Hospitalisation outcomes in pneumococcal-vaccinatedversus-unvaccinated patients with exacerbation of COPD: results from the HOPE COPD Study

Abstract

BackgroundInfectious exacerbations are crucial events that dictate the natural course of COPD patients. Pneumococcal vaccination has shown to decrease incidence of community acquired pneumonia in COPD patients. There is paucity of data on outcomes of hospitalisation in pneumococcal vaccinated COPD patients in comparison with unvaccinated subjects.ObjectivesTo evaluate the difference in hospitalisation outcomes in pneumococcal vaccinatedversusunvaccinated COPD subjects hospitalized with Acute Exacerbation.MethodsThis was a prospective analytical study on 120 subjects hospitalised with acute COPD exacerbation. 60 patients with prior pneumococcal vaccination and 60 unvaccinated patients were recruited. Outcomes of hospitalisation like mortality rate, need for assisted ventilation, length of hospital stay, need for ICU care, and length of ICU stay were collected and compared between two groups with appropriate statistical tools.Results60% of unvaccinated patients (36/60) required assisted ventilation whereas only 43.3% of vaccinated subjects (26/60) needed assisted ventilation (p value 0.04). Most of the secondary outcomes were better in the vaccinated group. The mean length of ICU stay in the vaccinated group was 0.67 days (±1.11) compared to 1.77 (± 1.89) in the unvaccinated group. The mean length of hospital stay was 4.50 days (±1.64) and 5.47 days (±2.03) days in vaccinated and unvaccinated group respectively (p value 0.005).ConclusionsCOPD patients who have received prior pneumococcal vaccination have better outcomes when they are hospitalised for an acute exacerbation. Pneumococcal vaccination may be recommended for all patients with COPD who are at risk of hospitalisation with acute exacerbation.

Prevention of exacerbation in patients with moderate-to-very severe COPD with the intent to modulate respiratory microbiome: a pilot prospective, multi-center, randomized controlled trial

“…Influenza vaccination has been believed to reduce the frequency of AECOPD, the number of outpatient visits, hospitalizations, and mortality (20, 21). Similarly, Streptococcus pneumoniae vaccine was associated with the reduced risk of hospitalization for patients with moderate to severe COPD (22,23). Given that influenza virus and S. pneumococcal infections are among the most common microbial causes of AECOPD (10,14), we wondered if the inoculation of both vaccines simultaneously might be more effective.…”