AUTHOR=Huang Kewu , Chung Kian Fan , Yang Ting , Xu Jianying , Yang Lan , Zhao Jianping , Zhang Xiangyan , Bai Chunxue , Kang Jian , Ran Pixin , Shen Huahao , Wen Fuqiang , Chen Yahong , Sun Tieying , Shan Guangliang , Lin Yingxiang , Xu Guodong , Wu Sinan , Wang Ying , Gu Xiaoying , Wang Ruiying , Shi Zhihong , Xu Yongjian , Ye Xianwei , Song Yuanlin , Wang Qiuyue , Zhou Yumin , Li Wen , Ding Liren , Wan Chun , Yao Wanzhen , Guo Yanfei , Xiao Fei , Lu Yong , Peng Xiaoxia , Xiao Dan , Bu Xiaoning , Zhang Hong , Zhang Xiaolei , An Li , Zhang Shu , Cao Zhixin , Zhan Qingyuan , Yang Yuanhua , Liang Lirong , Wang Wenjun , Dai Huaping , Cao Bin , He Jiang , Wang Chen TITLE=Chronic Obstructive Pulmonary Disease With Asthma-Like Features in the General Population in China JOURNAL=Frontiers in Medicine VOLUME=9 YEAR=2022 URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.876240 DOI=10.3389/fmed.2022.876240 ISSN=2296-858X ABSTRACT=Background

Patients with features of both asthma and chronic obstructive pulmonary disease (COPD) are seen commonly in the clinic but less is known in the general population. We investigated the prevalence and the heterogeneity of COPD with concomitant features of asthma in Chinese adult population.

Methods

COPD was defined as post-bronchodilator ratio of forced expiratory volume in 1s (FEV1) to forced vital capacity of less than the lower limits of normal. COPD with concomitant features of asthma was defined as either COPD with asthma diagnosed by self-reported physician-diagnosis or by presence of current wheeze, or as COPD with high bronchodilator response (HBR) defined as an increase in FEV1 >15% and >400 ml after bronchodilator.

Results

COPD with concomitant features of asthma was found in 1.62% (95% CI 1.31–2.00) of adults (≥20 years) or in 15.2% (95% CI 13.0–17.7) of COPD patients. Compared with COPD with HBR, COPD with asthma diagnosis or wheeze were older (61.8 ± 1.1 years vs. 47.4 ± 2.8 years, P < 0.001), and with a lower post-bronchodilator FEV1%pred (68.2 ± 2.3 vs. 96.6 ± 3.4, P < 0.001). Age, smoking status, biomass use and allergic rhinitis were associated with increasing prevalence of COPD with asthma diagnosis or wheeze, and had greater impaired health status, more comorbidities and more acute exacerbations in the preceding 12 months.

Conclusions

COPD with concomitant features of asthma is common in people with COPD and those with COPD with asthma diagnosis or wheeze experience worse clinical severity than COPD with HBR. These findings will help toward the definition of the asthma-COPD overlap condition.