Chronic obstructive pulmonary disease

In 2017, it was estimated that 544.9 million people were living with, and 3.9 million died from chronic respiratory diseases, making it the third leading causes of death globally.

Due to chronic changes in the lungs, respiratory infections are particularly troublesome for people with chronic respiratory diseases such as chronic obstructive pulmonary disease (COPD) and asthma.

COPD is a seriously debilitating and eventually deadly disease, characterized by chronic bronchitis and emphysema. Symptoms include shortness of breath, wheezing, chest tightness, cough, increased mucus in the lungs and frequent respiratory infections. People with COPD are also likely to experience episodes called exacerbations, during which their symptoms become worse than usual, and last for at least several days. During exacerbations, hospitalization may be needed and there is an increased risk of serious complications and even death if not managed properly.

In 2016, the global prevalence of COPD was estimated at 251 million cases. It is also implicated in 5% of all deaths. COPD doesn’t strike equally and is considerably more prevalent in low and middle income countries. Tobacco smoking is the most important etiological factor in COPD, but there are other risk factors, including outdoor and indoor pollution and occupational dusts and fumes, as well as frequent childhood respiratory infections.

“COPD doesn’t strike equally and is considerably more prevalent in low and middle income countries.”

It is expected that COPD will increase in the coming years due to the higher prevalence of smoking and an aging population. There is no cure for COPD. Available treatments primarily include ventilatory support, bronchodilating drugs, anti-inflammatory drugs and antibiotics. Both acute and chronic lower airway infections are more common in patients with COPD than in healthy subjects and it constitutes an important comorbidity for this group of patients. Furthermore, recurrent acute infections of both bacterial and viral origin have been clearly linked to the occurrence of exacerbations.

For many years, it was believed that bacterial infections were the main infectious agents in exacerbations. However, it has recently been demonstrated that viruses are present in about 50% of the cases. The viruses most frequently associated with COPD exacerbations are EV (including RV), RSV, the influenza virus and coronavirus. EVs have been found in several reports to be the most frequently found virus in COPD exacerbations, and an effective EV antiviral is expected to greatly improve the quality of life of COPD patients, and reduce morbidity, mortality, and healthcare costs.