Photo Credit: Sinenkiy

A recent study found that the respiratory and non-respiratory symptom burden in patients with COPD is high when compared with patients without COPD.

The respiratory and nonrespiratory symptom burden in patients with chronic obstructive pulmonary disease (COPD) is high when compared with patients without COPD, according to a study published in EJR Open Research.

“The most prevalent symptoms in patients with COPD were dyspnea (68%), fatigue (68%), and muscle weakness (53%), while non-COPD participants mainly complained about insomnia (16%) and daytime or night-time micturition (14%),” wrote Sarah Houben-Wilke, PhD, and colleagues.

The study included 538 patients with COPD from primary, secondary, and tertiary care settings and 116 patients without COPD from primary care practices. Participants rated the severity of 20 physical and psychological symptoms using a visual analog scale (VAS).

Both groups were comparable in gender and age. Male patients comprised 58% of the COPD group and 55% of the non-COPD group, and average ages were 64 ±9 years for the COPD group and 63 ±6 years for the non-COPD group.

The study found that forced expiratory volume in 1 second was lower in the COPD group (57 ±23% predicted vs 111 ±17% predicted). Additionally, VAS scores were higher in patients with COPD for most symptoms, except for pain, dizziness, and micturition during the day and night. Predominant symptoms in the COPD group were dyspnea, fatigue, and muscle weakness.

“Muscle weakness as the third most important symptom might be explained by the high prevalence of fatigue. Indeed, participants described the sensation of fatigue as persistent, overwhelming tiredness, severe lack of energy, and physical weakness that worsens over time,” the researchers wrote. “Furthermore, multiple physical and psychological factors seem to be associated with fatigue, but little is known about the underlying determinants of fatigue in patients with COPD.”

Cluster analysis of patients with COPD identified three patterns of symptom severity reflecting the least (cluster 1), medium (cluster 2), and highest (cluster 3) symptom burden. In all three clusters, dyspnea and fatigue were most common.

“Health status and care dependency differed between all clusters, while functional mobility, exacerbation history, and lung function differed between cluster 1 and the other two clusters,” researchers reported. “Identifying clusters of patients with shared symptom experiences will help us to understand the impact of the disease and define integrated, multidimensional treatment strategies.”

Cluster 3 included more female patients, which aligns with studies that show higher symptom burden and lower QOL in women compared with men with COPD.

“Further research should focus on appropriate approaches to achieve adequate treatment strategies in women with COPD,” researchers wrote.