Upper respiratory symptoms worsen over time and relate to clinical phenotype in chronic obstructive pulmonary disease
How nasal symptoms in patients with chronic obstructive pulmonary disease (COPD) change over time and resolve during naturally occurring exacerbations has not been described previously. To evaluate the evolution and impact of upper airway symptoms in a well-defined COPD cohort when stable and at exa...
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| Veröffentlicht in: | Annals of the American Thoracic Society 2015-07, Vol.12 (7), p.997-1004 |
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| creator | Huerta, Arturo Donaldson, Gavin C Singh, Richa Mackay, Alex J Allinson, James P Brill, Simon E Kowlessar, Beverly Torres, Antoni Wedzicha, Jadwiga A |
| description | How nasal symptoms in patients with chronic obstructive pulmonary disease (COPD) change over time and resolve during naturally occurring exacerbations has not been described previously.
To evaluate the evolution and impact of upper airway symptoms in a well-defined COPD cohort when stable and at exacerbation.
Patients in the London COPD cohort were asked about the presence of nasal symptoms (nasal discharge, sneezing, postnasal drip, blocked nose, and anosmia) over an 8-year period (2005-2013) every 3 months at routine clinic visits while in a stable state and daily during exacerbations with the use of diary cards. Data were prospectively collected, and, in a subgroup of patients, COPD Assessment Test scores and human rhinovirus identification by polymerase chain reaction were available. Patients were also defined as having infrequent or frequent exacerbations ( |
| doi_str_mv | 10.1513/AnnalsATS.201408-359OC |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_1855076337</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3771704661</sourcerecordid><originalsourceid>FETCH-LOGICAL-p272t-9eb68d9deb9db0302f412982080d16a5e79a8a463093735ff0d30f933dd127ef3</originalsourceid><addsrcrecordid>eNqFkU9r3DAQxUVoyYZtvkIQ9NKLE_1ZWdJxWdoksJBDk7ORrTFRsCVFkrfst6-abC-5ZC4zDL958N4gdEXJNRWU32y9N1PePv6-ZoRuiGq40A-7M3TBOBNN2zL65W3WTas5X6HLnF9ILSWokvocrZjQXDGpL9DyFCMknCBHl0wJ6YjzcY4lzBn_CSmDx-FQgeJmwMbbSk6mAC4BD5PzbjATjs_gQzlGwM7j4TmFusahzyUtQ3EHwHGZ5uBN1bYug8nwDX0dqwO4PPU1evr183F31-wfbu93230TmWSl0dC3ymoLvbY94YSNG8q0YkQRS1sjQGqjzKblRHPJxTgSy8lYLVtLmYSRr9GPd92YwusCuXSzywNMk_EQltxRJQSRLa_Xn6KtVlpIxlRFv39AX8KS_r2ko5IwVpOummt0daKWfgbbxeTmGkH3P3v-F2Fwip4</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1702200076</pqid></control><display><type>article</type><title>Upper respiratory symptoms worsen over time and relate to clinical phenotype in chronic obstructive pulmonary disease</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><source>American Thoracic Society (ATS) Journals Online</source><source>Alma/SFX Local Collection</source><creator>Huerta, Arturo ; Donaldson, Gavin C ; Singh, Richa ; Mackay, Alex J ; Allinson, James P ; Brill, Simon E ; Kowlessar, Beverly ; Torres, Antoni ; Wedzicha, Jadwiga A</creator><creatorcontrib>Huerta, Arturo ; Donaldson, Gavin C ; Singh, Richa ; Mackay, Alex J ; Allinson, James P ; Brill, Simon E ; Kowlessar, Beverly ; Torres, Antoni ; Wedzicha, Jadwiga A</creatorcontrib><description>How nasal symptoms in patients with chronic obstructive pulmonary disease (COPD) change over time and resolve during naturally occurring exacerbations has not been described previously.
To evaluate the evolution and impact of upper airway symptoms in a well-defined COPD cohort when stable and at exacerbation.
Patients in the London COPD cohort were asked about the presence of nasal symptoms (nasal discharge, sneezing, postnasal drip, blocked nose, and anosmia) over an 8-year period (2005-2013) every 3 months at routine clinic visits while in a stable state and daily during exacerbations with the use of diary cards. Data were prospectively collected, and, in a subgroup of patients, COPD Assessment Test scores and human rhinovirus identification by polymerase chain reaction were available. Patients were also defined as having infrequent or frequent exacerbations (<2 or ≥2 exacerbations/yr, respectively).
At an aggregate of 4,368 visits, 209 patients with COPD were asked about their nasal symptoms. At 2,033 visits when the patients were stable, the odds ratio (OR) for nasal discharge increased by 1.32% per year (95% confidence interval [CI], 1.19-1.45; P < 0.001); the OR for sneezing increased by 1.16% (95% CI, 1.05-1.29; P = 0.005); the OR for postnasal drip increased by 1.18% (95% CI, 1.03-1.36; P = 0.016); and the OR for anosmia increased by 1.19% (95% CI, 1.03-1.37; P = 0.015). At visits when the patients were having exacerbations, nasal discharge was present for 7 days and blocked nose, sneezing, and postnasal drip increased for just 3 days. Anosmia did not change. Nasal discharge was more likely in patients with frequent exacerbations (OR, 1.96; 95% CI, 1.17-3.28; P = 0.011), and COPD Assessment Test scores were higher by 1.06 units (95% CI, 0.32-1.80; P = 0.005) when patients were stable and higher by 1.30 units (95% CI, 0.05-2.57; P = 0.042) during exacerbations.
Upper airway symptoms increase over time in patients with COPD and are related to the frequent exacerbation phenotype. These longitudinal changes may be due to increasing airway inflammation or to progression of COPD.</description><identifier>ISSN: 2329-6933</identifier><identifier>EISSN: 2325-6621</identifier><identifier>DOI: 10.1513/AnnalsATS.201408-359OC</identifier><identifier>PMID: 25938279</identifier><language>eng</language><publisher>United States: American Thoracic Society</publisher><subject>Aged ; Cohort Studies ; Disease Progression ; Enterovirus ; Female ; Humans ; London ; Male ; Middle Aged ; Nasal Obstruction - complications ; Odds Ratio ; Olfaction Disorders - complications ; Phenotype ; Picornaviridae ; Pulmonary Disease, Chronic Obstructive - complications ; Pulmonary Disease, Chronic Obstructive - physiopathology ; Quality of Life ; Rhinovirus - isolation & purification ; Severity of Illness Index ; Sneezing ; Sputum - virology</subject><ispartof>Annals of the American Thoracic Society, 2015-07, Vol.12 (7), p.997-1004</ispartof><rights>Copyright American Thoracic Society Jul 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><orcidid>0000-0002-6191-4143</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25938279$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Huerta, Arturo</creatorcontrib><creatorcontrib>Donaldson, Gavin C</creatorcontrib><creatorcontrib>Singh, Richa</creatorcontrib><creatorcontrib>Mackay, Alex J</creatorcontrib><creatorcontrib>Allinson, James P</creatorcontrib><creatorcontrib>Brill, Simon E</creatorcontrib><creatorcontrib>Kowlessar, Beverly</creatorcontrib><creatorcontrib>Torres, Antoni</creatorcontrib><creatorcontrib>Wedzicha, Jadwiga A</creatorcontrib><title>Upper respiratory symptoms worsen over time and relate to clinical phenotype in chronic obstructive pulmonary disease</title><title>Annals of the American Thoracic Society</title><addtitle>Ann Am Thorac Soc</addtitle><description>How nasal symptoms in patients with chronic obstructive pulmonary disease (COPD) change over time and resolve during naturally occurring exacerbations has not been described previously.
To evaluate the evolution and impact of upper airway symptoms in a well-defined COPD cohort when stable and at exacerbation.
Patients in the London COPD cohort were asked about the presence of nasal symptoms (nasal discharge, sneezing, postnasal drip, blocked nose, and anosmia) over an 8-year period (2005-2013) every 3 months at routine clinic visits while in a stable state and daily during exacerbations with the use of diary cards. Data were prospectively collected, and, in a subgroup of patients, COPD Assessment Test scores and human rhinovirus identification by polymerase chain reaction were available. Patients were also defined as having infrequent or frequent exacerbations (<2 or ≥2 exacerbations/yr, respectively).
At an aggregate of 4,368 visits, 209 patients with COPD were asked about their nasal symptoms. At 2,033 visits when the patients were stable, the odds ratio (OR) for nasal discharge increased by 1.32% per year (95% confidence interval [CI], 1.19-1.45; P < 0.001); the OR for sneezing increased by 1.16% (95% CI, 1.05-1.29; P = 0.005); the OR for postnasal drip increased by 1.18% (95% CI, 1.03-1.36; P = 0.016); and the OR for anosmia increased by 1.19% (95% CI, 1.03-1.37; P = 0.015). At visits when the patients were having exacerbations, nasal discharge was present for 7 days and blocked nose, sneezing, and postnasal drip increased for just 3 days. Anosmia did not change. Nasal discharge was more likely in patients with frequent exacerbations (OR, 1.96; 95% CI, 1.17-3.28; P = 0.011), and COPD Assessment Test scores were higher by 1.06 units (95% CI, 0.32-1.80; P = 0.005) when patients were stable and higher by 1.30 units (95% CI, 0.05-2.57; P = 0.042) during exacerbations.
Upper airway symptoms increase over time in patients with COPD and are related to the frequent exacerbation phenotype. These longitudinal changes may be due to increasing airway inflammation or to progression of COPD.</description><subject>Aged</subject><subject>Cohort Studies</subject><subject>Disease Progression</subject><subject>Enterovirus</subject><subject>Female</subject><subject>Humans</subject><subject>London</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Nasal Obstruction - complications</subject><subject>Odds Ratio</subject><subject>Olfaction Disorders - complications</subject><subject>Phenotype</subject><subject>Picornaviridae</subject><subject>Pulmonary Disease, Chronic Obstructive - complications</subject><subject>Pulmonary Disease, Chronic Obstructive - physiopathology</subject><subject>Quality of Life</subject><subject>Rhinovirus - isolation & purification</subject><subject>Severity of Illness Index</subject><subject>Sneezing</subject><subject>Sputum - virology</subject><issn>2329-6933</issn><issn>2325-6621</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkU9r3DAQxUVoyYZtvkIQ9NKLE_1ZWdJxWdoksJBDk7ORrTFRsCVFkrfst6-abC-5ZC4zDL958N4gdEXJNRWU32y9N1PePv6-ZoRuiGq40A-7M3TBOBNN2zL65W3WTas5X6HLnF9ILSWokvocrZjQXDGpL9DyFCMknCBHl0wJ6YjzcY4lzBn_CSmDx-FQgeJmwMbbSk6mAC4BD5PzbjATjs_gQzlGwM7j4TmFusahzyUtQ3EHwHGZ5uBN1bYug8nwDX0dqwO4PPU1evr183F31-wfbu93230TmWSl0dC3ymoLvbY94YSNG8q0YkQRS1sjQGqjzKblRHPJxTgSy8lYLVtLmYSRr9GPd92YwusCuXSzywNMk_EQltxRJQSRLa_Xn6KtVlpIxlRFv39AX8KS_r2ko5IwVpOummt0daKWfgbbxeTmGkH3P3v-F2Fwip4</recordid><startdate>201507</startdate><enddate>201507</enddate><creator>Huerta, Arturo</creator><creator>Donaldson, Gavin C</creator><creator>Singh, Richa</creator><creator>Mackay, Alex J</creator><creator>Allinson, James P</creator><creator>Brill, Simon E</creator><creator>Kowlessar, Beverly</creator><creator>Torres, Antoni</creator><creator>Wedzicha, Jadwiga A</creator><general>American Thoracic Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>7U7</scope><scope>C1K</scope><orcidid>https://orcid.org/0000-0002-6191-4143</orcidid></search><sort><creationdate>201507</creationdate><title>Upper respiratory symptoms worsen over time and relate to clinical phenotype in chronic obstructive pulmonary disease</title><author>Huerta, Arturo ; Donaldson, Gavin C ; Singh, Richa ; Mackay, Alex J ; Allinson, James P ; Brill, Simon E ; Kowlessar, Beverly ; Torres, Antoni ; Wedzicha, Jadwiga A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p272t-9eb68d9deb9db0302f412982080d16a5e79a8a463093735ff0d30f933dd127ef3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Cohort Studies</topic><topic>Disease Progression</topic><topic>Enterovirus</topic><topic>Female</topic><topic>Humans</topic><topic>London</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Nasal Obstruction - complications</topic><topic>Odds Ratio</topic><topic>Olfaction Disorders - complications</topic><topic>Phenotype</topic><topic>Picornaviridae</topic><topic>Pulmonary Disease, Chronic Obstructive - complications</topic><topic>Pulmonary Disease, Chronic Obstructive - physiopathology</topic><topic>Quality of Life</topic><topic>Rhinovirus - isolation & purification</topic><topic>Severity of Illness Index</topic><topic>Sneezing</topic><topic>Sputum - virology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Huerta, Arturo</creatorcontrib><creatorcontrib>Donaldson, Gavin C</creatorcontrib><creatorcontrib>Singh, Richa</creatorcontrib><creatorcontrib>Mackay, Alex J</creatorcontrib><creatorcontrib>Allinson, James P</creatorcontrib><creatorcontrib>Brill, Simon E</creatorcontrib><creatorcontrib>Kowlessar, Beverly</creatorcontrib><creatorcontrib>Torres, Antoni</creatorcontrib><creatorcontrib>Wedzicha, Jadwiga A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>Annals of the American Thoracic Society</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Huerta, Arturo</au><au>Donaldson, Gavin C</au><au>Singh, Richa</au><au>Mackay, Alex J</au><au>Allinson, James P</au><au>Brill, Simon E</au><au>Kowlessar, Beverly</au><au>Torres, Antoni</au><au>Wedzicha, Jadwiga A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Upper respiratory symptoms worsen over time and relate to clinical phenotype in chronic obstructive pulmonary disease</atitle><jtitle>Annals of the American Thoracic Society</jtitle><addtitle>Ann Am Thorac Soc</addtitle><date>2015-07</date><risdate>2015</risdate><volume>12</volume><issue>7</issue><spage>997</spage><epage>1004</epage><pages>997-1004</pages><issn>2329-6933</issn><eissn>2325-6621</eissn><abstract>How nasal symptoms in patients with chronic obstructive pulmonary disease (COPD) change over time and resolve during naturally occurring exacerbations has not been described previously.
To evaluate the evolution and impact of upper airway symptoms in a well-defined COPD cohort when stable and at exacerbation.
Patients in the London COPD cohort were asked about the presence of nasal symptoms (nasal discharge, sneezing, postnasal drip, blocked nose, and anosmia) over an 8-year period (2005-2013) every 3 months at routine clinic visits while in a stable state and daily during exacerbations with the use of diary cards. Data were prospectively collected, and, in a subgroup of patients, COPD Assessment Test scores and human rhinovirus identification by polymerase chain reaction were available. Patients were also defined as having infrequent or frequent exacerbations (<2 or ≥2 exacerbations/yr, respectively).
At an aggregate of 4,368 visits, 209 patients with COPD were asked about their nasal symptoms. At 2,033 visits when the patients were stable, the odds ratio (OR) for nasal discharge increased by 1.32% per year (95% confidence interval [CI], 1.19-1.45; P < 0.001); the OR for sneezing increased by 1.16% (95% CI, 1.05-1.29; P = 0.005); the OR for postnasal drip increased by 1.18% (95% CI, 1.03-1.36; P = 0.016); and the OR for anosmia increased by 1.19% (95% CI, 1.03-1.37; P = 0.015). At visits when the patients were having exacerbations, nasal discharge was present for 7 days and blocked nose, sneezing, and postnasal drip increased for just 3 days. Anosmia did not change. Nasal discharge was more likely in patients with frequent exacerbations (OR, 1.96; 95% CI, 1.17-3.28; P = 0.011), and COPD Assessment Test scores were higher by 1.06 units (95% CI, 0.32-1.80; P = 0.005) when patients were stable and higher by 1.30 units (95% CI, 0.05-2.57; P = 0.042) during exacerbations.
Upper airway symptoms increase over time in patients with COPD and are related to the frequent exacerbation phenotype. These longitudinal changes may be due to increasing airway inflammation or to progression of COPD.</abstract><cop>United States</cop><pub>American Thoracic Society</pub><pmid>25938279</pmid><doi>10.1513/AnnalsATS.201408-359OC</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-6191-4143</orcidid></addata></record> |
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| source | MEDLINE; Journals@Ovid Complete; American Thoracic Society (ATS) Journals Online; Alma/SFX Local Collection |
| subjects | Aged Cohort Studies Disease Progression Enterovirus Female Humans London Male Middle Aged Nasal Obstruction - complications Odds Ratio Olfaction Disorders - complications Phenotype Picornaviridae Pulmonary Disease, Chronic Obstructive - complications Pulmonary Disease, Chronic Obstructive - physiopathology Quality of Life Rhinovirus - isolation & purification Severity of Illness Index Sneezing Sputum - virology |
| title | Upper respiratory symptoms worsen over time and relate to clinical phenotype in chronic obstructive pulmonary disease |
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