GOLD COPD Exacerbation History Categories and Disease Outcomes.

Importance: Previous exacerbations of chronic obstructive pulmonary disease (ECOPD) are associated with future events. For more than a decade, patients at high risk have been defined as individuals with a history of 2 or more moderate ECOPD, 1 or more severe ECOPD, or both within 12 months, and treatments have been allocated accordingly, but these cutoffs lack validation.

Objectives: To validate ECOPD history categories by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) and explore alternative cutoffs to estimate moderate and severe ECOPD and all-cause mortality in COPD.

Unravelling the Information Contained in the Single Items of the COPD Assessment Test for Different Outcomes and Smoking Status in Patients with COPD: Results from COSYCONET.

Background: The COPD Assessment Test (CAT) comprises eight questions. We evaluated the information that each of the questions and the total score contributed to outcomes and characteristics of chronic obstructive lung disease (COPD), including their dependence on smoking status.

Methods: Patients with COPD of the COSYCONET cohort with Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades 1-4 and the former grade 0 were included.

Association of Patients' Knowledge on the Disease and Its Management with Indicators of Disease Severity and Individual Characteristics in Patients with Chronic Obstructive Pulmonary Disease (COPD): Results from COSYCONET 2.

Background: In patients with chronic diseases, including those with chronic obstructive pulmonary disease (COPD), knowledge on the disease and its self-management is considered as relevant for improving disease control and long-term outcome. We studied to which extent components of knowledge depended on potential predictors, such as participation in educational programs and disease severity. For example, the perception of exacerbations or GOLD grade might modulate the content and reliability of COPD understanding.

Skin Markers of Premature Ageing in Patients with COPD: Results Form COSYCONET.

Chronic obstructive pulmonary disease (COPD) is commonly associated with ageing, with the prevalence and severity increasing by age. Smoking-induced premature ageing is thought to contribute to COPD, particularly lung emphysema. This study aimed to explore the relationship between lung function impairment and skin texture, as a marker of biological or premature ageing, in COPD patients.

Diffusion capacity and static hyperinflation as markers of disease progression predict 3-year mortality in COPD: Results from COSYCONET.

Background And Objective: Chronic obstructive pulmonary disease (COPD) exhibits diverse patterns of disease progression, due to underlying disease activity. We hypothesized that changes in static hyperinflation or KCO % predicted would reveal subgroups with disease progression unidentified by preestablished markers (FEV, SGRQ, exacerbation history) and associated with unique baseline biomarker profiles. We explored 18-month measures of disease progression associated with 18-54-month mortality, including changes in hyperinflation parameters and transfer factor, in a large German COPD cohort.

Midregional Proatrial Natriuretic Peptide (MRproANP) is associated with vertebral fractures and low bone density in patients with chronic obstructive pulmonary disease (COPD).

Background: Patients with COPD are often affected by loss of bone mineral density (BMD) and osteoporotic fractures. Natriuretic peptides (NP) are known as cardiac markers, but have also been linked to fragility-associated fractures in the elderly. As their functions include regulation of fluid and mineral balance, they also might affect bone metabolism, particularly in systemic disorders such as COPD.

[Development of two questionnaires for the assessment of knowledge and self-management in patients with chronic-obstructive pulmonary disease (COPD)].

Introduction: As with other chronic diseases, the course of chronic obstructive pulmonary disease (COPD) can be expected to be positively influenced if patients are well informed about their disease and undertake appropriate self-management. Assessments of the level of knowledge and management that are comparable should benefit from structured, systematically developed questionnaires. These, however, have not been published in Germany.

Effects of triple therapy on disease burden in patients of GOLD groups C and D: results from the observational COPD cohort COSYCONET.

Background: Randomized controlled trials described beneficial effects of inhaled triple therapy (LABA/LAMA/ICS) in patients with chronic obstructive pulmonary disease (COPD) and high risk of exacerbations. We studied whether such effects were also detectable under continuous treatment in a retrospective observational setting.

Methods: Data from baseline and 18-month follow-up of the COPD cohort COSYCONET were used, including patients categorized as GOLD groups C/D at both visits (n = 258).

Characteristics of Current Smokers versus Former Smokers with COPD and Their Associations with Smoking Cessation Within 4.5 Years: Results from COSYCONET.

Background: Many patients with chronic obstructive pulmonary disease (COPD) continue smoking. We used data from the "real-life" COSYCONET COPD cohort to evaluate whether these patients differed from patients with COPD who either had ceased smoking prior to inclusion or ceased during the follow-up time of the study.

Methods: The analysis was based on data from visits 1-5 (covering 4.

Clinical factors linked to the type of respiratory medication in COPD: results from the COSYCONET cohort.

Background: The use of maintenance medication in patients with chronic obstructive pulmonary disease (COPD) in real life is known to deviate from recommendations in guidelines, which are largely based on randomized controlled trials and selected populations.

Objectives: We used the COSYCONET (PD and stemic Consequences - morbidities work) cohort to analyze factors linked to the use of COPD drugs under non-interventional circumstances.

Design: COSYCONET is an ongoing, multi-center, non-interventional cohort of patients with COPD.

[Retrospective clinical-causal evaluation of a positive PCR for SARS-CoV-2 in hospitalised patients across the age spectrum in a primary care hospital].

Introduction: It is often discussed that a positive PCR for SARS-CoV-2 in hospitalized patients may not be causally linked to the hospital stay, but no scientific data are available from Germany. Therefore, we analyzed to what extent a positive PCR test could be assessed as causal or secondary to admission according to clinical criteria in a tertiary care hospital of the first 4 months of 2022.

Methods: SARS-CoV-2-positive patients of RoMed-Klinikum Rosenheim/Bavaria from 01/01/2022 to 30/04/2022 were included.

Phenotyping asthma with airflow obstruction in middle-aged and older adults: a CADSET clinical research collaboration.

Background: The prevalence and clinical profile of asthma with airflow obstruction (AO) remain uncertain. We aimed to phenotype AO in population- and clinic-based cohorts.

Methods: This cross-sectional multicohort study included adults ≥50 years from nine CADSET cohorts with spirometry data (N=69 789).

[COPD - what has changed in GOLD 2023 and is relevant for clinical practice?].

The annual report of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) is one of the most relevant documents covering prevention, diagnosis and treatment of chronic obstructive pulmonary disease (COPD). The 2023 edition contains a number of changes with impact on clinical practice. For assessment and categorization, a new patient group termed E based on individual exacerbation history has been introduced.

Standardized airway wall thickness Pi10 from routine CT scans of COPD patients as imaging biomarker for disease severity, lung function decline, and mortality.

Background: Chest computed tomography (CT) is increasingly used for phenotyping and monitoring of patients with COPD. The aim of this work was to evaluate the association of Pi10 as a measure of standardized airway wall thickness on CT with exacerbations, mortality, and response to triple therapy.

Methods: Patients of GOLD grades 1-4 of the COSYCONET cohort with prospective CT scans were included.

[Adherence to CPAP Three Months after Starting Therapy in 1078 Patients with Obstructive Sleep Apnea (OSA)].

Introduction: Nocturnal Continuous Positive Airway Pressure (CPAP) is considered the gold standard treatment for obstructive sleep apnoea (OSA). The CPAP therapy is a long-term treatment but does come with few possible side effects. The adherence to the therapy is frequently suboptimal.

Cardiovascular predictors of mortality and exacerbations in patients with COPD.

In chronic obstructive pulmonary disease (COPD), comorbidities and worse functional status predict worse outcomes, but how these predictors compare with regard to different outcomes is not well studied. We thus compared the role of cardiovascular comorbidities for mortality and exacerbations. Data from baseline and up to four follow-up visits of the COSYCONET cohort were used.

[What have we learned from the German COPD cohort COSYCONET and where do we go from here?].

COSYCONET 1 is the only German COPD cohort which is large enough to be internationally comparable. The recruitment, which started in 2010 and ended in December 2013, comprised 2741 patients with the diagnosis of COPD who were subsequently investigated in regular follow-up visits. All visits included a comprehensive functional and clinical characterisation.

Differential Impact of Low Fat-Free Mass in People With COPD Based on BMI Classifications: Results From the COPD and Systemic Consequences-Comorbidities Network.

Background: Alterations in body composition, including a low fat-free mass index (FFMI), are common in patients with COPD and occur regardless of body weight.

Research Question: Is the impact of low FFMI on exercise capacity, health-related quality of life (HRQL), and systemic inflammation different among patients with COPD stratified in different BMI classifications?

Study Design And Methods: We analyzed baseline data of patients with COPD from the COPD and Systemic Consequences-Comorbidities Network (COSYCONET) cohort. Assessments included lung function, bioelectrical impedance analysis, 6-min walk distance (6MWD), HRQL, and inflammatory markers.

A new approach for the detection of obesity-related airway obstruction in lung-healthy individuals.

Background: Subjects with obesity show an increased prevalence of airway obstruction but it is not clear in each case whether this reflects genuine lung disease. Via intentional increase in end-expiratory lung volume we studied the detection of obesity-induced airway obstruction in lung-healthy obese subjects.

Methods: The primary study population comprised 66 lung-healthy obese subjects and 23 normal weight subjects.

Association of coronary artery calcification with clinical and physiological characteristics in patients with COPD: Results from COSYCONET.

Chronic obstructive pulmonary disease (COPD) is frequently associated with coronary artery disease (CAD). When considering computed tomography (CT) for COPD phenotyping, coronary vessel wall calcification would be a potential marker of cardiac disease. However, non-ECG gated scans as used in COPD monitoring do not comply with established quantitative approaches using ECG-triggered CT and the Agatston score.

Disease Progression and Age as Factors Underlying Multimorbidity in Patients with COPD: Results from COSYCONET.

Background: Multimorbidity plays an important role in chronic obstructive pulmonary disease (COPD) but is also a feature of ageing. We estimated to what extent increases in the prevalence of multimorbidity over time are attributable to COPD progression compared to increasing patient age.

Methods: Patients with COPD from the long-term COSYCONET (COPD and Systemic Consequences - Comorbidities Network) cohort with four follow-up visits were included in this analysis.

Basic Determinants of Disease Knowledge in COPD Patients: Results from COSYCONET.

Introduction: In many chronic diseases, including COPD, the patients' basic knowledge of the disorder has been shown to be relevant for the course of the disease. We studied which clinical and functional characteristics were related to this knowledge as well as the patients' satisfaction with their knowledge about COPD.

Methods: The study population comprised 645 patients of GOLD grades 1-4 who participated in Visit 6 of the COSYCONET cohort (COPD and Systemic Consequences - Comorbidities Network).