Association Between Air Pollution and Viral Infection in Severe Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Choi, Juwhan; Shim, Jae Jeong; Lee, Myung Goo; Rhee, Chin Kook; Joo, Hyonsoo; Lee, Jin Hwa; Park, Hye Yun; Kim, Woo Jin; Um, Soo-Jung; Kim, Deog Kyeom; Min, Kyung Hoon

doi:10.3346/jkms.2023.38.e68

Cited by 10 publications

(1 citation statement)

References 23 publications

(27 reference statements)

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“…Exacerbations of respiratory symptoms in individuals with COPD can arise from numerous factors, either independently or in combination. These factors encompass respiratory infections triggered by bacteria or viruses, which might concurrently exist, as well as environmental pollutants or unidentified triggers [34]. During these exacerbation episodes, there is observable evidence of heightened inflammation within the airways and throughout the body.…”

Section: Discussionmentioning

confidence: 99%

The Effectiveness and Safety of Long-Term Macrolide Therapy for COPD in Stable Status: A Systematic Review and Meta-Analysis

Nakamura,

Fujita,

Chen

et al. 2023

Diseases

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Background: Chronic obstructive pulmonary disease (COPD) is a prevalent condition with fewer treatments available as the severity increases. Previous systematic reviews have demonstrated the benefits of long-term macrolide use. However, the therapeutic differences between different macrolides and the optimal duration of use remain unclear. Methods: A systematic review and meta-analysis were conducted to assess the effectiveness of long-term macrolide use in reducing COPD exacerbations, compare the therapeutic differences among macrolides, and determine the appropriate treatment duration. Four databases (PubMed, Cochrane Library, Web of Science, and ICHU-SHI) were searched until 20 March 2023, and a random-effects model was used to calculate the pooled effect. Results: The meta-analysis included nine randomized controlled trials involving 1965 patients. The analysis revealed an odds ratio (OR) of 0.34 (95% confidence interval [CI] 0.19, 0.59, p < 0.001) for the reduction in exacerbation frequency. Notably, only azithromycin or erythromycin showed suppression of COPD exacerbations. The ORs for reducing exacerbation frequency per year and preventing hospitalizations were −0.50 (95% CI: −0.81, −0.19; p = 0.001) and 0.60 (95% CI: 0.3, 0.97; p = 0.04), respectively. Statistical analyses showed no significant differences between three- and six-month macrolide prescriptions. However, studies involving a twelve-month prescription showed an OR of 0.27 (95% CI: 0.11, 0.68; p = 0.005; I2 = 81%). Although a significant improvement in St George’s Respiratory Questionnaire (SGRQ) total scores was observed with a mean difference of −4.42 (95% CI: −9.0, 0.16; p = 0.06; I2 = 94%), the minimal clinically important difference was not reached. While no adverse effects were observed between the two groups, several studies have reported an increase in bacterial resistance. Conclusions: Long-term use of azithromycin or erythromycin suppresses COPD exacerbations, and previous studies have supported the advantages of a 12-month macrolide prescription over a placebo.

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Section: Discussionmentioning

confidence: 99%

The Effectiveness and Safety of Long-Term Macrolide Therapy for COPD in Stable Status: A Systematic Review and Meta-Analysis

Nakamura,

Fujita,

Chen

et al. 2023

Diseases

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Associations Between Air Pollution and the Onset of Acute Exacerbations of COPD

Niu,

Meng

et al. 2024

CHEST

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Characteristics of the Spatiotemporal Distribution of Influenza Incidence and Its Driving Factors Among Residents in Mainland China From 2004 to 2018

Yao,

Ma,

et al. 2024

GeoHealth

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Influenza is an acute respiratory infection that spreads rapidly and widely in densely populated areas with low vaccination coverage. The trends and drivers of the spatial and temporal dynamics of influenza incidence among residents of mainland China have not been systematically studied. This study comprehensively analyses the dynamics and spatial correlation of influenza using long‐term scale data and spatial panel data. It then identifies the interactive process of socio‐economic and natural elements on the incidence of influenza. The highest prevalence of influenza was found in the 0–4 years age group in mainland China (mean prevalence, 67.56/100,000). In addition, influenza in mainland China shows seasonality, with fall and winter being the periods of high incidence. Between 2014 and 2017, influenza incidence was clustered in Hubei and Anhui provinces, and the spatial clustering was statistically significant (Z value > 1.96, P < 0.05). Moreover, the directionality of influenza onset continued to increase each year. Specifically, the clustering of influenza onset was stronger in the northwest‐southeast direction than in the southwest‐northeast direction between 2014 and 2018. The significant role of socioeconomic factors as a primary influence on influenza incidence, while their interaction with natural factors, such as air quality (NOx and PM2.5) and climatic conditions can exacerbate regional outbreaks. This study provides a novel perspective for better prevention and control of influenza disease among mainland Chinese residents.

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Association Between Air Pollution and Viral Infection in Severe Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Cited by 10 publications

References 23 publications

The Effectiveness and Safety of Long-Term Macrolide Therapy for COPD in Stable Status: A Systematic Review and Meta-Analysis

The Effectiveness and Safety of Long-Term Macrolide Therapy for COPD in Stable Status: A Systematic Review and Meta-Analysis

Associations Between Air Pollution and the Onset of Acute Exacerbations of COPD

Characteristics of the Spatiotemporal Distribution of Influenza Incidence and Its Driving Factors Among Residents in Mainland China From 2004 to 2018

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