RT Journal Article SR Electronic T1 Phenotypic characterisation of early COPD: a prospective case–control study JF ERJ Open Research JO erjor FD European Respiratory Society SP 00047-2020 DO 10.1183/23120541.00047-2020 VO 6 IS 4 A1 Borja G. Cosío A1 Sergi Pascual-Guardia A1 Alicia Borras-Santos A1 Germán Peces-Barba A1 Salud Santos A1 Laura Vigil A1 Juan José Soler-Cataluña A1 Cristina Martínez-González A1 Ciro Casanova A1 Pedro J. Marcos A1 Carlos J. Alvarez A1 José Luis López-Campos A1 Joaquim Gea A1 Judith Garcia-Aymerich A1 Jesús Molina A1 Miguel Román A1 Jorge Moises A1 Viktoria Szabo A1 Elizabeth A. Reagan A1 Raúl San José Estépar A1 George Washko A1 Alvar Agustí A1 Rosa Faner YR 2020 UL http://openres.ersjournals.com/content/6/4/00047-2020.abstract AB The phenotypic characteristics of chronic obstructive pulmonary disease (COPD) in individuals younger than 50 years of age (early COPD) are not well defined. This prospective, multicentre, case–control study sought to describe these characteristics and compare them with those of smokers (≥10 pack-years) of similar age with normal spirometry (controls).We studied 92 cases (post-bronchodilator forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) <0.7) and 197 controls. Results were contrasted with participants with similar inclusion criteria recruited into the ECLIPSE and COPDGene cohorts.Cases had moderate airflow limitation (FEV1 71.3±20.8%) but were often symptomatic, used healthcare resources frequently, had air trapping (residual volume 150.6±55.5% ref.), had reduced diffusing capacity (84.2±20.7% ref.) and had frequent evidence of computed tomography (CT) emphysema (61%). Of note, less than half of cases (46%) had been previously diagnosed with COPD. Interestingly, they also often reported a family history of respiratory diseases and had been hospitalised because of respiratory problems before the age of 5 years more frequently than controls (12% versus 3%, p=0.009). By and large, these observations were reproduced when available in the ECLIPSE and COPDGene cohorts.These results show that early COPD is associated with substantial health impact and significant structural and functional abnormalities, albeit it is often not diagnosed (hence, treated). The fact that a sizeable proportion of patients with early COPD report a family history of respiratory diseases and/or early-life events (including hospitalisations before the age of 5 years) renders further support to the possibility of early-life origin of COPD.Early COPD is associated with substantial health impact, and structural and functional abnormalities, albeit it is often not diagnosed and hence, not treated. It is frequently associated with family history of respiratory diseases and early-life events. https://bit.ly/2ZtoRkp