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Identifying and managing seasonal exacerbations of COPD

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The advent of COVID has made it even more imperati The advent of COVID has made it even more imperative to identify and manage exacerbations of COPD

This article will explore the nature of acute exacerbations of chronic obstructive pulmonary disease (COPD), their identification, treatment and impact on patient management, and when they are most likely to occur.1 It will also discuss how this affects the patient experience of disease, and prevention strategies.

An acute exacerbation of COPD (AECOPD) is defined by GOLD as an acute worsening of respiratory symptoms that results in the need for additional therapy, and by NICE as a sustained worsening of the patient’s symptoms from their usual stable state which is beyond normal day-to-day variations, and is acute in onset. Commonly reported symptoms are worsening breathlessness, cough, increased sputum production and change in sputum colour. The change in these symptoms often necessitates a change in medication.2

Since the start of the COVID-19 pandemic, the identification and management of AECOPD has assumed even greater urgency and importance for those with COPD, their carers and clinicians. AECOPD are known to be caused by bacteria, viruses or air pollution/environmental factors. Respiratory viruses have clear seasonal patterns, and there is a marked seasonal pattern to AECOPD, with a twofold increase in incidence during winter months in temperate climates.1

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