6533b85cfe1ef96bd12bc934
RESEARCH PRODUCT
Circadian rhythm of COPD symptoms in clinically based phenotypes. Results from the STORICO Italian observational study
Nicola ScichiloneRaffaele Antonelli IncalziFrancesco BlasiPietro SchinoGiuseppina CuttittaAlessandro ZulloAlessandra OriCanonicaGiorgio WalterSchino PCuttitta GFoschino MpPrediletto RTranfa CZappa McPatriciello PLabate LMariotta SNava SVatrella AMastroberardino MSarzani RIuliano AMaggi LZedda APesci ASera GNicolini ASalvatore Walter DdForte SMario DdRivolta FFerliga MRaco AfLuigi DrCabibbo GMaselli RGulotta CNardini SGuffanti EeCastellani WTriolo LPassalacqua GBeghè BSalvatore LcFaccini EAtzeni ETazza RGiamesio P.subject
MaleChronic bronchitisTime FactorsHealth StatusAnxietyHospital Anxiety and Depression ScaleSeverity of Illness IndexHealth StatuPulmonary Disease Chronic Obstructive0302 clinical medicineSurveys and QuestionnairesForced Expiratory VolumeClinical phenotypeMedicineSurveys and QuestionnaireRespiratory function030212 general & internal medicineProspective StudiesProspective cohort studyLungDepression (differential diagnoses)COPDDepressionMiddle AgedCircadian RhythmPhenotypeItalyAnxietyFemalemedicine.symptom24-hour symptoms Clinical phenotype Real-world Respiratory functionResearch ArticleHumanPulmonary and Respiratory Medicinemedicine.medical_specialtyChronic ObstructiveTime FactorSettore MED/10 - Malattie Dell'Apparato RespiratorioPulmonary Disease03 medical and health sciencesInternal medicineHumansAsthma24-hour symptoms; Clinical phenotype; Real-world; Respiratory function; Aged; Anxiety; Depression; Female; Forced Expiratory Volume; Health Status; Humans; Italy; Lung; Male; Middle Aged; Phenotype; Prospective Studies; Pulmonary Disease Chronic Obstructive; Severity of Illness Index; Sleep; Surveys and Questionnaires; Time Factors; Circadian Rhythm; Quality of LifeAgedlcsh:RC705-77924-hour symptomsbusiness.industryCorrectionlcsh:Diseases of the respiratory systemmedicine.disease24-hour symptomProspective Studie030228 respiratory systemReal-worldQuality of LifebusinessSleepRespiratory functiondescription
Abstract Background Chronic Obstructive Pulmonary Disease (COPD) encompasses various phenotypes that severely limit the applicability of precision respiratory medicine. The present investigation is aimed to assess the circadian rhythm of symptoms in pre-defined clinical COPD phenotypes and its association with health-related quality of life (HR-QoL), the quality of sleep and the level of depression/anxiety in each clinical phenotype. Methods The STORICO (NCT03105999) Italian observational prospective cohort study enrolled COPD subjects. A clinical diagnosis of either chronic bronchitis (CB), emphysema (EM) or mixed COPD-asthma (MCA) phenotype was made by clinicians at enrollment. Baseline early-morning, day-time and nocturnal symptoms (gathered via the Night-time, Morning and Day-time Symptoms of COPD questionnaire), HR-QoL (via the St. George’s Respiratory Questionnaire), anxiety and depression levels (via the Hospital Anxiety and Depression Scale), quality of sleep (via COPD and Asthma Sleep Impact Scale), physical activity (via the International Physical Activity Questionnaire) as well as lung function were recorded. Results 606 COPD subjects (age 71.4 ± 8.2 years, male 75.1%) were studied. 57.9, 35.5 5.3 and 1.3% of the sample belonged to the CB, EM, MCA and EM + CB phenotypes respectively. The vast majority of subjects reported early-morning and day-time symptoms (79.5 and 79.2% in the CB and 75.8 and 77.7% in the EM groups); the proportion suffering from night-time symptoms was higher in the CB than in the EM group (53.6% vs. 39.5%, p = 0.0016). In both CB and EM, indiscriminately, the presence of symptoms during the 24-h day was associated with poorer HR-QoL, worse quality of sleep and higher levels of anxiety/depression. Conclusions The findings highlight the primary classificatory role of nocturnal symptoms in COPD. Trial registration Trial registration number: NCT03105999, date of registration: 10th April 2017.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2019-09-01 |