Frontiers in Medicine (May 2022)

Chronic Obstructive Pulmonary Disease With Asthma-Like Features in the General Population in China

  • Kewu Huang,
  • Kewu Huang,
  • Kian Fan Chung,
  • Ting Yang,
  • Ting Yang,
  • Ting Yang,
  • Ting Yang,
  • Jianying Xu,
  • Lan Yang,
  • Jianping Zhao,
  • Xiangyan Zhang,
  • Chunxue Bai,
  • Jian Kang,
  • Pixin Ran,
  • Huahao Shen,
  • Fuqiang Wen,
  • Yahong Chen,
  • Tieying Sun,
  • Tieying Sun,
  • Guangliang Shan,
  • Yingxiang Lin,
  • Yingxiang Lin,
  • Guodong Xu,
  • Sinan Wu,
  • Sinan Wu,
  • Sinan Wu,
  • Ying Wang,
  • Ying Wang,
  • Xiaoying Gu,
  • Xiaoying Gu,
  • Xiaoying Gu,
  • Xiaoying Gu,
  • Ruiying Wang,
  • Zhihong Shi,
  • Yongjian Xu,
  • Xianwei Ye,
  • Yuanlin Song,
  • Qiuyue Wang,
  • Yumin Zhou,
  • Wen Li,
  • Liren Ding,
  • Chun Wan,
  • Wanzhen Yao,
  • Yanfei Guo,
  • Yanfei Guo,
  • Fei Xiao,
  • Yong Lu,
  • Yong Lu,
  • Xiaoxia Peng,
  • Dan Xiao,
  • Dan Xiao,
  • Dan Xiao,
  • Dan Xiao,
  • Dan Xiao,
  • Xiaoning Bu,
  • Xiaoning Bu,
  • Hong Zhang,
  • Hong Zhang,
  • Xiaolei Zhang,
  • Xiaolei Zhang,
  • Xiaolei Zhang,
  • Xiaolei Zhang,
  • Li An,
  • Li An,
  • Shu Zhang,
  • Shu Zhang,
  • Zhixin Cao,
  • Zhixin Cao,
  • Qingyuan Zhan,
  • Qingyuan Zhan,
  • Qingyuan Zhan,
  • Qingyuan Zhan,
  • Yuanhua Yang,
  • Yuanhua Yang,
  • Lirong Liang,
  • Lirong Liang,
  • Wenjun Wang,
  • Wenjun Wang,
  • Huaping Dai,
  • Huaping Dai,
  • Huaping Dai,
  • Bin Cao,
  • Bin Cao,
  • Bin Cao,
  • Jiang He,
  • Chen Wang,
  • Chen Wang,
  • Chen Wang,
  • Chen Wang,
  • Chen Wang,
  • Chen Wang,
  • Chen Wang,
  • Chen Wang

DOI
https://doi.org/10.3389/fmed.2022.876240
Journal volume & issue
Vol. 9

Abstract

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BackgroundPatients 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.MethodsCOPD 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.ResultsCOPD 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.ConclusionsCOPD 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.

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