Acute Exacerbation and Respiratory InfectionS in COPD (AERIS): protocol for a prospective, observational cohort study

Bourne, Simon; Cohet, Catherine; Kim, Viktoriya; Barton, Anna; Tuck, Andy; Aris, Emmanuel; Mesia-Vela, Sonia; Devaster, Jeanne-Marie; Ballou, W Ripley; Clarke, Stuart; Wilkinson, Tom

• Cohort retention is a key factor in the successful delivery of such a study and with in-depth sampling protocols, participant engagement, comfort and feedback are key factors in optimising cohort retention and comprehensive data collection. Considerable progress has been made concerning the epidemiology, pathophysiology and clinical management of COPD in recent years. However, significant challenges remain. Improved understanding of acute exacerbations of COPD (AECOPD) is a key research priority. AECOPD are highly relevant clinically, being a major cause of COPD-related morbidity and mortality, 7-11 as well as accounting for a substantial proportion of the significant social, healthcare and economic burden of COPD. 6 It has been estimated that AECOPD account for approximately 70% of total healthcare costs associated with COPD. 12 Patients with Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage II or more disease experience 1 or 2 exacerbations annually. Exacerbation varies from patient to patient with severity of disease. 13 Various triggers for AECOPD have been identified; 1 however, up to 75% of all exacerbations are associated with the detection Molecular diagnostic and typing techniques will be used to describe the dynamics of airway infection and its potential association with clinical outcome. The study will also assess the impact of AECOPD on health-related quality-of-life and healthcare resource utilisation, as well as the possible interaction between disease endotype and exacerbations.