The quality of life indicators in patients with chronic obstructive pulmonary disease after PCV vaccination: A posteriori analysis of 10-year follow-up

Introduction. The natural course of chronic obstructive pulmonary disease (COPD) is characterized by an exacerbation of symptoms and a decrease in quality of life (QOL). QOL is a complex indicator for assessing people’s health and well-being, which is influenced by many factors. Health-related QOL assessment tools are widely used to determine physical, functional, social, and psychosocial well-being from a patient’s perspective. Low QOL levels are common among patients with COPD, especially in the late stages. In 2023, the results of a 10-year evaluation of the effectiveness of vaccine prophylaxis against pneumococcal infection were published, but they did not include a QOL analysis.

Aim. To conduct a posteriori analysis of the assessment of QOL over 10 years of follow-up in patients with COPD vaccinated with conjugated pneumococcal vaccine Prevenar 13 (PCV13).

Materials and methods. The study included a total of 362 male patients who were treated or monitored at the Chelyabinsk Regional Pulmonological Center in 2012–2022. The 13-valent conjugated pneumococcal vaccine Preventar-13 was used for vaccine prophylaxis. The QOL assessment was conducted using two questionnaires: the Russian-language version of the St. George Hospital Questionnaire (SGRQ), and the universal CAT questionnaire.

Results. The indicators of the SGRQ questionnaire scales in the studied groups did not significantly differ (p > 0.05). A year after the start of the observation, changes in QOL were detected on all scales of the questionnaire, while maintaining statistically significant changes over the 10 years of observation. In the observation group of unvaccinated patients, there was no clinically or statistically significant change in QOL parameters according to all criteria. A similar dynamic was demonstrated by the indicator of the СAT questionnaire.

Conclusions. Vaccine prophylaxis with pneumococcal vaccines has a significant positive effect on the QOL of patients with COPD, at least in the 10-year follow-up period. The use of QOL questionnaires makes it possible to focus on the correctness of the chosen treatment tactics both in the early and long-term periods of follow-up of patients with COPD. The use of PCV13 for the vaccination of COPD patients reliably minimizes the number of exacerbations requiring outpatient and hospital treatment, reduces the number of episodes of pneumonia as much as possible, and reduces the cost of the healthcare system to combat this nosology.

1. Safiri S, Carson-Chahhoud K, Noori M, Nejadghaderi SA, Sullman MJM, Ahmadian Heris J et al. Burden of chronic obstructive pulmonary disease and its attributable risk factors in 204 countries and territories, 1990–2019: results from the Global Burden of Disease Study 2019. BMJ. 2022;378:e069679. https://doi.org/10.1136/bmj-2021-069679.

2. Dharmage SC, Faner R, Agustí A. Treatable traits in pre-COPD: Time to extend the treatable traits paradigm beyond established disease. Respirology. 2024;29(7):551–562. https://doi.org/10.1111/resp.14760.

3. GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258): 1204–1222. https://doi.org/10.1016/S0140-6736(20)30925-9.

4. Cadham CJ, Oh H, Han MK, Mannino D, Cook S, Meza R et al. The prevalence and mortality risks of PRISm and COPD in the United States from NHANES 2007–2012. Respir Res. 2024;25(1):208. https://doi.org/10.1186/s12931-024-02841-y.

5. Cunha AS, Raposo B, Dias F, Henriques S, Martinho H, Pedro AR. Management of Chronic Obstructive Pulmonary Disease: Constraints in Patient Pathway and Mitigation Strategies. Port J Public Health. 2024;42(2):93–100. https://doi.org/10.1159/000535474.

6. Guay CA, Maltais F, Beaudoin C, Carmichael PH, Laouan Sidi EA, Perreault L et al. Trends in COPD severe exacerbations, and all-cause and respiratory mortality, before and after implementation of newer long-acting bronchodilators in a large population-based cohort. BMC Pulm Med. 2024;24(1):450. https://doi.org/10.1186/s12890-024-03277-2.

7. Avdeev SN, Leshchenko IV, Aisanov ZR. New concept and algorithm for the management of patients with chronic obstructive pulmonary disease. Pulmonologiya. 2023;33(5):587–594. (In Russ.) https://doi.org/10.18093/0869-0189-2023-33-5-587-594.

8. Huang Y, Niu Y, Wang X, Li X, He Y, Liu X. Identification of novel biomarkers related to neutrophilic inflammation in COPD. Front Immunol. 2024;15:1410158. https://doi.org/10.3389/fimmu.2024.1410158.

9. Li HM, Zhong BL. Quality of life among college students and its associated factors: a narrative review. AME Med J. 2022;7:38. https://doi.org/10.21037/amj-22-96.

10. Anandan J, Dwivedi DP, Govindaraj V. Clinical phenotypes of COPD and their impact on quality of life: A cross-sectional study. Respir Med. 2023;220:107452. https://doi.org/10.1016/j.rmed.2023.107452.

11. Megari K. Quality of Life in Chronic Disease Patients. Health Psychol Res. 2013;1(3):e27. https://doi.org/10.4081/hpr.2013.e27.

12. Bordon J, Slomka M, Gupta R, Furmanek S, Cavallazzi R, Sethi S et al. Hospitalization due to community-acquired pneumonia in patients with chronic obstructive pulmonary disease: incidence, epidemiology and outcomes. Clin Microbiol Infect. 2020;26(2):220–226. https://doi.org/10.1016/j.cmi.2019.06.025.

13. Ignatova GL, Avdeev SN, Antonov VN, Blinova EV. Ten-year analysis of the efficacy of vaccination against pneumococcal infection in patients with chronic obstructive pulmonary disease. Pulmonologiya. 2023;33(6):750–758. (In Russ.) https://doi.org/10.18093/0869-0189-2023-33-6-750-758.

14. Ignatova GL, Avdeev SN, Antonov VN, Blinova EV, Osikov MV. Vaccination against pneumococcal infection as a tool to reduce mortality in patients with COPD and IHD. Bulletin Physiology and Pathology of Respiration. 2024;(94):8–19. (In Russ.) https://doi.org/10.36604/1998-5029-2024-94-8-19.

15. Winterberg AV, Richmond S, Tighe NTG, Buckley J, Buck DW. Implementation of a standardised questionnaire for documenting preoperative respiratory illness in paediatric patients. BMJ Open Qual. 2024;13(4):e002843. https://doi.org/10.1136/bmjoq-2024-002843.

16. Jones PW, Harding G, Berry P, Wiklund I, Chen WH, Kline Leidy N. Development and first validation of the COPD Assessment Test. Eur Resp J. 2009;34(3):648–654. https://doi.org/10.1183/09031936.00102509.

17. Hegelund MH, Jagerova L, Olsen MF, Ryrsø CK, Ritz C, Dungu AM et al. Health-related quality of life predicts prognosis in individuals with COPD hospitalized with community-acquired pneumonia – a prospective cohort study. Sci Rep. 2024;14(1):27315. https://doi.org/10.1038/s41598-024-74933-0.

18. Tan D, Wang B, Cao P, Wang Y, Sun J, Geng P et al. High flow nasal cannula oxygen therapy versus non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease with acute-moderate hypercapnic respiratory failure: a randomized controlled non-inferiority trial. Crit Care. 2024;28(1):250. https://doi.org/10.1186/s13054-024-05040-9.

19. Hardang IM, Søyseth V, Kononova N, Hagve TA, Einvik G. COPD: Iron Deficiency and Clinical Characteristics in Patients With and Without Chronic Respiratory Failure. Chronic Obstr Pulm Dis. 2024;11(3):261–269. https://doi.org/10.15326/jcopdf.2023.0477.

20. Tu Y, Chen Y, Li X, Wang Y, Fang B, Ren Y, Wang C. Advances in acute COPD exacerbation: clarifying specific immune mechanisms of infectious and noninfectious factors. Ther Adv Respir Dis. 2025;19:17534666241308408. https://doi.org/10.1177/17534666241308408.

21. Li J, Liang L, Samuel Cai Y, Zuo Y, Su J, Feng L et al. Tracking COPD exacerbation patterns and forecasting readmission risks utilizing electronic medical records. Int J Med Inform. 2024;189:105505. https://doi.org/10.1016/j.ijmedinf.2024.105505.

22. Aggarwal B, Jones P, Casas A, Gomes M, Juthong S, Litewka D et al. Association between Increased Risk of Pneumonia with ICS in COPD: A Continuous Variable Analysis of Patient Factors from the IMPACT Study. Pulm Ther. 2024;10(2):183–192. https://doi.org/10.1007/s41030-024-00255-1.

23. Nakagawa N, Katsurada M, Fukuda Y, Noguchi S, Horita N, Miki M et al. Risk factors for drug-resistant pathogens in community-acquired pneumonia: systematic review and meta-analysis. Eur Respir Rev. 2025;34(175):240183. https://doi.org/10.1183/16000617.0183-2024.

24. GBD 2021 Causes of Death Collaborators. Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet. 2024;403(10440): 2100–2132. https://doi.org/10.1016/S0140-6736(24)00367-2.

25. Roberts MH, Mannino DM, Mapel DW, Lunacsek O, Amin S, Farrelly E et al. Disease Burden and Health-Related Quality of Life (HRQoL) of Chronic Obstructive Pulmonary Disease (COPD) in the US – Evidence from the Medical Expenditure Panel Survey (MEPS) from 2016-2019. Int J Chron Obstruct Pulmon Dis. 2024;19:1033–1046. https://doi.org/10.2147/COPD.S446696.