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Impact of a Positive Viral Polymerase Chain Reaction on Outcomes of Chronic Obstructive Pulmonary Disease (COPD) Exacerbations

Author

Listed:
  • Kulothungan Gunasekaran

    (Division of Pulmonary Diseases and Critical Care, Yale-New Haven Health Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610, USA)

  • Mudassar Ahmad

    (Division of Pulmonary Diseases and Critical Care, St. Peter’s University Hospital, New Brunswick, NJ 08901, USA)

  • Sana Rehman

    (Department of Medicine, Shaikh Khalifa Bin Zayed Al-Nahyan Medical and Dental College, Lahore 53720, Pakistan)

  • Bright Thilagar

    (Division of Hospital Medicine, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202, USA)

  • Kavitha Gopalratnam

    (Division of Pulmonary Diseases and Critical Care, Yale-New Haven Health Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610, USA)

  • Sathish Ramalingam

    (Division of Hospital Medicine, Lovelace Medical Center, 601 Dr. Martin Luther King Jr. Ave NE, Albuquerque, NM 87102, USA)

  • Vijayakumar Paramasivam

    (Division of Nephrology, Baystate Medical Center, 759 Chestnut St, Springfield, MA 01199, USA)

  • Ashish Arora

    (Division of Pulmonary Diseases and Critical Care, Saint Mary’s Hospital, 56 Franklin St, Waterbury, CT 06610, USA)

  • Arul Chandran

    (Division of Pulmonary Diseases and Critical Care, Hurley Medical Center, G-3252 Beecher Road, Flint, MI 48532, USA)

Abstract

Introduction: More than 15 million adults in the USA have chronic obstructive pulmonary disease. Chronic obstructive pulmonary disease (COPD) places a high burden on the healthcare system. Many hospital admissions are due to an exacerbation, which is suspected to be from a viral cause. The purpose of this analysis was to compare the outcomes of patients with a positive and negative respiratory virus panel who were admitted to the hospital with COPD exacerbations. Methods: This retrospective cohort study was conducted in the Geisinger Healthcare System. The dataset included 2729 patient encounters between 1 January 2006 and 30 November 2017. Hospital length of stay was calculated as the discrete number of calendar days a patient was in the hospital. Patient encounters with a positive and negative respiratory virus panel were compared using Pearson’s chi-square or Fisher’s exact test for categorical variables and Student’s t-test or Wilcoxon rank-sum tests for continuous variables. Results: There were 1626 patients with a total of 2729 chronic obstructive pulmonary disease exacerbation encounters. Nineteen percent of those encounters ( n = 524) had a respiratory virus panel performed during their admission. Among these encounters, 161 (30.7%) had positive results, and 363 (69.3%) had negative results. For encounters with the respiratory virus panel, the mean age was 64.5, 59.5% were female, 98.9% were white, and the mean body mass index was 26.6. Those with a negative respiratory virus panel had a higher median white blood cell count (11.1 vs. 9.9, p = 0.0076). There were no other statistically significant differences in characteristics between the two groups. Respiratory virus panel positive patients had a statistically significant longer hospital length of stay. There were no significant differences with respect to being on mechanical ventilation or ventilation-free days. Conclusion: This study shows that a positive respiratory virus panel is associated with increased length of hospital stay. Early diagnosis of chronic obstructive pulmonary disease exacerbation patients with positive viral panel would help identify patients with a longer length of stay.

Suggested Citation

  • Kulothungan Gunasekaran & Mudassar Ahmad & Sana Rehman & Bright Thilagar & Kavitha Gopalratnam & Sathish Ramalingam & Vijayakumar Paramasivam & Ashish Arora & Arul Chandran, 2020. "Impact of a Positive Viral Polymerase Chain Reaction on Outcomes of Chronic Obstructive Pulmonary Disease (COPD) Exacerbations," IJERPH, MDPI, vol. 17(21), pages 1-9, November.
  • Handle: RePEc:gam:jijerp:v:17:y:2020:i:21:p:8072-:d:438950
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    Cited by:

    1. Andrés Calvache-Mateo & Laura López-López & Alejandro Heredia-Ciuró & Javier Martín-Núñez & Janet Rodríguez-Torres & Araceli Ortiz-Rubio & Marie Carmen Valenza, 2021. "Efficacy of Web-Based Supportive Interventions in Quality of Life in COPD Patients, a Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 18(23), pages 1-19, December.

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