International Journal of Chronic Obstructive Pulmonary Disease最新文献

{"title":"Plasma Levels of CXCL9 and MCP-3 are Increased in Asthma-COPD Overlap (ACO) Patients.","authors":"Jose Miguel Escamilla-Gil, Carlos A Torres-Duque, Kevin Llinás-Caballero, Nadia Juliana Proaños-Jurado, María M De Vivero, Jonathan Camilo Ramirez, Ronald Regino, Lucila Teresa Florez de Arco, Rodolfo Dennis, Mauricio González-García, Luis Caraballo, Nathalie Acevedo","doi":"10.2147/COPD.S506517","DOIUrl":"10.2147/COPD.S506517","url":null,"abstract":"<p><strong>Purpose: </strong>Asthma and chronic obstructive pulmonary disease overlap patients (ACO) have more exacerbations and a worse prognosis than pure asthma or COPD, and it is of great interest to identify differential biomarkers of ACO. We compared blood eosinophil counts, plasma IgE and protein levels among patients with asthma, ACO, COPD, and healthy subjects to identify those associated with ACO.</p><p><strong>Patients and methods: </strong>397 adults (age 40-90 years) were recruited from two Colombian cities: asthma (n=123), COPD (n=100), ACO (n=74) and healthy control (HC, n=100). Plasma protein levels were measured using the Proximity Extension Assay (Olink Proteomics).</p><p><strong>Results: </strong>There were no differences in blood eosinophil counts between the patient groups. Total and specified IgE levels were higher in patients with ACO than in those with COPD. Ten plasma proteins showed significant differences between the patients with ACO and HC. In patients above 60 years old, CXCL9 discriminates ACO from asthma patients with AUC 0.73 (0.63-0.82, DeLong test p=0.007), and in patients below 60 years old, MCP-3 discriminates ACO from COPD patients with AUC 0.84 (0.62-1.0, DeLong test p=0.006). CUB domain-containing protein 1 (CDCP1) levels (OR, 0.47; p=0.008) and age > 60 years (OR, 0.25; p=0.001) were negatively associated with ACO.</p><p><strong>Conclusion: </strong>CXCL9 levels could be used to discriminate ACO from asthma patients and MCP-3 to discriminate ACO from COPD. Protein inflammatory signatures in plasma of ACO patients were similar to the COPD group. This study revealed novel biomarkers that may help characterize patients with ACO.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1161-1174"},"PeriodicalIF":2.7,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Treatment for Hospitalized Patients with COPD: A Study on the Impact of a LINE App-Based Multidisciplinary Team Approach Targeting Pharmacological Treatment, Lifestyle Changes, and Smoking Cessation.","authors":"Hsiang-Yu Huang, Chia-Ling Chen, Yi-Ling Lin, Shu-Chuan Chen, Li-Chu Lee, Huei-Min Dai, Cheng-Yang Chiang, Yu-Fan Chang, Hsiu Lu, Mung-Rung Lee, Chih-Chiao Yang, Chiu-Hui Su, Ying-Zhen Chiang, Mei-Chen Yang, Rong-Yaun Shyu, Chou-Chin Lan","doi":"10.2147/COPD.S511869","DOIUrl":"https://doi.org/10.2147/COPD.S511869","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is a progressive respiratory condition that significantly impacts patients' health status. Effective management requires a multidisciplinary team (MDT) to address pharmacological and non- pharmacological treatments. The integration of mobile apps and devices improves COPD management by reducing symptoms and exacerbations. LINE, a commonly used communication app, enhanced team coordination and real-time decision-making. This study explored the effectiveness of LINE-based MDT interventions in hospitalized patients with COPD.</p><p><strong>Methods: </strong>This retrospective analysis included patients with COPD admitted for exacerbations and compared their outcomes before and after the implementation of LINE-based MDT care. The MDT consisted of pulmonologists, care managers, nurses, dietitians, social workers, pharmacists, respiratory therapists, and long-term care teams. A LINE group coordinated care in real-time, enabling the team to promptly review the patients' conditions, adjust treatment plans, and provide tailored interventions.</p><p><strong>Results: </strong>The LINE-based MDT group demonstrated significantly higher intervention rates, including systemic steroids, inhaled corticosteroids, long-acting beta-agonists, long-acting muscarinic antagonists, and pulmonary rehabilitation (p<0.05). BSRS improvement was greater in the MDT group than the non-MDT group (40.9% vs 29.7%, p = 0.016). However, there were no significant differences between the groups' readmission rates, emergency room visits, or one year survival (p>0.05).</p><p><strong>Conclusion: </strong>Implementing LINE-based MDT care significantly improved the delivery of pharmacological and non-pharmacological interventions, enhanced coordination, and facilitated comprehensive management, leading to better quality of life outcomes, as evidenced by improvements in BSRS scores. This highlights the value of leveraging real-time communication tools like LINE app to optimize COPD care.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1149-1159"},"PeriodicalIF":2.7,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Tracheal Stenosis Following Brief Intubation for an Acute Exacerbation of COPD.","authors":"Ju-Zhang Li, Qing Feng, Yu-Feng Liu, Jiang-Nan Zheng","doi":"10.2147/COPD.S503495","DOIUrl":"https://doi.org/10.2147/COPD.S503495","url":null,"abstract":"<p><p>Tracheal stenosis following brief intubation is a rare but serious complication and could be misdiagnosed in specific individuals, especially those with chronic obstructive pulmonary disease (COPD) and asthma. This case report describes a patient with COPD who developed tracheal stenosis following emergency intubation for an acute exacerbation. The patient was managed with invasive ventilation for 28 hours due to an acute exacerbation of COPD and pulmonary encephalopathy. After extubation, the patient presented with respiratory distress, which was successfully treated with bronchoscopic cryotherapy.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1143-1147"},"PeriodicalIF":2.7,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of Patients Initiated on Budesonide/Glycopyrronium Bromide/Formoterol Fumarate Single Inhaler Triple Therapy for the Treatment of Chronic Obstructive Pulmonary Disease: A Population-Based Observational Study.","authors":"Gaétan Deslee, Caroline Fabry-Vendrand, Elsa Salmi, Nolwenn Poccardi, Adrien Coriat, Idir Ghout, Caroline Eteve-Pitsaer, Nicola J Adderley, Henri Leleu","doi":"10.2147/COPD.S495086","DOIUrl":"https://doi.org/10.2147/COPD.S495086","url":null,"abstract":"<p><strong>Background: </strong>Budesonide/glycopyrronium bromide/formoterol fumarate (BUD/GLY/FOR) single inhaler triple therapy became available to prescribe to patients with severe chronic obstructive pulmonary disease (COPD) in France in 2021. The characteristics of patients prescribed BUD/GLY/FOR triple therapy and guideline adherence have not been previously described in France.</p><p><strong>Objective: </strong>To describe the characteristics of COPD patients initiated on BUD/GLY/FOR triple therapy, assess adherence to COPD management guidelines, and explore any differences by prescribing physician.</p><p><strong>Materials and methods: </strong>A cross-sectional study using data from The Health Improvement Network (THIN^®) France database was conducted. Patients with ≥2 recorded diagnostic codes for COPD were included. Demographic characteristics, comorbidities, management, COPD-related characteristics, and guideline adherence (Société de Pneumologie de Langue Française (SPLF); Haute Autorité de Santé (HAS)), stratified by initiating physician speciality (general practitioner (GP) or pulmonologist) were described.</p><p><strong>Results: </strong>A total of 263 patients initiating BUD/GLY/FOR triple therapy were included. Mean (SD) age was 68.8 (11.8) years; 53.6% were male. Mean (SD) COPD duration was 6.4 (5.5) years. Comorbidities were common, with slightly more cardiometabolic and mental health conditions recorded in the GP-initiated group, and more comorbid respiratory conditions recorded in the pulmonologist-initiated group. About 77.2% (n=203) of patients had at least one moderate or severe exacerbation in the 12 months before initiation. About 86.3% had a previous record of dual (n=117, 44.5%) or triple (n=110, 41.8%) therapy. About 68.8% had been initiated on BUD/GLY/FOR triple therapy in line with SPLF guidelines (62.4% and 72.4% in the GP- and pulmonologist-initiated groups, respectively); among those with a record of COPD severity, 75.2% were initiated in line with HAS guidelines (69.2% and 76.3% in the GP- and pulmonologist-initiated groups, respectively).</p><p><strong>Conclusion: </strong>The majority of COPD patients are prescribed BUD/GLY/FOR triple therapy in accordance with current treatment guidelines, irrespective of whether the therapy is prescribed by a general practitioner or a pulmonologist.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1131-1142"},"PeriodicalIF":2.7,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a Heating Voucher on Health Outcomes in COPD Patients: A Randomised Controlled Trial.","authors":"Helen Elizabeth Viggers, Tristram Richard Ingham, Ralph Brougham Chapman, Julian Crane, Ann Beatrice Currie, Cheryl Davies, Michael Keall, Philippa Lynne Howden-Chapman","doi":"10.2147/COPD.S483194","DOIUrl":"https://doi.org/10.2147/COPD.S483194","url":null,"abstract":"<p><strong>Purpose: </strong>Aotearoa New Zealand (NZ) homes are cold by international standards, with many failing to achieve temperatures recommended by WHO housing and health guidelines. Despite strong evidence of seasonal exacerbations in Chronic Obstructive Pulmonary Disease (COPD), there has been little examination of the effect of household warmth, or housing quality on COPD outcomes. The Warm Homes for Elder New Zealanders (WHEZ) study aimed to see if subsidising electricity costs would improve the health outcomes of older people with COPD. Previous analysis showed a modest, typically 2-10% dependent on prior usage, increase in electricity use among the subsidised households.</p><p><strong>Patients and methods: </strong>Participants aged over 55 with doctor-diagnosed COPD were recruited from three regional centres, and where possible their dwelling was insulated after enrolment. A single-blinded randomised controlled trial of the effect of an electricity voucher (NZ$500) on health care usage during winter was carried out in three locations across New Zealand. The primary outcome was exacerbations treated with antibiotics, and/or corticosteroids. The Clinical Trial Registration is NCT01627418. Of the 520 participants assigned to a wave, partial or better data was achieved for 424; 215 of those were randomised to the early intervention group, and 209 to receive the intervention later.</p><p><strong>Results: </strong>Despite the modest increase in energy use by study households, reported previously, there was no significant difference between study arms in the frequency of exacerbation of COPD (0.089, p=0.5875, 95% CI -1.406-1.584) nor hospitalisations. An exploratory analysis suggested a lower mortality among participants assigned to receive the intervention first (OR 0.310, p=0.0175, 95% CI 0.118-0.815).</p><p><strong>Conclusion: </strong>This study showed little effect of winter electricity vouchers on exacerbations of COPD. However, such vouchers increased energy use and may have reduced overall mortality. A larger study, particularly with susceptible subpopulations, is recommended to examine this mortality impact further.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1097-1109"},"PeriodicalIF":2.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recommendations for Improving Discharge-Related Care Following a COPD Exacerbation: An Expert Panel Consensus with Emphasis on Low- and Middle-Income Countries.","authors":"Adrian Rendon, Susana Luhning, Philip Bardin, Carlos Andrés Celis-Preciado, Moustafa El Shazly, Mark Cohen-Todd, Ahmad Izuanuddin Ismail, Majdy Idrees, Seong Yong Lim, Pin-Kuei Fu, Terence Seemungal, Nurdan Köktürk, John R Hurst","doi":"10.2147/COPD.S502971","DOIUrl":"https://doi.org/10.2147/COPD.S502971","url":null,"abstract":"<p><p>Exacerbations of chronic obstructive pulmonary disease (COPD) continue to place a considerable disease and financial burden on both patients and healthcare systems, particularly in low- and middle-income countries (LMICs). Therefore, preventing future exacerbations remains a key treatment goal. However, gaps remain in the standard of COPD care following exacerbations, despite the availability of evidence-based recommendations providing guidance on discharging patients from hospital or emergency department (ED) after a COPD exacerbation. To better understand these gaps in clinical practice, an advisory board meeting of 13 international pulmonologists was convened in September 2022, with the principal objective to formulate and recommend an evidence-based hospital discharge protocol following a COPD exacerbation, with a particular focus on LMICs. Based on identified gaps in COPD care, recommendations for alleviating the burden of exacerbations were proposed, which could be delivered as a discharge protocol for implementation in hospitals and/or ED. Following a review of the available clinical evidence, including an online survey of 11 pre-meeting questions and 5 additional questions discussed during the meeting, the key unmet needs identified by the experts included poor integration of standardized protocols in routine clinical practice, failure to ensure consistent delivery of post-discharge care, and lack of efficiently functioning healthcare systems. A protocol was formulated for delivery as part of a disease management program involving an interdisciplinary approach and a care bundle, aiming to address gaps in discharge-related care by determining the likelihood of readmission and optimizing maintenance treatment plans based on assessment of symptoms and future exacerbation risk. This can provide holistic care following hospital/ED discharge and personalized treatment plans by advocating referral to a specialist. To ensure wide-ranging uptake, implementation of a discharge protocol will need to be tailored to local healthcare settings by conducting feasibility studies, standardizing clinical pathways and healthcare policies, and engaging relevant stakeholders.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1111-1129"},"PeriodicalIF":2.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of Cuproptosis-Related Genes and Their Potential Role in COPD Pathogenesis: A Bioinformatics Analysis.","authors":"Qin Shen, Jin-Bo Huang, Mi Zhu, Dao-Jun Ji, Si-Jia Huang, Jun Li","doi":"10.2147/COPD.S497473","DOIUrl":"https://doi.org/10.2147/COPD.S497473","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide, and its pathogenesis and potentially relevant biomarkers require further study. Imbalance in copper (Cu²⁺) metabolism is related to a series of diseases, but its role in COPD has not been specified.</p><p><strong>Methods: </strong>A dataset relevant to COPD was downloaded from Gene Expression Omnibus database, among which a total of 18 cuproptosis-related genes (CRGs) were screened. The SimDesign package was used to perform single-factor Rogers regression to screen genes associated with disease phenotypes, risk score prediction models were constructed, and Receiver Operating Characteristic (ROC) curves were used to evaluate the efficacy of the prediction models. In addition, we verified the expression of CRGs in subtypes and the correlation between subtypes and clinical characteristics using a database. Finally, immune correlation analysis was used to explore immune cell infiltration.</p><p><strong>Results: </strong>Five biomarkers (DLST, GLS, LIPT1, MTF1, and PDHB) were identified. ROC analysis illustrated that these five biomarkers performed well (area under the curve (AUCs)>0.7), and the enrichment scores of diagnostic CRGs were significantly different among subtypes, among which the chi-square test P-values of the age groups were significantly different. The immune infiltration evaluation of cuproptosis subtypes revealed that the correlation analysis results of 22 types of immune cells showed a significant correlation between these cells, and the five CRGs were significantly correlated with the content of most immune cells in the 22 types of immune cells. The four pathways with the most significant differences in GSEA among subtypes were Oxidative Phosphorylation, Parkinson's Disease, Purine Metabolism, and Drug Metabolism Cytochrome P450.</p><p><strong>Conclusion: </strong>This study identified five candidate genes for further investigation (DLST, GLS, LIPT1, MTF1, and PDHB) and constructed disease prediction models and pathogenesis pathways. This study can provide a basis for further research on the role of cuproptosis in COPD.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1083-1096"},"PeriodicalIF":2.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise Prescription Training in Chronic Obstructive Pulmonary Disease: Benefits and Mechanisms.","authors":"Siqi Liu, Ailin Yang, Yue Yu, Bo Xu, Ganggang Yu, Haoyan Wang","doi":"10.2147/COPD.S512275","DOIUrl":"https://doi.org/10.2147/COPD.S512275","url":null,"abstract":"<p><p>Exercise rehabilitation training has emerged as one of the most promising modalities for enhancing clinical outcomes and overall well-being in patients with chronic obstructive pulmonary disease (COPD). Distinct exercise prescriptions yield different clinical benefits in this population. Endurance training has been demonstrated to significantly improve exercise capacity, alleviate dyspnea, and enhance health-related quality of life metrics. High-intensity interval training offers a time-efficient approach to boosting cardiorespiratory fitness and metabolic function. Resistance training addresses progressive muscle atrophy through targeted myofiber recruitment, thereby augmenting musculoskeletal performance and translating to enhanced exercise tolerance in patients with COPD. Exercise-mediated rehabilitation attenuates COPD progression and mitigates acute exacerbation risks via multifactorial mechanisms such as mitigation of inflammatory responses, reduction of oxidative stress, and improvement of endothelial cell function. Elucidating the pathophysiological mechanisms underlying exercise-induced benefits will pave the way for precision rehabilitation protocols, ultimately advancing COPD disease management paradigms, refining patient-centered outcome measures, and achieving sustainable health optimization in this clinical cohort.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1071-1082"},"PeriodicalIF":2.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics and Outcomes of Eosinophilic Exacerbations of COPD.","authors":"Matthew Donnan, Tong Lei Liu, Matthew Gvalda, Xinye Chen, Chuan T Foo, Martin Ian MacDonald, Francis Thien","doi":"10.2147/COPD.S485246","DOIUrl":"https://doi.org/10.2147/COPD.S485246","url":null,"abstract":"<p><strong>Introduction: </strong>The role of eosinophilic inflammation in exacerbations of chronic obstructive pulmonary disease (COPD) is increasingly recognised. Eosinophilic exacerbations have previously been associated with shorter hospital length of stay and lower inpatient mortality. The objective of this study was to examine clinical characteristics of hospitalised COPD exacerbations stratified by admission eosinophil count.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of exacerbations of COPD at an Australian tertiary health service between 1^st October 2019 and 30^th September 2020 that were identified using ICD-10 discharge codes. Patients were excluded if they received any systemic corticosteroids prior to hospitalisation. Admissions were stratified according to blood eosinophil count as high eosinophil (HE, ≥2% total white blood cell count), or low eosinophil (LE, <2%).</p><p><strong>Results: </strong>Four hundred and six patients were analysed. HE patients were younger (74.7 vs 77.7 years, p=0.001) and had fewer co-morbidities (1 [1-2] vs 2 [1-3], p=0.044). Patients with HE were less likely to be taking inhaled corticosteroids (59% vs 71%, p=0.017). HE exacerbations had a higher blood eosinophil count (0.31 vs 0.06 × 10⁹/L, p<0.0001), lower total white cell count (8.45 vs 10.6, p<0.001), lower CRP (10.4 vs 26.7, p<0.001), fewer infections (29.5% vs 52.1%, p<0.001) and less oxygen requirement (35.2% vs 46.8%, p=0.036). HE exacerbations had a shorter length of stay (3.56 vs 4.40 days, p=0.047) but similar inpatient mortality.</p><p><strong>Discussion: </strong>Eosinophilic exacerbations of COPD were phenotypically different, affect a younger, less co-morbid population and were associated with shorter length of stay. This may be useful to help prognosticate clinical outcomes and guide clinical management.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1061-1070"},"PeriodicalIF":2.7,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the COVID-19 Pandemic on ACO Prevalence Among AECOPD Patients (2019-2023) and Clinical Characteristics by Blood Eosinophil Levels.","authors":"Siming Zhang, Wenhui Song, Tongxinwei Sun, Siyu Wu, Zheng Wang, Aihong Meng","doi":"10.2147/COPD.S501626","DOIUrl":"https://doi.org/10.2147/COPD.S501626","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate changes in the prevalence of Asthma-COPD Overlap (ACO) among patients with Acute Exacerbations of COPD (AECOPD) from 2019 to 2023. It also compared the clinical characteristics of patients across EOS thresholds (50, 150, and 300 cells/μL) to identify disease severity markers and guide individualized treatment strategies.</p><p><strong>Patients and methods: </strong>Clinical data from AECOPD and ACO patients hospitalized at the Second Hospital of Hebei Medical University between January 2019 and December 2023 were analyzed. Patients were grouped by EOS levels (50, 150, and 300 cells/μL), and their clinical characteristics were compared.</p><p><strong>Results: </strong>Among 408 AECOPD and 275 ACO patients, the prevalence of ACO during the late pandemic period in 2023 was significantly higher than in the pre-pandemic period in 2019. ACO patients during the late pandemic period showed increased EOS counts and FeNO levels compared to pre-pandemic patients (P < 0.05). In AECOPD patients, those with EOS <50 cells/μL had lower lymphocyte counts and higher NLR and FDP levels than other groups. Similarly, in ACO patients, the EOS <50 cells/μL group showed lower lymphocyte counts and higher NLR levels. Patients with EOS ≥300 cells/μL were younger and exhibited higher FeNO levels than the EOS <50 and 50-150 cells/μL groups (P <0.05).</p><p><strong>Conclusion: </strong>The prevalence of ACO among AECOPD patients increased during the late pandemic period, possibly indicating a role for type 2 inflammation. EOS thresholds of 50, 150, and 300 cells/μL may serve as markers of disease severity and aid in tailoring individualized treatment strategies.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1051-1060"},"PeriodicalIF":2.7,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}