Patients with chronic obstructive pulmonary disease (COPD) who have frequent exacerbations were more likely to have a history of exacerbations, anxiety, and be unvaccinated against influenza, according to the results of a study published in Respiratory Medicine.

Clinical, comorbidity, and exacerbation history from patients enrolled in the Palomb project — an ongoing, prospective, multicenter, observational cohort of patients with COPD recruited from pulmonary clinics in France — diagnosed with COPD were collected. The researchers hypothesized that COPD exacerbations were associated with comorbidities and vaccination status.

Of the 932 patients with COPD included in the study, 446 were followed for ≥3 years and had a complete set of data. A total of 252 patients with COPD reported ≥2 exacerbations in the year before enrollment, of whom 142 also had frequent exacerbations in the first year of the study, and 69 who continued to have frequent exacerbations in the second year of the study. A history of exacerbations, presence of anxiety, and absence of the annual influenza vaccination were associated with the phenotypes for frequent exacerbations.

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 “Our study shows that the most important determinants of frequent exacerbations are: history of exacerbations, anxiety and unvaccinated against influenza,” the study authors wrote. “These analyses show the existence and clinical relevance of two frequent exacerbators’ phenotypes of patients with COPD and the currently used threshold to define this phenotype.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Ouaalaya EH, Falque L, Dupis JM, et al. Susceptibility to frequent exacerbation in COPD patients: impact of the exacerbations history, vaccinations and comorbidities? [published online May 11 2020]. Respir Med. doi:10.1016/j.rmed.2020.106018