How Common Does RSV Infection Cause A COPD Flare-up?

Background

Respiratory syncytial virus (RSV) is a common respiratory virus that is increasing recognized as a major cause of COPD flare-ups (exacerbations). It is important to be able to diagnosis RSV as other viruses (Influenza and COVID-19) and bacteria can also cause flare-ups. Accurate diagnosis can lead to appropriate treatment if such is available. Moreover, trials of RSV vaccines have shown excellent safety and efficacy in older adults.

Study

Dr. Dexter Wiseman and colleagues from the National Heart and Lung Institute in London evaluated the frequency of out-patient flare-ups due to RSV infection in patients with COPD. Subjects were recruited at respiratory clinics in London, UK, and Groningen, the Netherlands, starting in 2017 and observed fro three consecutive RSV seasons.

The results were published in the October 15, 2024, issue of the American Journal of Respiratory and Critical Care Medicine (volume 210; pages 994-1001).

Results

A total of 377 patients with COPD attended 1,999 clinic visits and reported 310 flare-ups. The diagnosis was made by viral testing of swabs of the nose-throat (nasopharyngeal) and/or sputum (if available) or by blood tests (protein-specific IgG). Testing of these specimens also evaluated possible infection due to rhinovirus, influenza A and B, COVID-19 virus, human enterovirus, human adenovirus, parainfluenza, and human metapneumovirus.

Overall, 8.7% of the flare-ups were due to RSV infection.

Electron micrograph of filamentous RSV particles

Conclusions

RSV is associated with 8.7% of out-patient flare-ups (exacerbations) in this study. Currently, vaccines are available that prevent RSV infections.

Subcutaneous injection of RSV vaccine in the arm

My Comments

In most regions of the United States, RSV season generally starts during fall and peaks in the winter. The timing and severity of RSV season in a given community can vary from year to year.

At the present time, there is no specific treatment for RSV if you were to become infected with this virus and developed a cough, shortness of breath, and/or wheezing. In my practice, I recommend the RSV vaccine to my patients with COPD in an effort to prevent infection and/or severe illness.