Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease (COPD) is a common chronic lung disease that causes restricted airflow and breathing difficulties. It develops gradually due to damage and inflammation of the airways and lungs and is commonly associated with chronic bronchitis and emphysema.[1]

COPD is a progressive disease that can significantly limit daily activities and quality of life. Although it cannot be cured, appropriate treatment and avoidance of harmful exposures can improve symptoms and slow disease progression.[1]

Global Impact

COPD is the third leading cause of death worldwide, causing approximately 3.4 million deaths in 2023, equivalent to about 6% of all global deaths. It is also the seventh leading cause of poor health worldwide, measured in disability-adjusted life years.[1]

Nearly 90% of COPD deaths among people younger than 70 years occur in low- and middle-income countries.[1]

Impact in India

COPD represents a major public health burden in India. According to WHO estimates, approximately 35.8 million people in India were living with COPD in 2021.[2]

COPD is also among the leading causes of death in India. WHO estimates indicate a mortality rate of approximately 70.5 deaths per 100,000 population in 2021.[3]

Risk Factors

Major risk factors for COPD include tobacco smoking and second-hand smoke, household air pollution from biomass fuels such as wood, animal dung and crop residues, outdoor air pollution, occupational exposure to dusts, fumes and chemicals, frequent or severe respiratory infections during childhood, poor lung growth during early life, childhood asthma and rare genetic conditions such as alpha-1 antitrypsin deficiency.[1]

Signs and Symptoms

Common symptoms of COPD include:

  • Shortness of breath
  • Persistent or chronic cough
  • Excessive phlegm or sputum production
  • Wheezing
  • Fatigue
  • Difficulty performing normal physical activities.[1]

Symptoms can suddenly worsen during COPD exacerbations or flare-ups, which may require additional treatment or hospitalization.[1]

Diagnosis

COPD should be suspected in people with characteristic respiratory symptoms and relevant risk-factor exposure. Diagnosis is confirmed using spirometry, a breathing test that measures airflow into and out of the lungs.[1]

Treatment and Management

COPD cannot currently be cured, but treatment can reduce symptoms, prevent exacerbations and improve quality of life.[1]

    1. Inhaled Medicines: Bronchodilator inhalers are the main medicines used to treat COPD and help keep the airways open. Inhaled corticosteroids may be combined with bronchodilators in selected patients.[1]
    2. Pulmonary Rehabilitation: Exercise training, education and breathing strategies can improve physical capacity and help people manage their symptoms.[1]
    3. Oxygen Therapy: Long-term oxygen therapy may be required in some people with severe COPD and persistently low blood oxygen levels.[1]

Avoiding tobacco smoke and air pollution, remaining physically active and receiving recommended influenza, pneumococcal and COVID-19 vaccinations are also important components of COPD management.[1]

Prevention

Many cases of COPD can be prevented by avoiding tobacco use and second-hand smoke, reducing household and outdoor air pollution and minimizing occupational exposure to harmful dusts, fumes and chemicals.[1]

Early recognition of symptoms, spirometry-based diagnosis and appropriate treatment can help reduce disease progression, exacerbations and complications.[1]

Evidence-based guidelines for the diagnosis and management of COPD have been developed jointly by the Indian Chest Society (ICS) and National College of Chest Physicians (India) [NCCP(I)], with the guideline development coordinated by the Department of Pulmonary Medicine, PGIMER, Chandigarh. These guidelines provide recommendations for the diagnosis and assessment of COPD, pharmacological and non-pharmacological management, prevention and management of acute exacerbations, pulmonary rehabilitation and other aspects of COPD care. Available on: https://www.ovid.com/jnls/lungindia/fulltext/10.4103/0970-2113.116248~guidelines-for-diagnosis-and-management-of-chronic?an=01408641-201330030-00018 [4]

References

  1. World Health Organization. Chronic obstructive pulmonary disease (COPD). Geneva: World Health Organization; 2026 Jun 10. Available from: https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd)
  2. World Health Organization Regional Office for South-East Asia. Chronic respiratory diseases in WHO South-East Asia: burden, risk factors and services for prevention and management. New Delhi: WHO Regional Office for South-East Asia; 2025. Available from: https://iris.who.int/server/api/core/bitstreams/1bee7cbe-f37c-45a7-bed3-76058e86ec60/content
  3. World Health Organization. India: leading causes of death. Geneva: World Health Organization. Available from: India
  4. Gupta D, Agarwal R, Aggarwal AN, Maturu VN, Dhooria S, Prasad KT, et al. Guidelines for diagnosis and management of chronic obstructive pulmonary disease: Joint ICS/NCCP (I) recommendations. Lung India. 2013;30(3):228–267. Available from: https://www.ovid.com/jnls/lungindia/fulltext/10.4103/0970-2113.116248~guidelines-for-diagnosis-and-management-of-chronic?an=01408641-201330030-00018