Respiratory Aspergillus Colonization Was Associated With Relapse of Acute Exacerbation in Patients With Chronic Obstructive Pulmonary Disease: Analysis of Data From A Retrospective Cohort Study
Background: Patients with chronic obstructive pulmonary disease (COPD) are more susceptible to Aspergillus colonization or infection. Several studies have demonstrated that invasive pulmonary Aspergillosis (IPA) and Aspergillus hypersensitivity (AH) have a detrimental effect on COPD. However, it rem...
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doaj-0d625ed1345a4e9097844f445ac0f2ef2021-05-04T04:57:56ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2021-05-01810.3389/fmed.2021.640289640289Respiratory Aspergillus Colonization Was Associated With Relapse of Acute Exacerbation in Patients With Chronic Obstructive Pulmonary Disease: Analysis of Data From A Retrospective Cohort StudyYi-xing Wu0Yi-hui Zuo1Qi-jian Cheng2Yi Huang3Zhi-yao Bao4Xiao-yan Jin5Xi-wen Gao6Chun-lin Tu7Wei-ping Hu8Jing-qing Hang9Wei-qin Wang10Feng-ying Zhang11Jing Zhang12Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Respiratory Medicine, Ruijin North Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Pulmonary and Critical Care Medicine, Changhai Hospital of Shanghai, Second Military Medical University, Shanghai, ChinaDepartment of Respiratory Medicine, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Respiratory Medicine, Tongren Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Respiratory Medicine, Central Hospital of Minhang District, Shanghai, Fudan University, Shanghai, ChinaDepartment of Respiratory Medicine, Central Hospital of Jiading District, Shanghai, Fudan University, Shanghai, ChinaDepartment of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Respiratory Medicine, Shanghai Putuo District People's Hospital, Shanghai, ChinaDepartment of Respiratory Medicine, Tongren Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Respiratory Medicine, Shanghai Putuo District People's Hospital, Shanghai, ChinaDepartment of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, ChinaBackground: Patients with chronic obstructive pulmonary disease (COPD) are more susceptible to Aspergillus colonization or infection. Several studies have demonstrated that invasive pulmonary Aspergillosis (IPA) and Aspergillus hypersensitivity (AH) have a detrimental effect on COPD. However, it remains to be clarified whether Aspergillus colonization is associated with acute exacerbation of COPD (AECOPD). This study aimed to explore the impact of Aspergillus colonization in the lower respiratory tract on AECOPD.Method: Patients with Aspergillus colonization were identified from a retrospective cohort of hospitalized AECOPD from 2011 to 2016 in eight centers in Shanghai, China. The demographic information, conditions of the stable stage, clinical characteristics during hospitalization, and 1-year follow-up information after discharge were collected and compared to participants without fungi colonization.Result: Twenty-six hospitalized AECOPD patients with Aspergillus colonization and 72 controls were included in the final analysis after excluding patients with other fungi isolation and matching. The rates of recurrence of acute exacerbation within 90 days and 180 days after discharge in the patients with Aspergillus colonization were both significantly higher than that in the fungi negative patients (90 days: 19.2 vs. 4.2%, p = 0.029; 180 days: 23.1 vs. 4.2%, p = 0.010), and the all-cause mortality within 1 year was also higher (11.5 vs. 0.0%, p = 0.017). Multivariate logistic regression analysis showed that Aspergillus colonization was an independent risk factor for the recurrence of acute exacerbation within 90 days and 180 days (90 days: OR = 8.661, 95% CI: 1.496-50.159, p = 0.016; 180 days: OR =10.723, 95% CI: 1.936-59.394, p = 0.007).Conclusion:Aspergillus colonization may predict poor prognosis of AECOPD while leading to an increased risk of recurrent AECOPD in a short period.https://www.frontiersin.org/articles/10.3389/fmed.2021.640289/fullchronic obstructive pulmonary diseaseacute exacerbationAspergillusprognosisrecurrence of AECOPD |
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language |
English |
format |
Article |
sources |
DOAJ |
author |
Yi-xing Wu Yi-hui Zuo Qi-jian Cheng Yi Huang Zhi-yao Bao Xiao-yan Jin Xi-wen Gao Chun-lin Tu Wei-ping Hu Jing-qing Hang Wei-qin Wang Feng-ying Zhang Jing Zhang |
spellingShingle |
Yi-xing Wu Yi-hui Zuo Qi-jian Cheng Yi Huang Zhi-yao Bao Xiao-yan Jin Xi-wen Gao Chun-lin Tu Wei-ping Hu Jing-qing Hang Wei-qin Wang Feng-ying Zhang Jing Zhang Respiratory Aspergillus Colonization Was Associated With Relapse of Acute Exacerbation in Patients With Chronic Obstructive Pulmonary Disease: Analysis of Data From A Retrospective Cohort Study Frontiers in Medicine chronic obstructive pulmonary disease acute exacerbation Aspergillus prognosis recurrence of AECOPD |
author_facet |
Yi-xing Wu Yi-hui Zuo Qi-jian Cheng Yi Huang Zhi-yao Bao Xiao-yan Jin Xi-wen Gao Chun-lin Tu Wei-ping Hu Jing-qing Hang Wei-qin Wang Feng-ying Zhang Jing Zhang |
author_sort |
Yi-xing Wu |
title |
Respiratory Aspergillus Colonization Was Associated With Relapse of Acute Exacerbation in Patients With Chronic Obstructive Pulmonary Disease: Analysis of Data From A Retrospective Cohort Study |
title_short |
Respiratory Aspergillus Colonization Was Associated With Relapse of Acute Exacerbation in Patients With Chronic Obstructive Pulmonary Disease: Analysis of Data From A Retrospective Cohort Study |
title_full |
Respiratory Aspergillus Colonization Was Associated With Relapse of Acute Exacerbation in Patients With Chronic Obstructive Pulmonary Disease: Analysis of Data From A Retrospective Cohort Study |
title_fullStr |
Respiratory Aspergillus Colonization Was Associated With Relapse of Acute Exacerbation in Patients With Chronic Obstructive Pulmonary Disease: Analysis of Data From A Retrospective Cohort Study |
title_full_unstemmed |
Respiratory Aspergillus Colonization Was Associated With Relapse of Acute Exacerbation in Patients With Chronic Obstructive Pulmonary Disease: Analysis of Data From A Retrospective Cohort Study |
title_sort |
respiratory aspergillus colonization was associated with relapse of acute exacerbation in patients with chronic obstructive pulmonary disease: analysis of data from a retrospective cohort study |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Medicine |
issn |
2296-858X |
publishDate |
2021-05-01 |
description |
Background: Patients with chronic obstructive pulmonary disease (COPD) are more susceptible to Aspergillus colonization or infection. Several studies have demonstrated that invasive pulmonary Aspergillosis (IPA) and Aspergillus hypersensitivity (AH) have a detrimental effect on COPD. However, it remains to be clarified whether Aspergillus colonization is associated with acute exacerbation of COPD (AECOPD). This study aimed to explore the impact of Aspergillus colonization in the lower respiratory tract on AECOPD.Method: Patients with Aspergillus colonization were identified from a retrospective cohort of hospitalized AECOPD from 2011 to 2016 in eight centers in Shanghai, China. The demographic information, conditions of the stable stage, clinical characteristics during hospitalization, and 1-year follow-up information after discharge were collected and compared to participants without fungi colonization.Result: Twenty-six hospitalized AECOPD patients with Aspergillus colonization and 72 controls were included in the final analysis after excluding patients with other fungi isolation and matching. The rates of recurrence of acute exacerbation within 90 days and 180 days after discharge in the patients with Aspergillus colonization were both significantly higher than that in the fungi negative patients (90 days: 19.2 vs. 4.2%, p = 0.029; 180 days: 23.1 vs. 4.2%, p = 0.010), and the all-cause mortality within 1 year was also higher (11.5 vs. 0.0%, p = 0.017). Multivariate logistic regression analysis showed that Aspergillus colonization was an independent risk factor for the recurrence of acute exacerbation within 90 days and 180 days (90 days: OR = 8.661, 95% CI: 1.496-50.159, p = 0.016; 180 days: OR =10.723, 95% CI: 1.936-59.394, p = 0.007).Conclusion:Aspergillus colonization may predict poor prognosis of AECOPD while leading to an increased risk of recurrent AECOPD in a short period. |
topic |
chronic obstructive pulmonary disease acute exacerbation Aspergillus prognosis recurrence of AECOPD |
url |
https://www.frontiersin.org/articles/10.3389/fmed.2021.640289/full |
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