1. Circadian rhythm of COPD symptoms in clinically based phenotypes. Results from the STORICO Italian observational study
- Author
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Scichilone, Nicola, Antonelli Incalzi, Raffaele, Blasi, Francesco, Schino, Pietro, Cuttitta, Giuseppina, Zullo, Alessandro, Ori, Alessandra, Canonica, Giorgio Walter, Schino P, Cuttitta G, Foschino MP, Prediletto R, Tranfa C, Zappa MC, Patriciello P, Labate L, Mariotta S, Nava S, Vatrella A, Mastroberardino M, Sarzani R, Iuliano A, Maggi L, Zedda A, Pesci A, Sera G, Nicolini A, Salvatore Walter DD, Forte S, Mario DD, Rivolta F, Ferliga M, Raco AF, Luigi DR, Cabibbo G, Maselli R, Gulotta C, Nardini S, Guffanti EE, Castellani W, Triolo L, Passalacqua G, Beghè B, Salvatore LC, Faccini E, Atzeni E, Tazza R, Giamesio P., Scichilone N., Antonelli Incalzi R., Blasi F., Schino P., Cuttitta G., Zullo A., Ori A., Canonica G., Foschino M.P., Prediletto R., Tranfa C.M.E., Zappa M.C., Patriciello P., Labate L., Mariotta S., Nava S., Vatrella A., Mastroberardino M., Sarzani R., Iuliano A., Maggi L., Zedda A., Pesci A., Sera G., Nicolini A., Salvatore Walter D.D., Forte S., Mario D.D., Rivolta F., Ferliga M., Raco A.F., Luigi D.R., Cabibbo G., Maselli R., Gulotta C., Nardini S., Guffanti E.E., Castellani W., Triolo L., Passalacqua G., Beghe B., Salvatore L.C., Faccini E., Atzeni E., Tazza R., Giamesio P., Scichilone, N, Antonelli Incalzi, R, Blasi, F, Schino, P, Cuttitta, G, Zullo, A, Ori, A, Canonica, G, Foschino, M, Prediletto, R, Tranfa, C, Zappa, M, Patriciello, P, Labate, L, Mariotta, S, Nava, S, Vatrella, A, Mastroberardino, M, Sarzani, R, Iuliano, A, Maggi, L, Zedda, A, Pesci, A, Sera, G, Nicolini, A, Salvatore Walter, D, Forte, S, Mario, D, Rivolta, F, Ferliga, M, Raco, A, Luigi, D, Cabibbo, G, Maselli, R, Gulotta, C, Nardini, S, Guffanti, E, Castellani, W, Triolo, L, Passalacqua, G, Beghe, B, Salvatore, L, Faccini, E, Atzeni, E, Tazza, R, Giamesio, P, Scichilone, Nicola, Antonelli Incalzi, Raffaele, Blasi, Francesco, Schino, Pietro, Cuttitta, Giuseppina, Zullo, Alessandro, Ori, Alessandra, Canonica, Giorgio, Walter, Foschino, Mp, Zappa, Mc, Salvatore Walter, Dd, Mario, Dd, Raco, Af, Luigi, Dr, Guffanti, Ee, Beghè, B, Salvatore, Lc, and Giamesio, P.
- Subjects
Male ,Chronic bronchitis ,Time Factors ,Health Status ,Anxiety ,Hospital Anxiety and Depression Scale ,Severity of Illness Index ,Health Statu ,Pulmonary Disease, Chronic Obstructive ,0302 clinical medicine ,Surveys and Questionnaires ,Forced Expiratory Volume ,Clinical phenotype ,Medicine ,Surveys and Questionnaire ,Respiratory function ,030212 general & internal medicine ,Prospective Studies ,Prospective cohort study ,Lung ,Depression (differential diagnoses) ,COPD ,Depression ,Middle Aged ,Circadian Rhythm ,Phenotype ,Italy ,Female ,medicine.symptom ,24-hour symptoms, Clinical phenotype, Real-world, Respiratory function ,Research Article ,Human ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Chronic Obstructive ,Time Factor ,Settore MED/10 - Malattie Dell'Apparato Respiratorio ,Pulmonary Disease ,03 medical and health sciences ,Internal medicine ,Humans ,Asthma ,24-hour symptoms ,Real-world ,Aged ,Sleep ,Quality of Life ,lcsh:RC705-779 ,business.industry ,Correction ,lcsh:Diseases of the respiratory system ,medicine.disease ,24-hour symptom ,Prospective Studie ,030228 respiratory system ,business - 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.
- Published
- 2019