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Clinical, laboratory, and functional characteristics of asthma-COPD overlap in patients with a primary diagnosis of COPD

OBJECTIVE: To evaluate the frequency of asthma-COPD overlap (ACO) in patients with COPD and to compare, from a clinical, laboratory, and functional point of view, patients with and without ACO, according to different diagnostic criteria. METHODS: The participants underwent evaluation by a pulmonolog...

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Detalles Bibliográficos
Autores principales: Queiroz, Ana Paula Adriano, Fonseca, Fernanda Rodrigues, de Rê, Alexânia, Maurici, Rosemeri
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Pneumologia e Tisiologia 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7889314/
https://www.ncbi.nlm.nih.gov/pubmed/33174971
http://dx.doi.org/10.36416/1806-3756/e20200033
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author Queiroz, Ana Paula Adriano
Fonseca, Fernanda Rodrigues
de Rê, Alexânia
Maurici, Rosemeri
author_facet Queiroz, Ana Paula Adriano
Fonseca, Fernanda Rodrigues
de Rê, Alexânia
Maurici, Rosemeri
author_sort Queiroz, Ana Paula Adriano
collection PubMed
description OBJECTIVE: To evaluate the frequency of asthma-COPD overlap (ACO) in patients with COPD and to compare, from a clinical, laboratory, and functional point of view, patients with and without ACO, according to different diagnostic criteria. METHODS: The participants underwent evaluation by a pulmonologist, together with spirometry and blood tests. All of the patients were instructed to record their PEF twice a day. The diagnosis of ACO was based on the Proyecto Latinoamericano de Investigación en Obstrucción Pulmonar (PLATINO, Latin American Project for the Investigation of Obstructive Lung Disease) criteria, the American Thoracic Society (ATS) Roundtable criteria, and the Spanish criteria. We investigated patient histories of exacerbations and hospitalizations, after which we applied the COPD Assessment Test and the modified Medical Research Council scale, to classify risk and symptoms in accordance with the GOLD criteria. RESULTS: Of the 51 COPD patients, 14 (27.5%), 8 (12.2%), and 18 (40.0) were diagnosed with ACO on the basis of the PLATINO, ATS Roundtable, and Spanish criteria, respectively. The values for pre-bronchodilator FVC, post-bronchodilator FVC, and pre-bronchodilator FEV(1) were significantly lower among the patients with ACO than among those with COPD only (1.9 ± 0.4 L vs. 2.4 ± 0.7 L, 2.1 ± 0.5 L vs. 2.5 ± 0.8 L, and 1.0 ± 0.3 L vs. 1.3 ± 0.5 L, respectively). When the Spanish criteria were applied, IgE levels were significantly higher among the patients with ACO than among those with COPD only (363.7 ± 525.9 kU/L vs. 58.2 ± 81.6 kU/L). A history of asthma was more common among the patients with ACO (p < 0.001 for all criteria). CONCLUSIONS: In our sample, patients with ACO were more likely to report previous episodes of asthma and had worse lung function than did those with COPD only. The ATS Roundtable criteria appear to be the most judicious, although concordance was greatest between the PLATINO and the Spanish criteria.
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spelling pubmed-78893142021-02-19 Clinical, laboratory, and functional characteristics of asthma-COPD overlap in patients with a primary diagnosis of COPD Queiroz, Ana Paula Adriano Fonseca, Fernanda Rodrigues de Rê, Alexânia Maurici, Rosemeri J Bras Pneumol Original Article OBJECTIVE: To evaluate the frequency of asthma-COPD overlap (ACO) in patients with COPD and to compare, from a clinical, laboratory, and functional point of view, patients with and without ACO, according to different diagnostic criteria. METHODS: The participants underwent evaluation by a pulmonologist, together with spirometry and blood tests. All of the patients were instructed to record their PEF twice a day. The diagnosis of ACO was based on the Proyecto Latinoamericano de Investigación en Obstrucción Pulmonar (PLATINO, Latin American Project for the Investigation of Obstructive Lung Disease) criteria, the American Thoracic Society (ATS) Roundtable criteria, and the Spanish criteria. We investigated patient histories of exacerbations and hospitalizations, after which we applied the COPD Assessment Test and the modified Medical Research Council scale, to classify risk and symptoms in accordance with the GOLD criteria. RESULTS: Of the 51 COPD patients, 14 (27.5%), 8 (12.2%), and 18 (40.0) were diagnosed with ACO on the basis of the PLATINO, ATS Roundtable, and Spanish criteria, respectively. The values for pre-bronchodilator FVC, post-bronchodilator FVC, and pre-bronchodilator FEV(1) were significantly lower among the patients with ACO than among those with COPD only (1.9 ± 0.4 L vs. 2.4 ± 0.7 L, 2.1 ± 0.5 L vs. 2.5 ± 0.8 L, and 1.0 ± 0.3 L vs. 1.3 ± 0.5 L, respectively). When the Spanish criteria were applied, IgE levels were significantly higher among the patients with ACO than among those with COPD only (363.7 ± 525.9 kU/L vs. 58.2 ± 81.6 kU/L). A history of asthma was more common among the patients with ACO (p < 0.001 for all criteria). CONCLUSIONS: In our sample, patients with ACO were more likely to report previous episodes of asthma and had worse lung function than did those with COPD only. The ATS Roundtable criteria appear to be the most judicious, although concordance was greatest between the PLATINO and the Spanish criteria. Sociedade Brasileira de Pneumologia e Tisiologia 2021 /pmc/articles/PMC7889314/ /pubmed/33174971 http://dx.doi.org/10.36416/1806-3756/e20200033 Text en © 2021 Sociedade Brasileira de Pneumologia e Tisiologia https://creativecommons.org/licenses/by-nc/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License
spellingShingle Original Article
Queiroz, Ana Paula Adriano
Fonseca, Fernanda Rodrigues
de Rê, Alexânia
Maurici, Rosemeri
Clinical, laboratory, and functional characteristics of asthma-COPD overlap in patients with a primary diagnosis of COPD
title Clinical, laboratory, and functional characteristics of asthma-COPD overlap in patients with a primary diagnosis of COPD
title_full Clinical, laboratory, and functional characteristics of asthma-COPD overlap in patients with a primary diagnosis of COPD
title_fullStr Clinical, laboratory, and functional characteristics of asthma-COPD overlap in patients with a primary diagnosis of COPD
title_full_unstemmed Clinical, laboratory, and functional characteristics of asthma-COPD overlap in patients with a primary diagnosis of COPD
title_short Clinical, laboratory, and functional characteristics of asthma-COPD overlap in patients with a primary diagnosis of COPD
title_sort clinical, laboratory, and functional characteristics of asthma-copd overlap in patients with a primary diagnosis of copd
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7889314/
https://www.ncbi.nlm.nih.gov/pubmed/33174971
http://dx.doi.org/10.36416/1806-3756/e20200033
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