Blood Biomarkers in Patients with COPD with Coexisting Bronchiectasis: A Cross-Sectional Study


Authors : Dr. Aditya Vishwanath Patil; Dr. Gajanan. S. Gaude

Volume/Issue : Volume 10 - 2025, Issue 2 - February


Google Scholar : https://tinyurl.com/ywjzt9xz

Scribd : https://tinyurl.com/3vjsse5c

DOI : https://doi.org/10.5281/zenodo.14965818


Abstract : Background: Chronic Obstructive Pulmonary Disease (COPD) and bronchiectasis frequently coexist, leading to more severe disease outcomes and an increased inflammatory burden. This study evaluates blood parameters in COPD patients with and without bronchiectasis to determine their significance in disease prognosis and management.  Methods: A cross-sectional study of 70 COPD patients (20 with bronchiectasis) was conducted at a tertiary hospital. Blood investigations included CRP, NLR, PLR, eosinophil count, hemoglobin, serum albumin, PCV, total leukocyte count, liver enzymes, and renal markers. Bronchiectasis was confirmed via HRCT. Statistical analysis used chi-square tests and logistic regression to assess biomarker differences.  Results: COPD patients with bronchiectasis exhibited significantly elevated CRP (7.7 ± 2.5 mg/L vs. 5.9 ± 2.0 mg/L; p=0.02), NLR (2.6 ± 0.9 vs. 2.0 ± 0.8; p=0.03), and PLR (100 ± 13 vs. 88 ± 10; p=0.04), indicating higher systemic inflammation. Eosinophil counts were lower (0.9 ± 0.2% vs. 1.8 ± 0.4%; p=0.05), suggesting a predominant neutrophilic inflammation. Additionally, bronchiectasis patients exhibited lower serum albumin (1.7 ± 0.3 g/dL vs. 2.5 ± 0.4 g/dL; p=0.02) and hemoglobin levels (12.8 ± 1.3 g/dL vs. 13.5 ± 1.2 g/dL; p=0.05), indicating potential malnutrition and anemia. These findings highlight the systemic inflammatory burden and altered hematological parameters in COPD-bronchiectasis overlap patients.  Conclusion: COPD patients with coexisting bronchiectasis show heightened inflammation, anemia, and organ dysfunction, indicating greater disease severity. Early detection and targeted management are crucial for better outcomes.

Keywords : COPD-Bronchiectasis Overlap, Systemic Inflammation, Neutrophil-To-Lymphocyte Ratio, Platelet-To-Lymphocyte Ratio, CRP, Hematological Biomarkers.

References :

  1. Martinez-Garcia MA, Miravitlles M, Garcia-Clemente M, Soler-Cataluña JJ, de la Rosa D, Diel R, et al. Bronchiectasis in COPD patients: More than a comorbidity? Int J Chron Obstruct Pulmon Dis 2017;12:1401–11.
  2. Polverino E, Dimakou K, Hurst J, Martinez-Garcia MA, Miravitlles M, Aliberti S, et al. The overlap between bronchiectasis and chronic airway diseases. Eur Respir J 2018;52(3):1800328,1-19.
  3. Alam MA, Mangapuram P, Fredrick FC, Singh A, Rajagopal K, Sharma V, et al. Bronchiectasis-COPD Overlap Syndrome: A Comprehensive Review of Its Pathophysiology and Potential Implications. Ther Adv Pulm Crit Care Med 2024;19:1–21.
  4. Hurst JR, Elborn JS, De Soyza A, Lonergan M, Poppelwell L, Turner AM, et al. COPD-bronchiectasis overlap syndrome: A distinct clinical phenotype? Eur Respir J 2015;45(2):310–3.
  5. Chalmers JD, Goeminne PC, Aliberti S, McDonnell MJ, Lonni S, Dimakou K, et al. Bronchiectasis and COPD Overlap: A Case of Mistaken Identity? Chest 2017;151(6):1204–6.
  6. Diaz AA, Regan EA, Curran-Everett D, Estepar RS, Hoffman EA, Bowler RP, et al. Emphysema and Bronchiectasis in Smokers: SPIROMICS. Ann Am Thorac Soc 2017;14(5):754–61.
  7. McDonnell MJ, Aliberti S, Goeminne PC, Restrepo MI, Finch S, Pesci A, et al. Comorbidities and the risk of mortality in patients with bronchiectasis: An international cohort study. Lancet Respir Med 2016;4(12):969–79.
  8. Piotrowska E, Krenke R, Górska K, Domagała-Kulawik J, Chazan R, Rolska-Wójcik P, et al. Systemic inflammation and multiorgan involvement in COPD: Current perspectives. Adv Respir Med 2022;90(1):10–18.
  9. Gava G, Núñez A, Esquinas C, Almonacid C, Martinez J, Gavilanes N, et al. Analysis of Blood Biomarkers in COPD and Asthma-COPD Overlap. COPD J Chronic Obstr Pulm Dis 2020;17(3):306–10.

Background: Chronic Obstructive Pulmonary Disease (COPD) and bronchiectasis frequently coexist, leading to more severe disease outcomes and an increased inflammatory burden. This study evaluates blood parameters in COPD patients with and without bronchiectasis to determine their significance in disease prognosis and management.  Methods: A cross-sectional study of 70 COPD patients (20 with bronchiectasis) was conducted at a tertiary hospital. Blood investigations included CRP, NLR, PLR, eosinophil count, hemoglobin, serum albumin, PCV, total leukocyte count, liver enzymes, and renal markers. Bronchiectasis was confirmed via HRCT. Statistical analysis used chi-square tests and logistic regression to assess biomarker differences.  Results: COPD patients with bronchiectasis exhibited significantly elevated CRP (7.7 ± 2.5 mg/L vs. 5.9 ± 2.0 mg/L; p=0.02), NLR (2.6 ± 0.9 vs. 2.0 ± 0.8; p=0.03), and PLR (100 ± 13 vs. 88 ± 10; p=0.04), indicating higher systemic inflammation. Eosinophil counts were lower (0.9 ± 0.2% vs. 1.8 ± 0.4%; p=0.05), suggesting a predominant neutrophilic inflammation. Additionally, bronchiectasis patients exhibited lower serum albumin (1.7 ± 0.3 g/dL vs. 2.5 ± 0.4 g/dL; p=0.02) and hemoglobin levels (12.8 ± 1.3 g/dL vs. 13.5 ± 1.2 g/dL; p=0.05), indicating potential malnutrition and anemia. These findings highlight the systemic inflammatory burden and altered hematological parameters in COPD-bronchiectasis overlap patients.  Conclusion: COPD patients with coexisting bronchiectasis show heightened inflammation, anemia, and organ dysfunction, indicating greater disease severity. Early detection and targeted management are crucial for better outcomes.

Keywords : COPD-Bronchiectasis Overlap, Systemic Inflammation, Neutrophil-To-Lymphocyte Ratio, Platelet-To-Lymphocyte Ratio, CRP, Hematological Biomarkers.

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