What Are the Stages of COPD?

Reviewed on 6/24/2021

There are four stages of COPD (chronic obstructive pulmonary disease), which are determined by the total volume of air that a person can exhale and the amount of air a person can exhale in the first second of a hard exhale, which are measured in a breathing test called spirometry.
There are four stages of COPD (chronic obstructive pulmonary disease), which are determined by the total volume of air that a person can exhale and the amount of air a person can exhale in the first second of a hard exhale, which are measured in a breathing test called spirometry.

COPD (chronic obstructive pulmonary disease) refers to a group of chronic, progressive lung diseases that block airflow and cause breathing problems. Types of COPD include: 

There are four stages, or grades, of COPD that refer to the level of airflow obstruction, as measured by a simple breathing test called spirometry. The spirometer measures:

  • The total volume of air that a person can exhale (or breathe out) in one try, called the forced vital capacity (FVC)
  • The amount of air a person can exhale in the first second of a hard exhale, called the forced expiratory volume in one second (FEV1)

The stages, or grades, of COPD range from mild to very severe, based on how reduced a person’s FEV1 spirometry score is for their age, as follows in the table below.

COPD Stages
COPD Stage FEV1 Spirometry Score
Stage 1: Mild  FEV1 is 80% or higher
Stage 2: Moderate FEV1 is between 50% and 79%
Stage 3: Severe  FEV1 is between 30% and 49%
Stage 4: Very severe FEV1 is less than 30%

What Are Symptoms of COPD?

Symptoms of COPD (chronic obstructive pulmonary disease) include:

  • Frequent coughing 
  • Shortness of breath
  • Wheezing
  • Excess phlegm, mucus, or sputum production
  • Spitting up phlegm (mucus) 
  • Difficulty inhaling deeply

When symptoms of COPD worsen, often quickly and suddenly, it’s called an exacerbation or flare-up. Signs of an oncoming COPD exacerbation include: 

  • More shortness of breath than usual
  • Coughing more than usual 
  • Wheezing more than usual
  • Being more tired or fatigued than usual 
  • Feeling unwell (malaise)
  • Cold symptoms: fever, sore throat, or other cold symptoms 
  • Changes in mucus thickness, color, or amount
  • Swollen legs or ankles
  • Difficulty sleeping
  • Needing to sleep sitting up instead of lying down
  • Feeling a need for increased oxygen in patients who are on oxygen
  • Oxygen levels will be lower than normal if measured

Call 911 immediately or go to a hospital’s emergency department (do not drive yourself) if you experience serious warning signs of a COPD exacerbation such as:

  • Feeling as if you are suffocating 
  • Chest pain
  • Blue lips or fingers
  • Confusion

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What Is the Treatment for COPD?

The goal of treatment for COPD (chronic obstructive pulmonary disease) is to relieve symptoms, decrease the frequency and severity of exacerbations, and increase tolerance to exercise

Treatment for COPD may include:

  • Quitting smoking
    • This is the most important part of COPD treatment for people who smoke as it’s the most common cause of COPD
  • Avoiding secondhand tobacco smoke
  • Avoiding air pollutants at home and at work
  • Pulmonary rehabilitation
    • An individualized treatment program that teaches strategies to improve quality of life for COPD patients
  • Medications to treat symptoms 
    • Bronchodilators including anticholinergics and beta2-agonists to help open airways and make breathing easier
    • Anti-inflammatories, such as corticosteroids 
    • Antibiotics for lung infections
    • Influenza (flu) and pneumococcal vaccinations to prevent lung infections, which can cause serious problems in people with COPD
  • Supplemental oxygen

Patients who have COPD should be prepared for exacerbations and need to work with their doctors to have a plan for when they occur. Treating flare-ups quickly can reduce the chances of serious illness and additional lung damage. 

Treatment for COPD exacerbations may include: 

  • Quick-relief inhaler
  • Nebulizer 
  • Steroids 
  • Antibiotics

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Reviewed on 6/24/2021
References
https://www.cdc.gov/copd/index.html

https://www.lung.ca/lung-health/lung-disease/copd/flare-ups

https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/treating

https://gaapp.org/copd/diagnosis/four-stages-of-copd/