COPD progression: Causes, Treatment and more

COPD is one of the leading causes of morbidity and mortality[1]. Living with chronic pulmonary obstructive disease (COPD) is often challenging now and then. Your lifestyle will inevitably change after being diagnosed with COPD. Unfortunately, it is not going to be be easy to lead a normal life as COPD progression appears. 

COPD symptoms are difficult to determine an appropriate period for development. It’s important to remember that the symptoms can vary from one individual to another. Some people have symptoms rapidly progressed and health is deteriorating. Others remain at the same stage of the disease for many years. COPD progresses often depending on how a person is compliant with their treatment plan and their life choices. 

COPD Progression: The Basics

Basically, COPD gets worse as time passes. It is important to know if your COPD gets worse. Protocols vary depending on the stage or severity of your condition. Progression of COPD indications may include the following:

Increased symptoms

If symptoms are more frequent or severe, it may be a sign that your COPD progresses. For example, if you use your inhaler without relief, or increased shortness of breath most of the time, it may indicate that your condition deteriorates.

A decline in lung function

Regularly, your healthcare provider orders a test of lung function spirometry to measure your lung function. One indicator of COPD is your forced expiratory[2] volume (FEV1). An FEV1 measures the amount of air you can forcefully exhale in one second. The result of your FEV1 is useful when diagnosing the stage of your disease. If FEV1 is getting worse, it may be a sign that your COPD progresses.

Chronic obstructive pulmonary disease is treatable with proper management, a lot of people with COPD can perform good symptom control and quality of life. There are things you can do to reduce the progression of the disease. These preventive measures, including the following:

  • Stop Smoking
  • Avoid Exposure to air pollutant ( Chemicals, fumes, and dust )
  • Timely Vaccinations
  • Eat a healthy diet
  • Keep with exercise
  • Breathing techniques to exercise lung

What Is COPD?

COPD chronic obstructive pulmonary disease. It is also known by different names, like chronic obstructive pulmonary disease (COPD), chronic obstructive lung disease (COLD), chronic obstructive disease of the respiratory tract (COPD), chronic airflow limitation (CAL), or chronic obstructive respiratory disease (CORD). It is also a group of problems manifesting with a few vast signs like shortness of breath, chest tightness, and cough. 

When air pockets and passages within the lungs lose their elasticity, breathing is more difficult. The tissue in the walls of the airways and air sacs can also get more because of inflammation, or even be destroyed. All this can produce thick, sticky mucus that inhibits other airflows. Part of this mucus is often discharged as the person’s sputum of COPD by coughing.

What Causes COPD?

First of all, Smoking[3] is, no doubt, the leading reason behind chronic obstructive lung disease. Other causes consist of dust labor and chemicals, air pollution outdoors, and exposure to secondhand smoke. Since chronic obstructive pulmonary disease is a disease that gradually progresses over time, it could take years before someone felt short of breath. Most likely, someone will develop a chronic cough and begin producing secretions increasingly in the throat (phlegm) before they ever have airway obstruction. 

COPD Progression
Smoking is the main cause for COPD

COPD Stages & Progression

COPD stages

Stages are used by professionals to describe the severity of COPD. This system is called the staging of the Global Initiative for Chronic Obstructive Lung Disease (GOLD), or classification system. GOLD helps increase awareness of COPD and work with physicians and other health professionals to create better ways to prevent and treat the condition. It also provides guidelines that most doctors use to classify and treat.

The GOLD system based step your COPD on several things:

  • Your common symptoms
  • How often your worsened Chronic
  • Staying in a hospital because your worsened COPD
  • The results of spirometry, a test to check on the amount of air and the speed you can exhale.

Spirometry and your stages of Chronic Obstructive Pulmonary disease are based on two measures:

Forced vital capacity (FVC)[4]: The largest amount of air you can breathe after breathing as deeply as possible.

Forced expiratory volume (FEV-1) [2]: Showing the amount of air you can blow out of your lungs per second.

Generally, COPD can progress in 4 stages as follows, which are:

Stage #1 COPD Developing Stage (Early) –  FEV-1 ≥ 80%

In the initial stage of COPD, the patients forced expiratory volume is less than or equal to 80%, other obvious symptoms may not be apparent in the patient’s body. However, coughing or excessive phlegm are likely to appear as well. Usually, patients experience minimal shortness of breath.

Stage #2 Moderate COPD- FEV-1 50-79%

Tests revealed that FEV-1 50-79% include some interruption in the flow of air along with symptoms such as chronic cough and sputum, also you may experience severe respiratory distress regularly. But this will not affect his daily life, as are brief periods of breathing difficulties. 

COPD Progression
COPD symptoms

Stage #3 Severe COPD – FEV-1 30-49%

In the third stage, the level of performing lung was affected as a result of FEV-1 30-49%. As the intensity of the disease increases, the quality of life is declining rapidly. Patients begin to realize that something is wrong because you are suffering shortness of breath often – even after little effort or exercise. Most people decide to consult a doctor at this stage.

Stage #4 Very Severe COPD – FEV-1 ≤30%

In the last stage when FEV-1 ≤ 30%, patients experience considerable difficulty breathing, even with less effort. There are probably complications like respiratory failure or signs of heart problems. The symptoms can be disabling and may threaten survival. This stage is considered extremely serious. In many cases, it can be fatal.

COPD progression

COPD typically reduces life expectancy. Assess life expectancy with chronic obstructive pulmonary disease seems like a challenge as there are so many variables to be noticed. However, one recent study[5] of COPD longevity showed about 70 percent of patients survived a minimum of one year. After two years, about 50 percent of patients were still alive. Within the three-year mark, COPD longevity dropped to 43 percent.

COPD patients who never smoked may have a slight reduction in life expectancy[6], while former and current smokers’ lifespan tend to significantly decrease. While COPD gets worse over, medication and proper treatment can slow its progression. As a result, the best way to slow COPD progression is to enhance your immune system by improving your overall physical condition. These include regular exercise and a healthy diet to maintain an ideal weight.

COPD Prognosis

Given all the factors affect the condition of patients diagnosed with COPD and available treatment, medical opinions also offer the course and outcome of the disease. Therefore, information about recovery prospects and disease prognosis is mentioned. The life expectancy of A COPD and prognosis can vary; because the rate at which the lungs are destroyed varies from patient to patient. It helps to know the chances of complications of COPD.

A Study[7] reports informed us about the survival rate and the mortality rate of COPD. However, the pathophysiology of COPD is complex and not precisely identified. Several factors influence the prognosis and life expectancy of COPD. A patient diagnosed with COPD finally dies when the lungs stop functioning and the organs and tissues in the body do not get sufficient oxygen. The lack of oxygen in patients leads to a malfunction of the immune system, and health complications occur due to serious infections. COPD treatment for patients can help avoid complications like pneumonia. It helps increase the life expectancy of the patients and helps enhance the quality of his life. After looking at the results of the spirometry test to check the capacity of the lungs, the doctor can determine if the patient has COPD and how severe it is.

Treatment for COPD

COPD or chronic obstructive pulmonary disease is not a curable disease. But timely treatment can slow the progression of the disease and make life easier for patients. Based on the patient’s condition and the body’s response to drugs, doctors recommend various types of treatments for different patients.

Smoking cessation[8]: The most vital treatment a patient receives. Since in most cases, the cause of COPD is smoking, stopping smoking significantly slows the progression of the disease. Smoking can be hard to quit because it is very addictive. There are many alternative systems of nicotine and self-help guides to assist in this endeavor.

Medications: The use of bronchodilators and antiinflammatories is often suggested to patients suffering severe dyspnea. In the same way, antibiotics are prescribed for patients suffering from acute exacerbations. The patients’ relief and possibilities of post-shock fingers comma reduced significantly.

Oxygen therapy: Therapy requires the introduction of high flow oxygen to patients. Oxygen saturation should be more than 90 percent for better management results. It prolongs longevity in those with advanced COPD and remarkably reduced levels of oxygen in their blood. This therapy is most effective when carried out around the clock, but using oxygen 12 hours a day also has its benefits. Oxygen therapy can improve problems with dyspnea.

COPD Progression
Oxygen therapy for COPD

Surgery: There are three surgical interventions[9] for COPD patients. 

  • Bullectomy is an option for patients with bullous emphysema that can improve lung function and reduce dyspnea. 
  • Lung Volume Reduction Surgery, this surgery palliative surgery in patients with the disease is concentrated in one region of the lung and not spread to the lungs.
  •  Lung Transplant, definitive surgical treatment for patients with end-stage disease.

Testosterone Replacement Therapy Slow The COPD Progression

GALVESTON, Texas –Researchers from The University of Texas Medical Branch at Galveston found that testosterone replacement therapy may slow disease progression of chronic obstructive pulmonary disease. The paper is currently available in Chronic Respiratory Disease.

Chronic obstructive pulmonary disease, or COPD, is predicted by the World Health Organization to be the third-leading cause of illness and death internationally by 2030. Low testosterone is common in men with COPD and may worsen their condition. Men with COPD have shortness of breath and often take steroid-based medications for an extended time, both of which increase their risk of low testosterone.

“Previous studies have suggested that testosterone replacement therapy may have a positive effect on lung function in men with COPD,” said Jacques Baillargeon, UTMB professor in preventive medicine and community health. “However, we are the first to conduct a large scale nationally representative study on this association.”

The goal of the study was to find out whether testosterone replacement therapy reduced the risk of respiratory hospitalizations in middle-aged and older men with COPD.

Using the Clinformatics Data Mart, a database of one of the largest commercially insured populations in the U.S Baillargeon, and colleagues examined data of 450 men aged 40 to 63 with COPD who began testosterone replacement therapy between 2005 and 2014. They also used the national Medicare database to study data from 253 men with COPD aged 66 and older who initiated testosterone replacement therapy between 2008 and 2013.

“We found that testosterone users had a greater decrease in respiratory hospitalizations compared with non-users. Specifically, middle-aged testosterone replacement therapy users had a 4.2 percent greater decrease in respiratory hospitalizations compared with non-users and older testosterone replacement therapy users had a 9.1 percent greater decrease in respiratory hospitalizations compared with non-users,” said Baillargeon. “The findings suggest that testosterone replacement therapy may slow the progression of disease in men with COPD.

Frequently Asked Questions

Is COPD curable?

No. Unfortunately, COPD is a chronic medical condition. It is incurable and in some cases is progressive. The good news: For some patients, proper treatment can help reduce symptoms and reduce the rate of progression.

Can we prevent COPD from worsening?

The best thing is to prevent the condition from progressing at a later stage. With proper maintenance therapy and a several habits to incorporate into your lifestyle, you can take a good approach to keep the symptoms of COPD remotely and prevent further.

Is COPD the same thing as emphysema?

Both diseases cause narrowing of the airways (respiratory tract) that may cause difficulty in breathing and wheezing. However, some of the airway narrowing in asthma may be reversible (but not always). The narrowing of the airways in COPD can not be reversed.

Why not have oxygen when I’m obviously out of breath?

Being out of breath and needed oxygen are sometimes different. Not everyone breathless needed oxygen. Some people with COPD are breathless because their airways diminished but they still have normal levels of oxygen in their blood. Anxiety, stress, or, having to work harder to breathe can make you feel out of breath.

Why have I got COPD? I’ve never been a smoker.

There are different causes of COPD. It may be a result of chronic asthma, a genetic deficiency, or irritant exposure to a certain environment. You may have COPD if exposed to passive smoke or secondhand smoke from someone else. If you have an alpha 1-antitrypsin deficiency, you need to have your children and spouse tested.

Can VAPE cause COPD?

Same as cigarettes, Vape cartridges contain nicotine, the chemical that makes cigarettes addictive. A recent study[10] speculates that vaping may be associated with COPD. The repeated exposure to the chemical acrolein[11] that comes from a liquid vaporizer can cause inflammation leading to COPD.

Can surgery help me live longer?

Undergoing surgery can improve the quality of life, but has not been proved to increase survival rates to 10 years in people with COPD. Survival rates five years for people who undergo lung transplants are in the range of 54%, whereas the survival rates of one to three years are 80% and 65% respectively.

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  1. Cristine E Berry, Robert A Wise. 2010. Mortality in COPD: causes, risk factors, and prevention. Available from: https://pubmed.ncbi.nlm.nih.gov/20854053/
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  8. National Center for Chronic Disease Prevention and Health Promotion. 2020 [May 21 2020]. Smoking Cessation: Fast Facts. Available from: https://www.cdc.gov/tobacco/data_statistics/fact_sheets/cessation/smoking-cessation-fast-facts/index.html
  9. Nathaniel Marchetti, Gerard J. Criner. 2015. Surgical Approaches to Treating Emphysema: Lung Volume Reduction Surgery, Bullectomy, and Lung Transplantation, 36(04), 592-608. 333 Seventh Avenue, New York, USA: Thieme Medical Publishers. Available from: https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0035-1556064
  10. Stanton A. Glantz & David W. Bareham. 2018 [Jan 11, 2018]. E-Cigarettes: Use, Effects on Smoking, Risks, and Policy Implications, 39, 215-235. San Francisco, California, USA: University of California. Available from: https://www.annualreviews.org/doi/10.1146/annurev-publhealth-040617-013757#_i15
  11. National Center for Biotechnology Information. 2020. PubChem Compound Summary for CID 7847, Acrolein. Available from: https://pubchem.ncbi.nlm.nih.gov/compound/Acrolein.