Stages of COPD

Chronic obstructive pulmonary disease (COPD) is a lung disease classified into stages based on the severity of the condition.¹ By establishing the stage of COPD, it allows doctors to help determine the best plan to manage your symptoms.¹

So, how many stages of COPD are there? The Global Initiative for Chronic Obstructive Lung Disease (GOLD) system is commonly used by doctors to categorize the severity of COPD. Most doctors use the GOLD guidelines to classify and treat COPD.

The GOLD system classifies COPD into 4 different stages based on results from:

• breathing tests, such as results from spirometry, a test that checks the amount of air and speed that you can exhale.
• the severity of symptoms and
• how frequently exacerbations, also known as flare-ups, occur.^1,2

Your doctor will examine your medical history, evaluate your symptoms and may also carry out tests such as lung function tests, chest X-rays, or a computed tomography (CT) scan to get these results and find out what stage of COPD you have.²

These criteria, and considering other health problems you have, help your doctor grade your COPD and deciding the most appropriate management option for you.⁸

Detecting COPD early is important in order to determine how to manage your disease.³

COPD is categorised into 4 stages: mild, moderate, severe, and very severe. Each stage is characterised by different levels of symptom severity, with symptoms typically worsening when COPD is not well managed.^1,2

These may not be a comprehensive list of signs and symptoms of COPD please always speak to your healthcare professional if you have any of the below symptoms and they can help find out the cause.

Stage 1: Mild COPD

The earliest stage of COPD is known as mild or stage 1 and is defined by limited airflow into the lungs.⁴

The most common symptoms of this stage are:⁴

• • Breathlessness
  • Cough
  • Sputum production

Some symptoms of COPD, such as coughing and sputum production, may not be present in all people with COPD and many are not aware they have the disease until more severe symptoms develop.⁴

At this stage, you may not notice many symptoms. You might experience occasional shortness of breath or a cough, especially when being active.

Stage 2: Moderate COPD

Stage 2 of COPD is also known as moderate COPD. Symptoms that were present in stage 1 of the disease, such as coughing, sputum production and shortness of breath during exercise, become more noticeable as airflow gets more restricted.⁴

Stage 3: Severe COPD

In stage 3 of COPD, previous symptoms have worsened such as increased shortness of breath and coughing with everyday activities.⁴ Other symptoms of stage 3 COPD can include reduced exercise ability and chronic fatigue (tiredness), you may find it harder to breathe even when resting.

Stage 4: Very Severe COPD

In Stage 4 of COPD is the most advanced stage, where lung function is low. Symptoms from stage 3 worsen with breathing difficulties being very noticeable and can severely limit your daily activities. You may need oxygen therapy to help with breathing.

Some patients may go to hospital due to breathing complications, lung infections, or respiratory failure during stage 4, with sudden exacerbations posing a life-threatening risk.⁴

COPD management is personalised and may change over time. Your doctor will work with you to find the best approach for your needs :

For mild symptoms: your doctor may recommend starting with a bronchodilator, most often in the form of an inhaler,to help with breathing.¹ Lifestyle changes like quitting smoking and staying active are also important to manage symptoms and help prevent worsening.¹

For more noticeable symptoms: Your doctor might recommend a combination of two types of long-acting bronchodilators. These medications work together to keep your airways open for extended periods.¹ In addition, and on top of the lifestyle changes such as quitting smoking, pulmonary rehabilitation (exercise programs designed for lung health) can help improve your quality of life.

For patients with frequent exacerbations or exacerbations that require to go to the hospital, the doctor may recommend adding inhaled corticosteroids (to reduce inflammation) along with the long-acting bronchodilators.

Blood tests can be used to help make decisions for individual needs.

After starting treatment, your doctor will check how well it’s working and identify any challenges you may face.

Your treatment will depend on factors like the stage of your COPD and any other health conditions you have. Always follow the advice of your healthcare provider, and only take medications prescribed for you. Regular check-ups will allow your doctor to make any necessary adjustments to your plan.

As COPD is a progressive lung disease, symptoms can become worse over time. Individuals with COPD can be at an increased risk for developing complications.^1,5

It is important to understand your symptoms and what is the stage of COPD, as it can help your doctor tailor the most effective management plan for you.¹

Complete the COPD self-assessment questionnaire to understand how you can improve the management of your disease.