https://doi.org/10.4081/monaldi.2024.2927
Prevalence and risk factors for chronic pulmonary aspergillosis in chronic obstructive pulmonary disease patients with acute exacerbations
Submitted: February 12, 2024
Accepted: March 13, 2024
Published: March 21, 2024
Accepted: March 13, 2024
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Chronic obstructive pulmonary disease (COPD) patients often experience acute exacerbations requiring hospitalization. Recently, attention has focused on Aspergillus sensitization in the airways of these COPD patients. This study aimed to assess the prevalence of chronic pulmonary aspergillosis (CPA) in COPD patients with acute exacerbations and identify associated risk factors. A cross-sectional descriptive study was conducted at the Jawaharlal Institute of Postgraduate Medical Education and Research from January 2021 to June 2022. Sixty-one COPD patients presenting with acute exacerbations were included. Demographic details, blood investigations, and sputum examinations were performed for all patients. A high-resolution computed tomography thorax was conducted for eligible patients. The prevalence of CPA among patients with an acute exacerbation of COPD was found to be 9.8%, with chronic cavitary pulmonary aspergillosis being the most common presentation (50%). Among post-tubercular COPD patients, the prevalence of CPA was significantly higher at 22.7%. Hemoptysis (p<0.001) and a previous history of tuberculosis (p=0.008) were associated with Aspergillus sensitization. This study highlights the substantial prevalence of CPA in COPD patients with acute exacerbations, particularly in those with a history of tuberculosis. Early recognition and targeted management of CPA in COPD patients may improve outcomes and reduce hospitalization rates. Further large-scale multi-center studies are needed to validate these findings and comprehensively address the impact of CPA on all COPD patients.
Bongomin F, Gago S, Oladele RO, et al. Global and multi-national prevalence of fungal diseases-estimate precision. J Fungi 2017;3:57.
DOI: https://doi.org/10.3390/jof3040057
Smith NL, Denning DW. Underlying conditions in chronic pulmonary aspergillosis including simple aspergilloma. Eur Respir J 2011;37:865-72.
DOI: https://doi.org/10.1183/09031936.00054810
Denning DW, Cadranel J, Beigelman-Aubry C, et al. Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management. Eur Respir J 2016;47:45-68.
DOI: https://doi.org/10.1183/13993003.00583-2015
Lopez AD, Shibuya K, Rao C, et al. Chronic obstructive pulmonary disease: current burden and future projections. Eur Respir J 2006;27:397-412.
DOI: https://doi.org/10.1183/09031936.06.00025805
Celli BR, Fabbri LM, Aaron SD, et al. An updated definition and severity classification of chronic obstructive pulmonary disease exacerbations: the Rome proposal. Am J Respir Crit Care Med 2021;204:1251-8.
DOI: https://doi.org/10.1164/rccm.202108-1819PP
Sethi S, Murphy TF. Infection in the pathogenesis and course of chronic obstructive pulmonary disease. N Engl J Med 2008;359:2355-65.
DOI: https://doi.org/10.1056/NEJMra0800353
Gu Y, Ye X, Liu Y, et al. A risk-predictive model for invasive pulmonary aspergillosis in patients with acute exacerbation of chronic obstructive pulmonary disease. Respir Res 2021;22:176.
DOI: https://doi.org/10.1186/s12931-021-01771-3
Shawki M, Abdel-Hamid HM. Prevalence of pulmonary aspergillosis among chronic obstructive pulmonary disease patients presented with acute exacerbation. Egypt J Chest Dis Tuberc 2019;68:129-34.
DOI: https://doi.org/10.4103/ejcdt.ejcdt_42_18
Nguyen NTB, Le Ngoc H, Nguyen NV, et al. Chronic pulmonary aspergillosis situation among post tuberculosis patients in Vietnam: an observational study. J Fungi 2021;7:532.
DOI: https://doi.org/10.3390/jof7070532
Yoshimura K, Suzuki Y, Inoue Y, et al. Utility of serum Aspergillus-galactomannan antigen to evaluate the risk of severe acute exacerbation in chronic obstructive pulmonary disease. PLoS One 2018;13:e0198479.
DOI: https://doi.org/10.1371/journal.pone.0198479
Decramer M, Janssens W, Miravitlles M. Chronic obstructive pulmonary disease. Lancet 2012;379:1341-51.
DOI: https://doi.org/10.1016/S0140-6736(11)60968-9
Kohansal R, Martinez-Camblor P, Agustí A, et al. The natural history of chronic airflow obstruction revisited: an analysis of the Framingham Offspring Cohort. Am J Respir Crit Care Med 2009;180:3-10.
DOI: https://doi.org/10.1164/rccm.200901-0047OC
Yin P, Jiang C, Cheng K, et al. Passive smoking exposure and risk of COPD among adults in China: the Guangzhou Biobank cohort study. Lancet 2007;370:751-7.
DOI: https://doi.org/10.1016/S0140-6736(07)61378-6
Page ID, Byanyima R, Hosmane S, et al. Chronic pulmonary aspergillosis commonly complicates treated pulmonary tuberculosis with residual cavitation. Eur Respir J 2019;53:1801184.
DOI: https://doi.org/10.1183/13993003.01184-2018
Molinos-Castro S, Pesqueira-Fontán PM, Rodríguez-Fernández S, et al. Clinical factors associated with pulmonary aspergillosis in patients with chronic obstructive pulmonary disease. Enferm Infecc Microbiol Clin 2020;38:4-10.
DOI: https://doi.org/10.1016/j.eimce.2019.06.007
Agarwal R, Denning DW, Chakrabarti A. Estimation of the burden of chronic and allergic pulmonary aspergillosis in India. PLoS One 2014;9:e114745.
DOI: https://doi.org/10.1371/journal.pone.0114745
Iqbal N, Irfan M, Mushtaq A, et al. Underlying conditions and clinical spectrum of chronic pulmonary aspergillosis (CPA): an experience from a tertiary care hospital in Karachi, Pakistan. J Fung 2020;6:41.
DOI: https://doi.org/10.3390/jof6020041
Denning DW, Cole DC, Ray A, et al. New estimation of the prevalence of chronic pulmonary aspergillosis (CPA) related to pulmonary TB - a revised burden for India. IJID Regions 2023;6:7-14.
DOI: https://doi.org/10.1016/j.ijregi.2022.11.005
Bafadhel M, Mckenna S, Agbetile J, et al. Aspergillus fumigatus during stable state and exacerbations of COPD. Eur Respir J 2014;43:64-71.
DOI: https://doi.org/10.1183/09031936.00162912
Aggarwal D, Gupta A, Janmeja A, et al. Evaluation of tuberculosis-associated chronic obstructive pulmonary disease at a tertiary care hospital: a case–control study. Lung India 2017;34:415-9.
DOI: https://doi.org/10.4103/lungindia.lungindia_522_16
Denning DW. Diagnosing pulmonary aspergillosis is much easier than it used to be: a new diagnostic landscape. Int J Tuberc Lung Dis 2021;25:525-36.
DOI: https://doi.org/10.5588/ijtld.21.0053
Moghoofei M, Azimzadeh Jamalkandi S, Moein M, et al. Bacterial infections in acute exacerbation of chronic obstructive pulmonary disease: a systematic review and meta-analysis. Infection 2020;48:19-35.
DOI: https://doi.org/10.1007/s15010-019-01350-1
Huerta A, Soler N, Esperatti M, et al. Importance of Aspergillus spp. isolation in acute exacerbations of severe COPD: prevalence, factors and follow-up: the FUNGI-COPD study. Respir Res 2014;15:17.
DOI: https://doi.org/10.1186/1465-9921-15-17
Tong X, Cheng A, Xu H, et al. Aspergillus fumigatus during COPD exacerbation: a pair-matched retrospective study. BMC Pulm Med 2018;18:55.
DOI: https://doi.org/10.1186/s12890-018-0611-y
Ethics Approval
The study protocol was approved by Institutional Ethical Committee for observational studies DHR REG.NO.EC/NEW/INST/2020/331 issued by Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER) (Protocol no. JIP/IEC/2021/077 dated 25/06/2021).How to Cite
Palanivel, Jayabharathi, Madhusmita Mohanty Mohapatra, Manju Rajaram, Debasis Gochhait, Sunitha Vellathussery Chakkalakkoombil, and Rakesh Singh. 2024. “Prevalence and Risk Factors for Chronic Pulmonary Aspergillosis in Chronic Obstructive Pulmonary Disease Patients With Acute Exacerbations”. Monaldi Archives for Chest Disease, March. https://doi.org/10.4081/monaldi.2024.2927.
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