Respiratory syncytial virus infection in COPD exacerbations: the RECODE study protocol.

introductionPatients with chronic obstructive pulmonary disease (COPD) often suffer episodes of exacerbation (ECOPD). Respiratory syncytial virus (RSV) is an increasingly recognised cause of illness in adults. Yet the prevalence of RSV during ECOPD and its association with clinically relevant outcomes remain insufficiently defined. The RECODE study sought to determine the prevalence of RSV infection in patients with ECOPD and to assess the association between RSV and hospitalisation, length of stay, acute cardiovascular events and/or death. METHODS AND ANALYSIS: Prospective, multicentre, observational, controlled (RSV-positive cases vs RSV-negative controls), longitudinal study (NCT06735612). Adults ≥50 years with ECOPD will be enrolled at urgent-care presentation (V1), contacted by telephone at day 15 (V2) and seen in the clinic at 3 months (V3). RSV status will be determined by Reverse Transcription (RT-PCR) on nasopharyngeal swabs; additional measures include paired serology, routine clinical data, spirometry at V3 and predefined outcomes. ETHICS AND DISSEMINATION: The leading Ethics Committee was that of Clinic Barcelona (HCB/2024/0771). All participating centres accepted this approval or requested local approval from their respective Institutional Review Boards (Appendix). Results will be disseminated in international publications and meeting presentations as well as in a plain language summary to be distributed among participating patients. TRIAL REGISTRATION NUMBER: NCT06735612.