Scabies increased the risk and severity of COPD: a nationwide population-based study
Received 3 June 2016
Accepted for publication 10 August 2016
Published 9 September 2016 Volume 2016:11(1) Pages 2171—2178
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Amy Norman
Peer reviewer comments 2
Editor who approved publication: Dr Richard Russell
Jung-Yueh Chen,1,* Jui-Ming Liu,2,* Fung-Wei Chang,3 Hung Chang,4,5 Kuan-Chen Cheng,6,7 Chia-Lun Yeh,2 Yu-Feng Wei,1 Ren-Jun Hsu8–10
1Division of Chest Medicine, Department of Internal Medicine, E-DA Hospital, I-Shou University, Kaohsiung, 2Division of Urology, Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, 3Department of Obstetrics & Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, 4Division of Thoracic Surgery, Department of Surgery, Taichung Armed Forces General Hospital, Taichung, 5Department of Physiology, National Defense Medical Center, 6Graduate Institute of Food Science and Technology, National Taiwan University, 7Institute of Biotechnology, National Taiwan University, 8Graduate Institute of Life Sciences, National Defense Medical Center, 9Department of Pathology, Graduate Institute of Pathology and Parasitology, Tri-Service General Hospital, National Defense Medical Center, 10Biobank Management Center, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
*These authors contributed equally to this work
Background: Scabies is a common parasitic infectious disease, and COPD is a major pulmonary disease. However, there have been no previous studies that have investigated the relationship between scabies and COPD.
Materials and methods: This nationwide population-based study included a total of 3,568 patients with scabies as the study group and 14,255 patients as a control group. We followed up patients in both groups for a 5-year period to identify any new diagnoses of COPD. We then followed them up for an additional 2-year period to determine the severity of any newly diagnosed cases of COPD as indicated by acute respiratory events. Cox proportional hazard regression analyses were performed to calculate the hazard ratio (HR) of COPD during the 5-year follow-up period and COPD complication during the additional 2-year follow-up period.
Results: Of the 17,823 patients in the study, 2,765 (15.5%) were newly diagnosed with COPD during the 5-year follow-up period; 904 (32.7%) were from the scabies group; and 1,861 (67.3%) were from the control group. Compared to the patients without scabies, the adjusted HR (aHR) for COPD for the subjects with scabies was 1.72 (95% CI: 1.59–1.87) during the 5-year follow-up period. For those newly diagnosed with COPD, the aHR for COPD with acute exacerbation was 1.85 (95% CI: 1.67–2.06), the aHR for COPD with pneumonia was 3.29 (95% CI: 2.77–3.92), the aHR for COPD with acute respiratory failure was 4.00 (95% CI: 3.08–5.19), and the aHR for COPD with cardiopulmonary arrest was 3.95 (95% CI: 2.25–6.95) during the additional 2-year follow-up period.
Conclusion: The results of this study indicate a 72% increased risk for COPD among patients with scabies. The results also reveal an increased risk of severe COPD complications such as acute respiratory failure, cardiopulmonary arrest, pneumonia, and acute exacerbation among patients with scabies. This useful information may help physicians in treating scabies and remaining alert to the potential development of COPD and its severe complications.
Keywords: scabies, chronic obstructive pulmonary disease, National Health Insurance Research Database
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