical impacts of respiratory viruses between the two groups have not been well investigated. The clinical and microbiological data from COPD patients admitted with AE‐COPD (n = 281) or CP‐COPD (n = 284) between January 2010 and December 2012 were reviewed. After excluding 88 patients (40 with AE‐COPD and 48 with CP‐COPD) who did not undergo a multiplex RT‐PCR test for respiratory viruses, the demographic characteristics, identified viruses, and clinical outcomes of the AE‐COPD and CP‐COPD groups were compared. Respiratory viruses were identified in 41.9% of AE‐COPD group and 33.5% of the CP‐COPD groups. The most common virus was influenza virus in the AE‐COPD group (33.7%) versus human coronavirus (24.1%) in the CP‐COPD group. Influenza virus was significantly more common in the AE‐ACOPD group than in the CP‐COPD group (P < 0.01). In‐hospital mortality of AE‐COPD and CP‐COPD were 1.2% and 12.3%, respectively (P < 0.01). Among CP‐COPD patients, in‐hospital mortality of patients with only viral infection group, only bacterial infection group, and viral‐bacterial co‐infection were 2.6%, 25.8%, and 17.5%, respectively (P = 0.01). Respiratory viruses were commonly identified in both AE‐COPD and CP‐COPD, influenza virus and human coronavirus were the most common viruses identified in AE‐COPD and CP‐COPD patients, respectively. The mortality rates of only viral infection group was significantly lower than only bacterial infection or viral‐bacterial co‐infection group in CP‐COPD patients. J. Med. Virol. 88:2092–2099, 2016. © 2016 Wiley Periodicals, Inc.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Ho‐Cheol Kim</name><affiliations><json:string>Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea</json:string></affiliations></json:item><json:item><name>Sang‐Ho Choi</name><affiliations><json:string>Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea</json:string></affiliations></json:item><json:item><name>Jin‐Won Huh</name><affiliations><json:string>Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea</json:string></affiliations></json:item><json:item><name>Heungsup Sung</name><affiliations><json:string>Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea</json:string></affiliations></json:item><json:item><name>Sang Bum Hong</name><affiliations><json:string>Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea</json:string></affiliations></json:item><json:item><name>Chae‐Man Lim</name><affiliations><json:string>Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea</json:string></affiliations></json:item><json:item><name>Younsuck Koh</name><affiliations><json:string>Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea</json:string><json:string>E-mail: yskoh@amc.seoul.kr</json:string><json:string>Correspondence to: Younsuck Koh, MD, PhD, Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic‐ro 43‐gil, Songpa‐gu, Seoul 05505, South Korea. E‐mail:</json:string><json:string>E-mail: yskoh@amc.seoul.kr</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>acute exacerbation</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>COPD</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>outcome</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>pneumonia</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>respiratory virus</value></json:item></subject><articleId><json:string>JMV24577</json:string></articleId><arkIstex>ark:/67375/WNG-4B28NBXV-6</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>article</json:string></originalGenre><abstract>Respiratory viruses are well‐known causes of acute exacerbation of chronic obstructive pulmonary disease (AE‐COPD) and also important pathogens for concomitant pneumonia in COPD (CP‐COPD). However, the differences in a viral infection pattern and clinical impacts of respiratory viruses between the two groups have not been well investigated. The clinical and microbiological data from COPD patients admitted with AE‐COPD (n = 281) or CP‐COPD (n = 284) between January 2010 and December 2012 were reviewed. After excluding 88 patients (40 with AE‐COPD and 48 with CP‐COPD) who did not undergo a multiplex RT‐PCR test for respiratory viruses, the demographic characteristics, identified viruses, and clinical outcomes of the AE‐COPD and CP‐COPD groups were compared. Respiratory viruses were identified in 41.9% of AE‐COPD group and 33.5% of the CP‐COPD groups. The most common virus was influenza virus in the AE‐COPD group (33.7%) versus human coronavirus (24.1%) in the CP‐COPD group. Influenza virus was significantly more common in the AE‐ACOPD group than in the CP‐COPD group (P > 0.01). In‐hospital mortality of AE‐COPD and CP‐COPD were 1.2% and 12.3%, respectively (P > 0.01). Among CP‐COPD patients, in‐hospital mortality of patients with only viral infection group, only bacterial infection group, and viral‐bacterial co‐infection were 2.6%, 25.8%, and 17.5%, respectively (P = 0.01). Respiratory viruses were commonly identified in both AE‐COPD and CP‐COPD, influenza virus and human coronavirus were the most common viruses identified in AE‐COPD and CP‐COPD patients, respectively. The mortality rates of only viral infection group was significantly lower than only bacterial infection or viral‐bacterial co‐infection group in CP‐COPD patients. J. Med. 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type="first">Jin‐Won</forename><surname>Huh</surname></persName><affiliation><orgName type="division">Department of Pulmonary and Critical Care Medicine</orgName><orgName type="division">Asan Medical Center</orgName><orgName type="institution">University of Ulsan College of Medicine</orgName><address><settlement>Seoul</settlement><country key="KR" xml:lang="en">KOREA, REPUBLIC OF</country></address></affiliation></author><author xml:id="author-0003"><persName><forename type="first">Heungsup</forename><surname>Sung</surname></persName><affiliation><orgName type="division">Department of Laboratory Medicine</orgName><orgName type="division">Asan Medical Center</orgName><orgName type="institution">University of Ulsan College of Medicine</orgName><address><settlement>Seoul</settlement><country key="KR" xml:lang="en">KOREA, REPUBLIC OF</country></address></affiliation></author><author xml:id="author-0004"><persName><forename type="first">Sang 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<ref target="http://www.tei-c.org/">We use TEI</ref></desc></application></appInfo></encodingDesc><profileDesc><abstract xml:lang="en" style="main"><p>Respiratory viruses are well‐known causes of acute exacerbation of chronic obstructive pulmonary disease (AE‐COPD) and also important pathogens for concomitant pneumonia in COPD (CP‐COPD). However, the differences in a viral infection pattern and clinical impacts of respiratory viruses between the two groups have not been well investigated. The clinical and microbiological data from COPD patients admitted with AE‐COPD (n = 281) or CP‐COPD (n = 284) between January 2010 and December 2012 were reviewed. After excluding 88 patients (40 with AE‐COPD and 48 with CP‐COPD) who did not undergo a multiplex RT‐PCR test for respiratory viruses, the demographic characteristics, identified viruses, and clinical outcomes of the AE‐COPD and CP‐COPD groups were compared. Respiratory viruses were identified in 41.9% of AE‐COPD group and 33.5% of the CP‐COPD groups. The most common virus was influenza virus in the AE‐COPD group (33.7%) versus human coronavirus (24.1%) in the CP‐COPD group. Influenza virus was significantly more common in the AE‐ACOPD group than in the CP‐COPD group (<hi rend="italic">P</hi> < 0.01). In‐hospital mortality of AE‐COPD and CP‐COPD were 1.2% and 12.3%, respectively (<hi rend="italic">P</hi> < 0.01). Among CP‐COPD patients, in‐hospital mortality of patients with only viral infection group, only bacterial infection group, and viral‐bacterial co‐infection were 2.6%, 25.8%, and 17.5%, respectively (<hi rend="italic">P</hi> = 0.01). Respiratory viruses were commonly identified in both AE‐COPD and CP‐COPD, influenza virus and human coronavirus were the most common viruses identified in AE‐COPD and CP‐COPD patients, respectively. The mortality rates of only viral infection group was significantly lower than only bacterial infection or viral‐bacterial co‐infection group in CP‐COPD patients. <hi rend="bold"><hi rend="italic">J. Med. Virol. 88:2092–2099, 2016</hi>.</hi> © 2016 Wiley Periodicals, Inc.</p></abstract><textClass><keywords xml:lang="en"><term xml:id="jmv24577-kwd-0001">acute exacerbation</term><term xml:id="jmv24577-kwd-0002">COPD</term><term xml:id="jmv24577-kwd-0003">outcome</term><term xml:id="jmv24577-kwd-0004">pneumonia</term><term xml:id="jmv24577-kwd-0005">respiratory virus</term></keywords><keywords rend="articleCategory"><term>Research Article</term></keywords><keywords rend="tocHeading1"><term>Research Articles</term></keywords></textClass><langUsage><language ident="en"></language></langUsage></profileDesc><revisionDesc><change when="2019-12-20" who="#istex" xml:id="pub2tei">formatting</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/ark:/67375/WNG-4B28NBXV-6/fulltext.txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" xml:lang="en" type="serialArticle" xml:id="jmv24577"><header><publicationMeta level="product"><doi origin="wiley" registered="yes">10.1002/(ISSN)1096-9071</doi><issn type="print">0146-6615</issn><issn type="electronic">1096-9071</issn><idGroup><id type="product" value="JMV"></id></idGroup><titleGroup><title type="main" sort="JOURNAL OF MEDICAL VIROLOGY">Journal of Medical Virology</title><title type="short">J. Med. Virol.</title></titleGroup></publicationMeta><publicationMeta level="part" position="120"><doi registered="yes">10.1002/jmv.v88.12</doi><copyright ownership="publisher">© 2016 Wiley Periodicals, Inc.</copyright><numberingGroup><numbering type="journalVolume" number="88">88</numbering><numbering type="journalIssue">12</numbering></numberingGroup><coverDate startDate="2016-12">December 2016</coverDate></publicationMeta><publicationMeta level="unit" position="120" type="article" status="forIssue"><doi>10.1002/jmv.24577</doi><idGroup><id type="unit" value="JMV24577"></id></idGroup><countGroup><count type="pageTotal" number="8"></count></countGroup><titleGroup><title type="articleCategory">Research Article</title><title type="tocHeading1">Research Articles</title></titleGroup><copyright ownership="publisher">© 2016 Wiley Periodicals, Inc.</copyright><eventGroup><event type="manuscriptAccepted" date="2016-05-15"></event><event type="xmlCreated" agent="Thomson Digital" date="2016-05-25"></event><event type="firstOnline" date="2016-05-30"></event><event type="publishedOnlineAccepted" date="2016-05-17"></event><event type="publishedOnlineEarlyUnpaginated" date="2016-05-30"></event><event type="publishedOnlineFinalForm" date="2016-10-04"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:5.0.6 mode:FullText" date="2017-02-09"></event></eventGroup><numberingGroup><numbering type="pageFirst">2092</numbering><numbering type="pageLast">2099</numbering></numberingGroup><correspondenceTo><lineatedText><line>Correspondence to: Younsuck Koh, MD, PhD, Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic‐ro 43‐gil, Songpa‐gu, Seoul 05505, South Korea. E‐mail:
<email>yskoh@amc.seoul.kr</email></line></lineatedText></correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:JMV.JMV24577.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="1"></count><count type="tableTotal" number="3"></count><count type="wordTotal" number="6823"></count></countGroup><titleGroup><title type="main">Different pattern of viral infections and clinical outcomes in patient with acute exacerbation of chronic obstructive pulmonary disease and chronic obstructive pulmonary disease with pneumonia</title><title type="short">Respiratory Viral Infections in COPD Patients</title><title type="shortAuthors">Kim et al</title></titleGroup><creators><creator xml:id="jmv24577-cr-0001" creatorRole="author" affiliationRef="#jmv24577-aff-0001"><personName><givenNames>Ho‐Cheol</givenNames> <familyName>Kim</familyName></personName></creator><creator xml:id="jmv24577-cr-0002" creatorRole="author" affiliationRef="#jmv24577-aff-0002"><personName><givenNames>Sang‐Ho</givenNames> <familyName>Choi</familyName></personName></creator><creator xml:id="jmv24577-cr-0003" creatorRole="author" affiliationRef="#jmv24577-aff-0001"><personName><givenNames>Jin‐Won</givenNames> <familyName>Huh</familyName></personName></creator><creator xml:id="jmv24577-cr-0004" creatorRole="author" affiliationRef="#jmv24577-aff-0003"><personName><givenNames>Heungsup</givenNames> <familyName>Sung</familyName></personName></creator><creator xml:id="jmv24577-cr-0005" creatorRole="author" affiliationRef="#jmv24577-aff-0001"><personName><givenNames>Sang Bum</givenNames> <familyName>Hong</familyName></personName></creator><creator xml:id="jmv24577-cr-0006" creatorRole="author" affiliationRef="#jmv24577-aff-0001"><personName><givenNames>Chae‐Man</givenNames> <familyName>Lim</familyName></personName></creator><creator xml:id="jmv24577-cr-0007" creatorRole="author" affiliationRef="#jmv24577-aff-0001" corresponding="yes"><personName><givenNames>Younsuck</givenNames> <familyName>Koh</familyName></personName><contactDetails><email>yskoh@amc.seoul.kr</email></contactDetails></creator></creators><affiliationGroup><affiliation xml:id="jmv24577-aff-0001" countryCode="KR"><orgDiv>Department of Pulmonary and Critical Care Medicine</orgDiv><orgDiv>Asan Medical Center</orgDiv><orgName>University of Ulsan College of Medicine</orgName><address><city>Seoul</city><country>South Korea</country></address></affiliation><affiliation xml:id="jmv24577-aff-0002" countryCode="KR"><orgDiv>Department of Infectious Diseases</orgDiv><orgDiv>Asan Medical Center</orgDiv><orgName>University of Ulsan College of Medicine</orgName><address><city>Seoul</city><country>South Korea</country></address></affiliation><affiliation xml:id="jmv24577-aff-0003" countryCode="KR"><orgDiv>Department of Laboratory Medicine</orgDiv><orgDiv>Asan Medical Center</orgDiv><orgName>University of Ulsan College of Medicine</orgName><address><city>Seoul</city><country>South Korea</country></address></affiliation></affiliationGroup><keywordGroup type="author" xml:lang="en"><keyword xml:id="jmv24577-kwd-0001">acute exacerbation</keyword><keyword xml:id="jmv24577-kwd-0002">COPD</keyword><keyword xml:id="jmv24577-kwd-0003">outcome</keyword><keyword xml:id="jmv24577-kwd-0004">pneumonia</keyword><keyword xml:id="jmv24577-kwd-0005">respiratory virus</keyword></keywordGroup><supportingInformation><p>Additional supporting information may be found in the online version of this article at the publisher's web‐site.</p><supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:01466615:media:jmv24577:jmv24577-sup-0001-SupTable-S1"></mediaResource><caption><p><b>TABLE I</b>. Baseline Clinical Characteristics of 477 COPD Patients.</p><p><b>TABLE II</b>. Comparison of Clinical Outcome Between Identified Etiology in CP‐COPD Patients.</p><p><b>TABLE III</b>. Comparison of Clinical Outcome Between Identified Etiology in AE‐COPD Patients.</p><p><b>TABLE IV</b>. Factors Predicting 28 Day Mortality in CP‐COPD Patients Identified by Logistic Regression.</p></caption></supportingInfoItem><supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:01466615:media:jmv24577:jmv24577-sup-0002-SupFig-S2"></mediaResource><caption><p><b>FIGURE I</b>. Seasonal distribution of viral pathogens identified in AE‐COPD and CP‐COPD; AE‐COPD: Acute exacerbation of chronic obstructive pulmonary disease; CP‐COPD: Concomitant pneumonia in chronic obstructive pulmonary disease.</p></caption></supportingInfoItem></supportingInformation><abstractGroup><abstract type="main" xml:lang="en"><section xml:id="jmv24577-sec-0001"><p>Respiratory viruses are well‐known causes of acute exacerbation of chronic obstructive pulmonary disease (AE‐COPD) and also important pathogens for concomitant pneumonia in COPD (CP‐COPD). However, the differences in a viral infection pattern and clinical impacts of respiratory viruses between the two groups have not been well investigated. The clinical and microbiological data from COPD patients admitted with AE‐COPD (n = 281) or CP‐COPD (n = 284) between January 2010 and December 2012 were reviewed. After excluding 88 patients (40 with AE‐COPD and 48 with CP‐COPD) who did not undergo a multiplex RT‐PCR test for respiratory viruses, the demographic characteristics, identified viruses, and clinical outcomes of the AE‐COPD and CP‐COPD groups were compared. Respiratory viruses were identified in 41.9% of AE‐COPD group and 33.5% of the CP‐COPD groups. The most common virus was influenza virus in the AE‐COPD group (33.7%) versus human coronavirus (24.1%) in the CP‐COPD group. Influenza virus was significantly more common in the AE‐ACOPD group than in the CP‐COPD group (<i>P</i> < 0.01). In‐hospital mortality of AE‐COPD and CP‐COPD were 1.2% and 12.3%, respectively (<i>P</i> < 0.01). Among CP‐COPD patients, in‐hospital mortality of patients with only viral infection group, only bacterial infection group, and viral‐bacterial co‐infection were 2.6%, 25.8%, and 17.5%, respectively (<i>P</i> = 0.01). Respiratory viruses were commonly identified in both AE‐COPD and CP‐COPD, influenza virus and human coronavirus were the most common viruses identified in AE‐COPD and CP‐COPD patients, respectively. The mortality rates of only viral infection group was significantly lower than only bacterial infection or viral‐bacterial co‐infection group in CP‐COPD patients. <b><i>J. Med. Virol. 88:2092–2099, 2016</i>.</b> © 2016 Wiley Periodicals, Inc.</p></section></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Different pattern of viral infections and clinical outcomes in patient with acute exacerbation of chronic obstructive pulmonary disease and chronic obstructive pulmonary disease with pneumonia</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Respiratory Viral Infections in COPD Patients</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Different pattern of viral infections and clinical outcomes in patient with acute exacerbation of chronic obstructive pulmonary disease and chronic obstructive pulmonary disease with pneumonia</title></titleInfo><name type="personal"><namePart type="given">Ho‐Cheol</namePart><namePart type="family">Kim</namePart><affiliation>Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Sang‐Ho</namePart><namePart type="family">Choi</namePart><affiliation>Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jin‐Won</namePart><namePart type="family">Huh</namePart><affiliation>Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Heungsup</namePart><namePart type="family">Sung</namePart><affiliation>Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Sang Bum</namePart><namePart type="family">Hong</namePart><affiliation>Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Chae‐Man</namePart><namePart type="family">Lim</namePart><affiliation>Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Younsuck</namePart><namePart type="family">Koh</namePart><affiliation>Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea</affiliation><affiliation>E-mail: yskoh@amc.seoul.kr</affiliation><affiliation>Correspondence to: Younsuck Koh, MD, PhD, Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic‐ro 43‐gil, Songpa‐gu, Seoul 05505, South Korea. E‐mail:</affiliation><affiliation>E-mail: yskoh@amc.seoul.kr</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><dateIssued encoding="w3cdtf">2016-12</dateIssued><dateCreated encoding="w3cdtf">2016-05-25</dateCreated><dateValid encoding="w3cdtf">2016-05-15</dateValid><copyrightDate encoding="w3cdtf">2016</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><extent unit="figures">1</extent><extent unit="tables">3</extent><extent unit="words">6823</extent></physicalDescription><abstract lang="en">Respiratory viruses are well‐known causes of acute exacerbation of chronic obstructive pulmonary disease (AE‐COPD) and also important pathogens for concomitant pneumonia in COPD (CP‐COPD). However, the differences in a viral infection pattern and clinical impacts of respiratory viruses between the two groups have not been well investigated. The clinical and microbiological data from COPD patients admitted with AE‐COPD (n = 281) or CP‐COPD (n = 284) between January 2010 and December 2012 were reviewed. After excluding 88 patients (40 with AE‐COPD and 48 with CP‐COPD) who did not undergo a multiplex RT‐PCR test for respiratory viruses, the demographic characteristics, identified viruses, and clinical outcomes of the AE‐COPD and CP‐COPD groups were compared. Respiratory viruses were identified in 41.9% of AE‐COPD group and 33.5% of the CP‐COPD groups. The most common virus was influenza virus in the AE‐COPD group (33.7%) versus human coronavirus (24.1%) in the CP‐COPD group. Influenza virus was significantly more common in the AE‐ACOPD group than in the CP‐COPD group (P < 0.01). In‐hospital mortality of AE‐COPD and CP‐COPD were 1.2% and 12.3%, respectively (P < 0.01). Among CP‐COPD patients, in‐hospital mortality of patients with only viral infection group, only bacterial infection group, and viral‐bacterial co‐infection were 2.6%, 25.8%, and 17.5%, respectively (P = 0.01). Respiratory viruses were commonly identified in both AE‐COPD and CP‐COPD, influenza virus and human coronavirus were the most common viruses identified in AE‐COPD and CP‐COPD patients, respectively. The mortality rates of only viral infection group was significantly lower than only bacterial infection or viral‐bacterial co‐infection group in CP‐COPD patients. J. Med. Virol. 88:2092–2099, 2016. © 2016 Wiley Periodicals, Inc.</abstract><subject lang="en"><genre>keywords</genre><topic>acute exacerbation</topic><topic>COPD</topic><topic>outcome</topic><topic>pneumonia</topic><topic>respiratory virus</topic></subject><relatedItem type="host"><titleInfo><title>Journal of Medical Virology</title></titleInfo><titleInfo type="abbreviated"><title>J. Med. Virol.</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><note type="content"> Additional supporting information may be found in the online version of this article at the publisher's web‐site.Supporting Info Item: TABLE I. Baseline Clinical Characteristics of 477 COPD Patients. TABLE II. Comparison of Clinical Outcome Between Identified Etiology in CP‐COPD Patients. TABLE III. Comparison of Clinical Outcome Between Identified Etiology in AE‐COPD Patients. TABLE IV. Factors Predicting 28 Day Mortality in CP‐COPD Patients Identified by Logistic Regression. - FIGURE I. 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