Frequency and Clinical Presentation of Asthma-COPD Overlap in COPD Patients
Abstract
Background: Asthma-COPD Overlap (ACO) represents a unique clinical phenotype that poses significant diagnostic and therapeutic challenges. Despite its clinical importance, limited data exists regarding its prevalence and characteristics in single-center settings.
Objective: To investigate the frequency of ACO among COPD patients and characterize its clinical presentation in a single-center study.
Methods: This cross-sectional study enrolled 60 consecutive COPD patients. ACO was diagnosed based on GINA/GOLD consensus criteria. Comprehensive clinical assessment included spirometry with bronchodilator reversibility testing, blood eosinophil counts, and detailed symptom evaluation. Clinical characteristics, laboratory parameters, and healthcare utilization patterns were compared between ACO and non-ACO COPD patients. Results: ACO was identified in 18 patients (30% of the cohort). ACO patients were significantly younger (62.4 ± 8.3 vs. 68.7 ± 7.2 years, p=0.002) and demonstrated higher blood eosinophil counts (385 ± 158 vs. 182 ± 124 cells/μL, p<0.001) compared to non-ACO COPD patients. They exhibited greater bronchodilator reversibility (18.4 ± 5.2% vs. 8.7 ± 3.8%, p<0.001) and experienced more frequent exacerbations (2.8 ± 1.4 vs. 1.6 ± 1.2 per year, p=0.002). ACO patients also showed higher rates of emergency department utilization (1.9 ± 1.1 vs. 1.2 ± 0.9 visits per year, p=0.014). Conclusion: ACO affects a substantial proportion of COPD patients and is characterized by distinct clinical features, including enhanced bronchodilator reversibility and increased exacerbation frequency. These findings emphasize the importance of systematic screening for ACO features among COPD patients to facilitate appropriate management strategies.
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References
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