This study aimed to identify symptom clusters of chronic obstructive pulmonary disease (COPD) and to examine the relationship between symptom clusters and health-related quality of life (HRQoL). It included 154 hospitalized patients with COPD. The majority of the participants (88.6%) were aged 60 years and above, and the numbers of men and women were approximately equal (men: 55.2%). The Charlson Comorbidity Index (CCI), the Memorial Symptom Assessment Scale (MSAS), and the Chinese version of the Clinical COPD Questionnaire (CCQ) were used to evaluate comorbidity, participant’s symptoms, and HRQoL, respectively. Five symptom clusters were identified using exploratory factor analysis, and symptom clusters, especially the Psychological, Pain and Fatigue, GI, and Dyspnea-Sweat symptom clusters, had negative effects on HRQoL in patients with COPD. Understanding the patterns and occurrences of symptom clusters could be essential for developing effective interventions to manage COPD symptoms and improve the patients’ HRQoL.

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Daily symptom variability refers to the fluctuation of chronic obstructive pulmonary disease (COPD) symptoms over the day. Although most clinicians can describe the day-to-day variation in symptoms experienced by patients with COPD, little has been done to quantify the variability. This review aims to synthesize evidence of daily symptom variability among patients with stable COPD. Of the 325 potentially relevant articles that were retrieved, 11 observational articles were finally included in the review. Patients with stable COPD commonly experience daily symptom variability, with morning being the most troublesome time of day, followed by night. Morning symptoms had a significant effect on morning routines or daily activities, and night-time symptoms affected the sleep quality of patients. In comparison with patients without symptom variability, patients with morning/night-time symptoms or symptom variability exhibited poorer health status as well as greater disease severity and incidence of exacerbation.

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