Characteristics of asthma–chronic obstructive pulmonary disease overlap among chronic obstructive pulmonary disease and asthma patients: Based on one center cross-sectional study

Abstract

BACKGROUND: Asthma-chronic obstructive pulmonary disease overlap (ACO) is a disease characterized by persistent airflow obstruction with several features of both asthma and chronic obstructive pulmonary disease (COPD). AIM: The aim was to find patients who meet ACO criteria among COPD and asthmatics. MATERIALS AND METHODS: This cross-sectional study included outpatients who applied to our pulmonology outpatient clinic with the previous diagnosis of asthma and COPD in 2019. These participants were evaluated to determine whether they met criteria of ACO. The diagnostic criteria in Global Initiative for Asthma (GINA)-Chronic Obstructive Lung Disease (GOLD), Spanish, and American Thoracic Society (ATS) Guidelines were used as the diagnostic assessment for ACO. RESULTS: There were 156 men (56%) and 123 women (44%) with a mean age of 56.7 ± 15.6. Of the 279 patients analyzed, 25 (9%) met the ACO diagnostic criteria; 137 (49.1%) had COPD, and 117 (41.9%) had asthma. 5.5% of COPD and 12.7% of asthma patients were given the diagnosis of ACO. Eighty eight percent of ACO patients met the diagnostic criteria of GINA-GOLD, whereby 64% of them met Spanish, and 68% met ATS Guideline Criteria. Patients with ACO were of older age, had more comorbidities, higher rates of smoking, and worse spirometry parameters when compared with asthmatics (P < 0.01, P < 0.01, P = 0.017, and P < 0.01, respectively). ACO patients had a higher rate of female gender, higher mean age and more allergic symptoms than COPD patients (all P < 0.01). CONCLUSION: There were more patients who were given the diagnosis of ACO in asthma group when compared with COPD group. Clinicians may consider the diagnosis of ACO in smokers and older asthmatics and in COPD patients with atopic symptoms.