https://doi.org/10.4081/monaldi.2022.2323

Assessment of prevalence and characteristics of asthma-COPD overlap among patients with chronic airflow obstruction

Vol. 93 No. 2 (2023)
Submitted: May 13, 2022
Accepted: August 7, 2022
Published: September 2, 2022
prevalence, HRCT, COPD, asthma, asthma-COPD overlap
Abstract Views: 1156
PDF: 441
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Kapil Kumar
https://orcid.org/0000-0001-8148-8164
Respiratory Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, India.
Prem Parkash Gupta
drprempgupta@yahoo.co.in
https://orcid.org/0000-0002-9670-6870
Respiratory Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, India.
Arvind Kumar Verma
https://orcid.org/0000-0001-6874-6165
Pulmonary Medicine, Moti Lal Nehru Medical College, Prayagraj, India.
Rohtas Yadav
Radio-Diagnosis, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, India.

Given the paucity of research on asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) and the high prevalence of co-morbidities and healthcare utilization associated with it, the current study looked at the prevalence of ACO and its clinico-radiological phenotype in patients with chronic airflow obstruction. The study was conducted at a tertiary care hospital in North India. Patients over 40 with COPD or asthma were screened for inclusion in the ACO, asthma, and COPD groups. The ACO and COPD groups were further investigated. The clinical characteristics, lung functions, health-related quality of life, and radiological features of both groups were investigated and compared. ACO was discovered in 16.3% of patients with chronic airflow obstruction (asthma and COPD). The most commonly observed symptoms at presentation in the evaluated ACO patients (n=77) were shortness of breath, wheezing, cough, and expectoration (mean age at presentation: 57.9; mean duration of illness: 8.62 years). Exacerbation rates in ACO patients were significantly higher than in COPD patients (p<0.001). The ACO group had a significantly greater mean change in FEV1 post-bronchodilator in millilitres (ml) and percentage (379.61 ml and 37.72%) than the COPD group (p<0.001). The proportion of patients with emphysema was lower in the ACO group than in the COPD group (p<0.001). The ACO and COPD groups did not differ significantly in major airway wall thickness (p=0.3), but the COPD group had a significantly higher proportion of patients with vascular attenuation and distortion (p<0.001). Patients with COPD had a higher degree of hyperinflation, according to high resolution computed tomography (HRCT) indices. This study found that patients with ACO have a distinct phenotype in terms of clinical presentation and HRCT features. More research on the radiological features of ACO is required to identify the anatomical abnormalities involved in the disease's pathogenesis and to validate the radiological features of ACO.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
de Marco R, Pesce G, Marcon A, et al. The coexistence of asthma and chronic obstructive pulmonary disease (COPD): prevalence and risk factors in young, middle-aged and elderly people from the general population. PloS One 2013;8:e62985. DOI: https://doi.org/10.1371/journal.pone.0062985
Rabe KF, Hurd S, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 2007;176:532–55. DOI: https://doi.org/10.1164/rccm.200703-456SO
Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PloS Med 2006;3e442. DOI: https://doi.org/10.1371/journal.pmed.0030442
Koul PA. Chronic obstructive pulmonary disease: Indian guidelines and the road ahead. Lung India 2013;30:175–7. DOI: https://doi.org/10.4103/0970-2113.116233
To T, Stanojevic S, Moores G, et al. Global asthma prevalence in adults: findings from the cross-sectional world health survey. BMC Public Health 2012;12:204. DOI: https://doi.org/10.1186/1471-2458-12-204
Koul PA, Patel D. Indian guidelines for asthma: Adherence is the key. Lung India 2015;32:S1-2. DOI: https://doi.org/10.4103/0970-2113.154511
Ehteshami-Afshar S, FitzGerald JM, Carlsten C, et al. The impact of comorbidities on productivity loss in asthma patients. Respir Res 2016;17:106. DOI: https://doi.org/10.1186/s12931-016-0421-9
Mukherjee M, Stoddart A, Gupta RP, et al. The epidemiology, healthcare and societal burden and costs of asthma in the UK and its member nations: analyses of standalone and linked national databases. BMC Med 2016;14:113. DOI: https://doi.org/10.1186/s12916-016-0657-8
Louie S, Zeki AA, Schivo M, Chan AL, et al. The asthma-chronic obstructive pulmonary disease overlap syndrome: pharmacotherapeutic considerations. Expert Rev Clin Pharmacol 2013;6:197-219. DOI: https://doi.org/10.1586/ecp.13.2
Soler-Cataluña JJ, Cosío B, Izquierdo JL, et al. Consensus document on the overlap phenotype COPD-asthma in COPD. Arch Bronconeumol 2012;48:331–7. DOI: https://doi.org/10.1016/j.arbr.2012.06.017
Hardin M, Cho M, McDonald ML, et al. The clinical and genetic features of COPD-asthma overlap syndrome. Eur Respir J 2014;44:341–50. DOI: https://doi.org/10.1183/09031936.00216013
Menezes AMB, Montes de Oca M, Pérez-Padilla R, Nadeau G, Wehrmeister FC, Lopez-Varela MV, et al. Increased risk of exacerbation and hospitalization in subjects with an overlap phenotype: COPD-asthma. Chest 2014;145:297–304. DOI: https://doi.org/10.1378/chest.13-0622
Kraft M. Asthma and chronic obstructive pulmonary disease exhibit common origins in any country! Am J Respir Crit Care Med 2006;174:238–40. DOI: https://doi.org/10.1164/rccm.2604007
Global Initiative for Asthma - GINA. 2017 Diagnosis and initial treatment of asthma, COPD and asthma-COPD overlap. Accessed 2022 Apr 2. Available from: https://ginasthma.org/wp-content/uploads/2019/11/GINA-GOLD-2017-overlap-pocket-guide-wms-2017-ACO.pdf
Jones PW, Harding G, Berry P, et al. Development and first validation of the COPD assessment test. Eur Respir J 2009;34:648–54. DOI: https://doi.org/10.1183/09031936.00102509
Reda AA, Kotz D, Kocks JWH, et al. Reliability and validity of the clinical COPD questionniare and chronic respiratory questionnaire. Respir Med 2010;104:1675–82. DOI: https://doi.org/10.1016/j.rmed.2010.04.023
Miller MR, Hankinson J, Brusasco V, et al. Standardisation of spirometry. Eur Respir J 2005;26:319–38. DOI: https://doi.org/10.1183/09031936.05.00034805
Andersén H, Lampela P, Nevanlinna A, et al. High hospital burden in overlap syndrome of asthma and COPD. Clin Respir J 2013;7:342–6. DOI: https://doi.org/10.1111/crj.12013
Marsh SE, Travers J, Weatherall M, et al. Proportional classifications of COPD phenotypes. Thorax 2008;63:761–7. DOI: https://doi.org/10.1136/thx.2007.089193
Miravitlles M, Soriano JB, Ancochea J, et al. Characterisation of the overlap COPD-asthma phenotype. Focus on physical activity and health status. Respir Med 2013;107:1053–60. DOI: https://doi.org/10.1016/j.rmed.2013.03.007
Kauppi P, Kupiainen H, Lindqvist A, et al. Overlap syndrome of asthma and COPD predicts low quality of life. J Asthma 2011;48:279–85. DOI: https://doi.org/10.3109/02770903.2011.555576
Corlateanu A, Botnaru V, Rusu D, et al. Assessment of health-related quality of life in different phenotypes of COPD. Eur Respir J 2017;50:PA3581. DOI: https://doi.org/10.1183/1393003.congress-2017.PA3581
Cosentino J, Zhao H, Hardin M, et al. Analysis of asthma-chronic obstructive pulmonary disease overlap syndrome defined on the basis of bronchodilator response and degree of emphysema. Ann Am Thorac Soc 2016;13:1483–9. DOI: https://doi.org/10.1513/AnnalsATS.201511-761OC
Gao Y, Zhai X, Li K, et al. Asthma COPD Overlap syndrome on CT densitometry: A distinct phenotype from COPD. COPD 2016;13:471–6. DOI: https://doi.org/10.3109/15412555.2015.1102874
Suzuki T, Tada Y, Kawata N, et al. Clinical, physiological, and radiological features of asthma-chronic obstructive pulmonary disease overlap syndrome. Int J Chron Obstruct Pulmon Dis 2015;10:947–54. DOI: https://doi.org/10.2147/COPD.S80022
Fayed HK, Abd-Elkareem YG, Samaha WA, Abdalshakour MS. Functional and radiological characteristics of asthma combined chronic obstructive pulmonary disease overlap. Egypt J Bronchol 2019;13:596–604. DOI: https://doi.org/10.4103/ejb.ejb_14_19

How to Cite

Kumar, Kapil, Prem Parkash Gupta, Arvind Kumar Verma, and Rohtas Yadav. 2022. “Assessment of Prevalence and Characteristics of Asthma-COPD Overlap Among Patients With Chronic Airflow Obstruction”. Monaldi Archives for Chest Disease 93 (2). https://doi.org/10.4081/monaldi.2022.2323.
Copyright (c) 2022 The Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.