Study on Asthma and Chronic Obstructive Pulmonary Disease Overlaps among Patients with Obstructive Airway Diseases

Abstract

Background and Aim: Although asthma and chronic obstructive pulmonary disease (COPD) are clinically distinct
diseases, they represent biologically diverse and overlapping clinical entities and it has been observed that they
often co-occur. Some research and theorizing suggest there is a common comorbid condition termed asthmachronic obstructive pulmonary disease overlap (ACO). However, the existence of ACO is controversial.
Material and Methods: This is prospective, observational and descriptive study conducted at tertiary care
institute of Gujarat for the duration of 1 year. Among chronic airway diseases who were classified into three
groups (COPD, asthma and ACO). Patients with COPD and ACO were diagnosed according to GOLD guidelines
2020 and patients with asthma were diagnosed according to Global Initiative for Asthma (GINA) guidelines
2020. Total 150 participants were included in the research. All patients are subjected to full history taking, clinical
examination, full laboratory examinations, chest radiography, spirometry and post bronchodilator reversibility
test was performed and sputum analysis, where induction of sputum by hypertonic saline or mannitol is done by
a trained staff with strict airborne respiratory precautions.
Results: We found that 71.42% of ACO group, 79.48% of asthma group and 25% of COPD group had a positive
history of atopy. Comparison of study groups regarding sputum eosinophils revealed that 30.15 % of ACO group,
76.92% of asthma group and 31.25% of COPD group had positive sputum eosinophils.
Conclusion: ACO addresses an enormous rate among patients with obstructive airway diseases. It shares a few
highlights of asthma like atopy and positive sputum eosinophilia, and a few highlights of COPD like old age of
shows and positive smoking history