Early detection of chronic obstructive pulmonary disease (COPD) with focused spirometry may improve treatment options and, in the long term, lower the illness’s high burden. As a result, researchers explored the possible therapeutic benefits of focused spirometry for COPD identification, with a focus on both pulmonary and extrapulmonary diseases in a current general population sample. From 2014 to 2017, they recruited 29,678 persons at random from the Copenhagen General Population Study. Individuals who were unlikely to have undetected COPD with a treatment potential (age <40 or >80, no smoking or respiratory symptoms, previous COPD/asthma diagnosis) were eliminated. COPD was characterized as a pre-bronchodilator forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) ratio of <0.70 and FEV1 of <80% of expected. 

About 5,520 people (19%) were at high risk of having undiagnosed COPD, with 589 (11%) meeting the COPD criteria. Around 45% were smokers, 23% had a modified Medical Research Council dyspnoea scale (mMRC) ≥2, 49% had a COPD assessment test (CAT) ≥10, and 12% had a poor physical activity level. Moreover, 8% were underweight, 28% were obese, 28% had undetected hypertension, 49% had undiagnosed hypercholesterolemia, and 1% had undiagnosed diabetes. Only 6.5% of those with undiagnosed COPD had no potentially treatable disease, whereas 73% had at least two.

Among the general community, one undiscovered COPD case will be found for every tenth spirometry in smokers with respiratory symptoms. Smoking cessation, treatment of respiratory symptoms, improved physical activity, and treatment of other undiscovered comorbidities might possibly benefit up to half of those with undiagnosed COPD.

Reference:www.resmedjournal.com/article/S0954-6111(22)00117-2/fulltext