Characterisation of winter respiratory viral infections in patients
with asthma and COPD in Qatar
Hisham A. Sattar
Received: 12 September 2012 / Accepted: 6 November 2012 / Published online: 14 December 2012
Ó Springer-Verlag Wien 2012
Abstract Respiratory viruses in patients with chronic
obstructive pulmonary disease (COPD) or asthma have not
been characterised in Qatar. This study aimed to identify
the most common viral strains responsible for respiratory
tract infections in asthma/COPD patients (without exacer-
bations) in Qatar during the winter season (2008-2009).
Nasal swabs from patients with asthma/COPD and respi-
ratory symptoms were evaluated for 15 common viruses.
200 adult patients (190 with asthma and 10 with COPD)
were enrolled. Viral infections were present in 36 out of
200 patients (18 %). Cough and wheezing were the most
common symptoms. Rhinovirus was the most common
causative agent, followed by coronaviruses. Our ﬁndings
conﬁrm previous reports of rhinovirus prevalence in
respiratory tract infections in asthma/COPD. A country-
wide survey to conﬁrm our ﬁndings is warranted.
Respiratory viruses in patients with underlying lung dis-
eases such as chronic obstructive pulmonary disease
(COPD) or asthma are associated with exacerbations and
excess morbidity and mortality. Murphy et al. reported that
inﬂuenza in patients with asthma can cause acute exacer-
bations, whereas in patients with COPD, it can lead to
respiratory distress . Other common respiratory viruses,
especially rhinoviruses, cause the majority of exacerbations
in children and adults with asthma . Johnston et al.
carried out a study in the UK to investigate the role of viral
infections in acute exacerbations of asthma in schoolchil-
dren, and they reported that the most commonly identiﬁed
virus type in this population was rhinovirus .
In one of the earlier studies using PCR to detect respi-
ratory viruses in adults, a respiratory virus was found in
44 % of exacerbations (60 % rhinoviruses) . Rhinovirus
infection has also been associated with nearly half of all
chronic obstructive pulmonary disease (COPD) exacerba-
tions . Furthermore, the presence of two or more viral
agents may contribute to the severity of exacerbations.
Wilkinson et al. have reported that a total of 70 % of
COPD exacerbations in the UK were associated with the
bacterial pathogen Haemophilus inﬂuenzae, and rhinovirus
was identiﬁed in 20 % of exacerbations . However,
higher bacterial loads were observed in exacerbations with
both rhinovirus and H. inﬂuenzae, thus suggesting that
interaction between these pathogens may contribute to
exacerbation severity .
Other viruses have also been implicated in exacerbation
of asthma and COPD symptoms. For example, Ko et al.
reported that the most prevalent viruses detected during
acute exacerbations of COPD in Hong Kong were inﬂuenza
A virus and coronavirus .
Much of the morbidity, mortality, and excess health-care
utilisation associated with asthma and COPD are related to
exacerbations . Identifying viral aetiology associated
with respiratory tract infections in asthma and COPD is
useful for the development of strategies for the prevention
and treatment of infections leading to exacerbations in this
There is little data on the frequency of respiratory
viruses in the Middle East, particularly in Qatar. In this
study, we sought to determine the burden of respiratory
viruses in adult patients with asthma/COPD in Qatar, using
real-time reverse transcription polymerase chain reaction
A. Althani (&) Á S. Bushra Á N. Shaath
Qatar University, P.O.BOX 2713, Doha, Qatar
H. A. Sattar
Hamad Medical Corporation, Doha, Qatar
Arch Virol (2013) 158:1079–1083