RT Journal Article
SR Electronic
T1 Unravelling young COPD and pre-COPD in the general population
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00334-2022
DO 10.1183/23120541.00334-2022
VO 9
IS 1
A1 Borja G. Cosío
A1 Ciro Casanova
A1 Juan José Soler-Cataluña
A1 Joan B. Soriano
A1 Francisco García-Río
A1 Pilar de Lucas
A1 Inmaculada Alfageme
A1 José Miguel Rodríguez González-Moro
A1 Guadalupe Sánchez
A1 Julio Ancochea
A1 Marc Miravitlles
YR 2023
UL http://openres.ersjournals.com/content/9/1/00334-2022.abstract
AB Background Chronic obstructive pulmonary disease (COPD) is commonly diagnosed when the airflow limitation is well established and symptomatic. We aimed to identify individuals at risk of developing COPD according to the concept of pre-COPD and compare their clinical characteristics with 1) those who have developed the disease at a young age, and 2) the overall population with and without COPD.Methods The EPISCAN II study is a cross-sectional, population-based study that aims to investigate the prevalence of COPD in Spain in subjects ≥40 years of age. Pre-COPD was defined as the presence of emphysema >5% and/or bronchial thickening by computed chromatography (CT) scan and/or diffusing capacity of the lung for carbon monoxide (DLCO) <80% of predicted in subjects with respiratory symptoms and post-bronchodilator forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) >0.70. Young COPD was defined as FEV1/FVC <0.70 in a subject ≤50 years of age. Demographic and clinical characteristics were compared among pre-COPD, young COPD and the overall population with and without COPD.Results Among the 1077 individuals with FEV1/FVC <0.70, 65 (6.0%) were ≤50 years of age. Among the 8015 individuals with FEV1/FVC >0.70, 350 underwent both DLCO testing and chest CT scanning. Of those, 78 (22.3%) subjects fulfilled the definition of pre-COPD. Subjects with pre-COPD were older, predominantly women, less frequently active or ex-smokers, with less frequent previous diagnosis of asthma but with higher symptomatic burden than those with young COPD.Conclusions 22.3% of the studied population was at risk of developing COPD, with similar symptomatic and structural changes to those with well-established disease without airflow obstruction. This COPD at-risk population is different from those that develop COPD at a young age.Subjects fulfilling the definition of pre-COPD show similar symptomatic and structural changes to those with well-stablished disease. The fixed ratio of FEV1/FVC definition for COPD is missing an important group of patients that have significant disease. https://bit.ly/3B3FUO3