Contribution of Influenza to Acute Exacerbations of Chronic Obstructive Pulmonary Disease in Kashmir, India, 2010–2012

Parvaiz A. Koul; Umar H. Khan; Romana Asad; Rubaya Yousuf; Shobha Broor; Renu B. Lal; Fatimah S. Dawood


Influenza Resp Viruses. 2015;9(1):40-42. 

In This Article

Abstract and Introduction


We estimate the contribution of influenza to hospitalizations for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) in Kashmir, India. Prospective surveillance for influenza among patients hospitalized with AECOPD was conducted at a tertiary care hospital. Patients had clinical data collected and nasal/throat swabs tested for influenza viruses. Outcomes among patients with and without influenza were compared with logistic regression adjusting for age and underlying conditions. During October 2010–September 2012, 498 patients hospitalized with AECOPD were enrolled, of whom 40 (8%) had received influenza vaccine. Forty (8%) had influenza; influenza virus detection peaked in winter (January–March). Patients with influenza were more likely to die during hospitalization (adjusted OR 3·4, CI 1·0–11·4) than those without.


Globally, an estimated 64 million people have chronic obstructive pulmonary disease (COPD), with 90% of COPD deaths occurring in low- and middle-income countries.[1] In India, estimates of COPD prevalence in India have varied from 2 to 20% depending upon method of diagnosis. In Kashmir, India, the prevalence of spirometrically diagnosed COPD is 17% in males and 15% in females aged ≥40 years.[2] Against a backdrop of high COPD prevalence, measures to prevent COPD exacerbations in India would have substantial public health impact. However, seasonal influenza vaccines are not routinely recommended for any target group in India due in part to a lack of national data on influenza.[3] We used data from prospective surveillance for influenza among patients hospitalized with acute exacerbations of COPD (AECOPD) to estimate the contribution of influenza to the overall burden of AECOPD and describe the epidemiology of AECOPD at a tertiary care hospital in Kashmir, India.