As per World Health Organization (WHO), Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable, and treatable chronic lung disease that affects men and women globally. COPD at the same time is called emphysema (destruction of tiny air sacs at the end of airways in the lungs) or chronic bronchitis (chronic cough with phlegm) for common people. Approximately 90 per cent of COPD deaths in those under 70 years of age occur in low- and middle-income countries. COPD is the third leading cause of death worldwide, causing 3.23 million deaths in 2019.
During the winter season, as AQI gets deteriorates, it leads to exacerbation of COPD problems. Environmental exposure to tobacco smoke, indoor air pollution, and occupational dust, fumes, Biomass Fuel and chemicals are major risk factors. COPD should be considered in any patient with the following clinical features- breathlessness progressive over time, characteristically worse with exercise, and persistent Chronic cough, which may be intermittent and may be unproductive but is associated with recurrent wheezing. As COPD progresses, people find it more difficult to carry out their daily activities, often due to breathlessness.
Diagnosis of COPD is made by considering three points of a triangle. The three points that are required to sum up the diagnosis of COPD are- 1) symptoms (shortness of breath, chronic cough, sputum), 2) risk factors (host factors, Tobacco, occupational exposure, indoor/outdoor pollution), 3)Pulmonary Function Test (to establish the diagnosis). Apart from these, the patient suspected of COPD is also subjected to other investigations like sputum examination, chest X-ray, and several other investigations to rule out co morbidities that play an important role in the management of COPD.
Management of COPD can be divided into two parts non-pharmacotherapy measures and pharmacotherapy measures. Non-pharmacological therapy includes- smoking cessation (it has the greatest capacity to influence the natural history of COPD), avoidance of air pollution, avoidance of biomass exposure(use of clean energy resources), vaccination(pneumococcal influenza, Covid etc ), and pulmonary rehabilitation (which also includes, Yoga, Pranayam and Breathing Exercises).
In addition to this, various pharmacological therapies are used in the management of COPD. Out of these, the mainstay is the bronchodilators via inhaled route. Advanced cases of COPD, mainly emphysema or bulla, are subjected to surgical interventions.
Uncontrolled symptoms of COPD make the patient vulnerable to COVID-19 infection. Hence COPD should be managed properly to reduce the chances of COVID-19 infection. The use of masks not only prevents COVID-19 infection but also helps in preventing people from air pollution.
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) releases COPD guidelines annually. The first gold guideline was propounded in 2001, and the GOLD report has been updated every year. As per new guidelines released for the year 2023, the global prevalence of COPD is 10.3 per cent. According to GOLD's new guidelines, COPD is increasing rapidly worldwide due to increased smoking in developing countries and the elderly population in rich countries.
The new report estimates that by 2060, the number of deaths from COPD due to increasing smoking (in poor countries) and elderly persons (in rich countries) could exceed 5.4 million. COPD is higher in ex-smokers (who have smoked for at least one year) and smokers (people who smoke) than nonsmokers (who do not smoke). Smoking is the major risk factor for COPD.
According to the new report, 50 per cent of smoking and 50 per cent of non-smoking factors are responsible for COPD. Three billion people in the globe utilize biomass fuels (coal, cow dung, wood, fireplaces, earthen stoves, etc.) for cooking, heating, and other purposes. It is referred to as biomass fuel exposure. All of these individuals are also at elevated risk for COPD.
COPD patients should talk to their doctors about getting flu, corona, pneumonia, Pertussis and Varicella vaccines. There are new rules about COPD and Covid-19, updated reports for telemedicine, and rules about spirometry. Lung cancer is usually the cause of death for many COPD patients. Because of this, people with COPD who got it from smoking should get a low-dose CT scan once a year as a screening tool for Lung Cancer. Both lung cancer and COPD can be treated better this way.
Bone illnesses, depression, and anxiety disorders are frequently neglected in COPD patients. These disorders should be adequately investigated and treated in COPD patients. In addition to this, COPD patients should also be treated for their other diseases while receiving COPD treatment (heart disease, diabetes, etc.).
Apart from this, innovation has been incorporated into the new COPD guidelines by modifying some new definitions, diagnostic procedures, treatment strategies, inhaler devices, investigation methodologies, etc.