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Tuberc Respir Dis > Accepted Articles
DOI: https://doi.org/10.4046/trd.2020.0031    [Accepted]
Published online October 13, 2020.
Clinical characteristics and changes of clinical features in patients with asthma-COPD overlap in Korea according to different diagnostic criteria
Jeong Uk Lim, 1, Deog Kyeom Kim, 2, Myung Goo Lee, 3, Yong-Il Hwang, 4, Kyeong-Cheol Shin, 5, Kwang Ho In, 6, Sang Yeub Lee, 7, Chin Kook Rhee, 8, Kwang Ha Yoo, 9, Hyoung Kyu Yoon, 1
1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yeouido St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
2Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
3Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
4Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea
5Regional Center for Respiratory Disease, Yeungnam University Medical Center,Yeungnam University College of Medicine, Daegu, Korea
6Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
7Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
8Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
9Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
Correspondence:  Hyoung Kyu Yoon, Tel: +82-2-3779-2213, Fax: +82-2-784-5458, 
Email: cmcyhg@catholic.ac.kr
Received: 3 April 2020   • Revised: 25 July 2020   • Accepted: 13 October 2020
Abstract
Introduction: Asthma-COPD overlap (ACO) is a condition characterized by overlapping clinical features of asthma and COPD. To evaluate appropriateness of different sets of ACO definition, we compared the clinical characteristics of previously defined diagnostic criteria and the specialist opinion in this study.
Methods
Patients enrolled in the KOrea COpd Subgroup Study (KOCOSS) were evaluated. Based on the questionnaire data, patients were categorized into ACO and non-ACO COPD groups according to the four sets of diagnostic criteria.
Results
In total 1,475 patients evaluated: 202 of 1,475 (13.6%), 32 of 1,475 (2.2%), 178 of 1,113 (16.0%), and 305 of 1,250 (24.4%) were categorized as ACO according to the modified SEPAR, ATS Roundtable, GINA/GOLD criteria, and specialists diagnosis respectively. The ACO group defined according to the GINA/GOLD criteria showed significantly higher SGRQ and CAT scores than the non-ACO COPD group. When the modified SEPAR definition was applied, the ACO group showed a significantly larger decrease in FEV1 (%). The ACO group defined by the ATS Roundtable showed significantly larger decrease in FVC values compared to the non-ACO COPD group (-18.9% vs. -2.2%; p=0.007 and -412 vs. -17 ml; p=0.036). The ACO group diagnosed by specialists showed a significantly larger decrease in the FEV1 (%) compared to the non- ACO group (-5.4% vs. -0.2%; p=0.003).
Conclusion
In the present study, prevalence and clinical characteristics of ACO varied depending on the diagnostic criteria applied.


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