Abstract
Introduction: The aim of this study was to compare the differences between elderly and non-elderly patients with AECOPD due to a viral infection.
Methods: Patients presenting with an AECOPD were recruited. They were classified as elderly (>65 years) and non-elderly (<65 years). Sputum and oropharyngeal samples were assessed, PCR for respiratory viruses and cultures for common pathogens were performed. Clinical outcome was reported.
Results: During the study period 247 patients were recruited [median age 69.3±9.5 years] and categorized in two groups: group A, non elderly [n=81 (32.8%) median age 58±5.99)] and group B elderly patients [n=166 (67.2%) median age 74.8±4.8 years]. In 133 (53.8%) patients a viral infection was identified and in 34 (13.8%) a bacterial pathogen was isolated from sputum or blood culture. In 18 (7.3%) patients a dual infection from both a bacterial and a viral pathogen was identified. In Group B influenza vaccination (57% vs 21%, p<0.001), comorbidities (cardiac failure 55.4% vs 28.3%, p<0.001, renal failure 13.8% vs 4%, p=0.03), bacterial infections [28(16.9%) vs 6 (7%) patients, p=0.04] and longer hospital stay (8.9±4.8 vs 7.5±3.2 days, p=0.02) were higher with a statistical significant difference. No differences were identified in the rate [elderly 93 (69.9%), non-elderly 40(49.4%), p=0.3] of isolated viruses.
Conclusion: In this study in elderly patients with AECOPD were identified a higher vaccination rate against influenza, more comorbitities, more bacterial infections and longer hospitalization compared to non elderly patients but no differences on the rate and the type of viral infections which led to exacerbations.