Prevalence and demographical variation of asthma COPD overlap (ACO) in previously diagnosed chronic obstructive pulmonary disease patients of Southern Rajasthan: A cross sectional study

Abstract

Background: Asthma COPD overlap (ACO) is widely gaining recognition as separate phenotype of chronic obstructive airway disease with distinct treatment and prognosis. It is an important challenge of accurately diagnosing ACO. Aim: To estimate the prevalence of ACO among patients previously diagnosed as COPD and compare their demographical profile. Methodology: This was observational study of 351 patients with COPD visited at our center between 2018-2019. A detailed chart review including demographic, clinical, laboratory investigations, spirometry, and radiological findings were recorded in pre-structured proforma. The diagnosis of ACO was based on GINA/GOLD criteria 2019. Results: Of the total (n=351), ACO was diagnosed in 109 (31.05%) patients. Female predominance 61 (55.96%) patients were observed. There was a significantly higher incidence of wheeze, nasal symptoms, family history of atopy, as compared to obstructive airway disease. There was no significant difference in radiological findings between two groups. Conclusion: ACO represents a large proportion (31.05%) of bronchial asthma patients with female predominance, higher comorbidities. GINA/GOLD criteria 2019 are important questionnaire to differentiate ACO from COPD with limited role of chest imaging. The study results have implications for earlier identification and appropriate treatment of this distinct clinical phenotype.