COPD and respiratory viral infections as risk factors for the development of cardiovascular events

<b>Introduction:</b> COPD exacerbations, most of them caused by viruses, are associated with higher incidence of CVE. Our main objective was to assess the influence of respiratory viral infections for the development of CVE in patients with COPD. <b>Methods:</b> A retrospective case-control study was performed. COPD patients with positive PCR for respiratory viruses during flu season between 2017 and 2018 were included. The controls were patients with COPD with negative PCR. We registered smoking history, phenotype, FEV1, sputum culture and cardiovascular risk factors (CVRF): high blood pressure, diabetes and dyslipidemia. We had a follow up of CVE and mortality during the year after the nasopharyngeal sample was obtained. <b>Results:</b> 122 patients with COPD were included. The most frequent phenotype was non exacerbator (37.7%). The mean FEV1 was 49.4%. They presented 1.1 exacerbations during the previous year. 66.4% had a viral infection. The most frequent viruses were Rhinovirus (23%). 95.1% had smoking history and 74.6% a CVRF. 16.4% developed a CVE and only 2 deceased. If we compare patients with viral infection with those without positive PCR, the first ones had less exacerbations during the previous year (0.8 vs 1.7 p0.01), with a higher incidence in men (100% vs 41.4% p0.00) and emphysema exacerbator phenotype (79.4%, p0.04). Exacerbations were not related with smoking history, previous CVRF, the development of new CVE or mortality. Furthermore, patients with CVRF did not developed more CVE (19.7% vs 6.4%; p0.06). <b>Conclusion:</b> In COPD patients, a respiratory viral infection is not a risk factor for the development of CVE. Viral infections in these patients are related with gender and COPD phenotype.