The proportion of untreated exacerbations was not affected by season, indicating that the increase in the proportion of exacerbations that resulted in patient hospitalization in the winter was due to a decrease in the proportion of exacerbations that received only drug treatment. There is also evidence that patients with COPD stay longer in the hospital in winter; the patients spent 11 days in the hospital in the cold seasons, compared with 8 days in the warm seasons, but this did not achieve statistical significance. There was no seasonal difference in the time patients took to receive treatment, discounting the possibility that the longer exacerbation recoveries were due to a reluctance of patients to leave home on cold days, thereby delaying treatment, which can prolong exacerbation recovery.
We found that the reductions in outdoor activity associated with exacerbation were greater in the cold seasons. This suggests that viral-associated exacerbations may have a greater impact on activity than exacerbations triggered by other causes AWC viagra online Pharmacy. The clinical implications of these findings are that patients who suffer frequent respiratory virus infections may need to focus on maintaining activity, particularly in the winter, and may need to be enrolled as a priority into pulmonary rehabilitation programs targeted at patients with exacerbations. We also found that patients spend less time outdoors during very hot weather, an adaptation to climate change that has been predicted24 but, to our knowledge, not previously substantiated.
Outside of exacerbations when the patients were stable, daily respiratory symptoms were more common during the cold seasons than the warm seasons. These seasonal differences were small in absolute terms but large in relative terms and highly significant. Patients with chronic respiratory disease may report more symptoms Canadian Fluoxetine during cold weather, but it is possible that there are more “subclinical” viral infections in cold seasons, a possibility consistent with the finding of airway viruses in patients who are stable.