{
  "abstract": "Background COPD is a known risk factor for poor outcomes following respiratory viral infection (RVI), but its impact on patient-reported symptom burden and early hospital trajectory remains under-characterised. Using data from the UK UNIVERSAL study—a prospective multicentre cohort of hospitalised adults with PCR-confirmed RVI—we compared clinical profiles, symptom severity and short-term outcomes in individuals with and without COPD.Methods Adults (≥18 years) enrolled from August 2022 to May 2025 were stratified by clinician-diagnosed COPD. FLU-PRO Plus domain scores (0–100 scale) and symptom duration were recorded at admission. Outcomes were: (i) length of stay (LOS: ≤2, 3–7, 8–14, ≥15 days), (ii) respiratory high-dependency unit (RHDU) or GICU admission, (iii) 30-day readmission for acute respiratory illness (ARI), and (iv) 60-day all-cause mortality. Between-group differences were assessed using Mann-Whitney U, χ 2, or Fisher’s exact tests.Results Of 836 participants, 234 (28%) had COPD. They were older (median 71 vs 63 years, p<0.001) and reported significantly lower symptom intensity scores across most domains: nasal (28.5 vs 33.1, p=0.015), throat (14.4 vs 22.1, p=0.003), gastrointestinal (9.0 vs 15.6, p<0.001), and systemic (31.4 vs 37.8, p=0.003); eye and chest/respiratory scores were comparable. Despite this, COPD was associated with more prolonged symptom duration across multiple domains (p<0.03), and significantly worse clinical outcomes: LOS ≥15 days (8.5% vs 5.7%, p=0.003), RHDU admission (2.6% vs 0.7%, p=0.036), 30-day ARI readmission (12.0% vs 6.8%, p=0.019), and 60-day mortality (7.3% vs 2.1%, p<0.001). COPD patients also more frequently reached WHO OSCI ≥5 (72.6% vs 66.2%, p=0.068).Abstract P11 Table 1Patient characteristics and outcomes by COPD statusConclusion Adults with COPD hospitalised for RVI demonstrated paradoxically lower perceived symptom severity despite more prolonged symptom duration and significantly worse early outcomes. These findings highlight the need for enhanced monitoring and targeted intervention strategies—including antiviral trials—focused on this high-risk population.",
  "authors": [
    {
      "affiliations": [
        "University of Southampton, Southampton, UK"
      ],
      "name": "T Morelli"
    },
    {
      "affiliations": [
        "University of Southampton, Southampton, UK"
      ],
      "name": "A Freeman"
    },
    {
      "affiliations": [
        "University of Southampton, Southampton, UK"
      ],
      "name": "A Jones"
    },
    {
      "affiliations": [
        "University of Southampton, Southampton, UK"
      ],
      "name": "T Wilkinson"
    }
  ],
  "title": "P11 COPD and respiratory viral infection in hospitalised adults: longer symptom duration, blunted perception, and poor early outcomes",
  "uid": "0b4398b4-feae-505a-8d96-807b9b98ff07"
}