Wheezing and Fatigue May Be Symptoms of COPD

Chest Diseases Specialist Assoc. Prof. Cengiz Özdemir explained frequently asked questions about COPD, stating: "Treatment options vary depending on disease severity, including bronchodilators, rehabilitation programs, and bronchoscopic treatments. However, these treatments are effective mainly in controlling symptoms and improving quality of life rather than curing the disease."

COPD ranks 3rd among causes of death globally and 7th in disability-adjusted life years. In Turkey, it similarly ranks 3rd among causes of death and 8th in disability-adjusted life years. According to World Health Organization data, 3.23 million people died from COPD in 2019.

Most common risk factors for COPD development

• Tobacco use and smoke exposure,
• Occupational and environmental dust exposure, and
• Air pollution.

Beyond these, genetic disorders (alpha 1 antitrypsin deficiency), lung development abnormalities, respiratory tract infections, nutritional disorders, oxidative stress, male gender, and advanced age are also identified risk factors for COPD development. In high-income countries, cigarettes and other tobacco products are responsible for more than 70% of COPD cases. In low and middle-income countries, while air pollution is the most important risk factor for COPD development, tobacco and cigarette use accounts for 30-40% of COPD cases. Approximately 90% of COPD deaths in people under 70 occur in low and middle-income countries.

What is COPD?

COPD is a common lung disease that causes airway narrowing and restriction of airflow, leading to respiratory problems. It is sometimes also called emphysema or chronic bronchitis. Emphysema generally refers to the persistent enlargement of small air sacs (alveoli) at the ends of airways in the lungs due to their destruction.

What is chronic bronchitis?

Chronic bronchitis refers to chronic cough accompanied by sputum production resulting from inflammation of the respiratory tract. What are the most common symptoms of COPD?

• Shortness of breath,
• Cough (productive or dry), and
• Wheezing and fatigue.

Shortness of breath is the most important and typically the first symptom, beginning as exertional dyspnea in early stages of COPD. Patients notice their capacity has decreased and their breath becomes restricted when climbing stairs or during running and sports activities compared to the past, or they tire more quickly than their peers. As the disease progresses, shortness of breath becomes more pronounced and can be felt even at rest. For this reason, patients with previously mentioned risk factors such as tobacco use and smoke exposure, and organic and inorganic dust exposure should be evaluated for COPD when they begin to experience difficulty with exertion, as this is very important for early diagnosis. Early diagnosis is of great importance in detecting and eliminating disease risk factors early to slow disease progression, preventing comorbid diseases that may develop later, and achieving better quality of life by reducing exacerbation risk.

In COPD patients;

• Lung infections,
• Lung cancer,
• Heart disease,
• Osteoporosis,
• Depression and anxiety and other accompanying diseases carry higher risk. Comorbidity with these and other chronic diseases worsens the course of COPD.

What factors affect disease progression?

• Exacerbations of COPD, which are characterized by rapid and sudden worsening of patient complaints, are the most important factors affecting disease progression.
• The most common cause of exacerbations is infections, particularly viral infections.
• Viral infections such as influenza and COVID in recent years progress more severely in COPD patients. For this reason, COPD patients must absolutely receive flu, COVID, and pneumonia vaccines and should pay attention to personal hygiene rules and mask use during periods when respiratory tract infections increase.

Eliminating risk factors, particularly tobacco use and smoke exposure as well as air pollution, constitutes the most important step in combating COPD.

What are the risk factors?

• The main pillars of treatment consist of eliminating risk factors,
• Controlling symptoms,
• Improving quality of life and preventing exacerbations.

How are symptoms controlled?

Treatment includes various options depending on disease severity, such as bronchodilators, rehabilitation programs, and bronchoscopic treatments. However, these treatments are effective mainly in controlling symptoms and improving quality of life rather than curing the disease.