Chronic obstructive pulmonary disease (COPD) is a persistent respiratory disease that may cause long-term, progressive lung damage. Acute exacerbations are when a person’s respiratory symptoms significantly worsen.

People with chronic obstructive pulmonary disease (COPD) may experience episodes of severe, acute symptoms that require therapy. An acute flare-up is a sudden, short-term onset of symptoms.

These are known as exacerbations and may:

  • contribute to COPD progression
  • increase healthcare costs
  • lead to a change in your treatment plan and medication
  • cause irreversible lung damage
  • lower your quality of life
  • increase your risk of hospitalization and death

The average person with COPD experiences between 0.85–1.3 exacerbations a year. Exacerbation symptoms may take 2–3 days to develop, and periods may last between 7 and 14 days. However, according to research, lung function may not fully return to pre-exacerbation levels after 8 weeks.

It’s estimated that more than 10 million healthcare visits per year in the United States are due to COPD exacerbations. In 2019, according to the Centers for Disease Control and Prevention (CDC), COPD was the fourth leading cause of death.

Exacerbation symptoms may differ from typical COPD symptoms, and they’re often more severe. The most common exacerbation symptom is dyspnea, which is shortness of breath or difficulty breathing.

Other signs and symptoms may include:

  • breathing in a fast, shallow pattern
  • coughing
  • feeling excessively sleepy or confused
  • lower oxygen levels than the clinical expectation
  • increased sputum production, which is often yellow, green, tan, or even blood-tinged
  • wheezing and chest tightness

It’s important to speak with a doctor if you recognize early indications or experience any of these signs or symptoms. One exacerbation may be enough to increase the frequency, duration, and severity of episodes.

Some COPD exacerbation symptoms require immediate emergency care. Examples include:

A COPD exacerbation increases the current inflammation of your airway and lungs. This may be triggered by:

  • viral infections, such as those caused by human rhinoviruses, which include the common cold
  • bacterial tracheobronchial infections
  • smoking
  • air pollutants and irritants, such as chemical agents, fumes, and dust
  • chronic bronchitis

There’s currently no single test to diagnose a COPD exacerbation. A doctor will assess your symptoms to see whether they stem from a worsening comorbidity, such as pneumonia, osteoporosis, or acute cardiac failure.

They may also ask you to complete a few patient-centered surveys, which may include:

  • COPD Assessment Test (CAT)
  • Medical Research Council (mMRC) dyspnea scale
  • Clinical COPD Questionnaire (CCQ)
  • St. George’s Respiratory Questionnaire (SGRQ)

The doctor will then make a diagnosis based on the questionnaire and the symptom elimination process.

The strongest predictor of an exacerbation occurring is whether you’ve had one before. But with some COPD exacerbations, there are no known causes, according to the American Thoracic Society.

If you have COPD, it’s important to take every step possible to avoid lung infection. Actionable steps can include getting your annual flu shot, getting the annual pneumococcal vaccine, and staying up to date with COVID-19 vaccination. Infections and colds may cause serious complications.

Treatments for COPD exacerbations focus on reducing the effects of the current episode and depend on whether you’re hospitalized. Exacerbations may be classified as mild, moderate, or severe.

Home treatments

It is estimated that 80% or more of COPD exacerbations are typically mild or moderate and can be treated at home with medication.

A doctor may prescribe:

Emergency treatments

Some people who experience severe COPD exacerbations may be hospitalized. This might be due to symptom severity, limited support at home, or poor response to initial treatments.

At a hospital, the doctor may provide you with oxygen therapy to support your breathing. The first method is through a venturi mask or nasal cannula, which is known as noninvasive ventilation (NIV).

If your symptoms are very severe, such as involving cardiac or respiratory arrest, or you do not respond well to NIV, the doctor will likely put you on a ventilator. If mechanical ventilation is needed, you’ll stay in the intensive care unit until your infection clears or your lungs become less inflamed.

Establishing a COPD treatment plan with a doctor is an important step to help prevent future exacerbations.

Along with taking any prescribed medication, some self-care practices include:

What are the common signs of COPD exacerbation?

The most common indicator of a COPD exacerbation is dyspnea, which is shortness of breath or difficulty breathing. Other common signs are wheezing, chest tightness, and increased mucus.

What does a COPD exacerbation feel like?

A COPD exacerbation is when you experience an episode of severe, acute symptoms. You may experience chest tightness and find it very difficult to catch your breath. You may also notice that you’re breathing in a fast, shallow pattern. This might make you feel anxious or excessively tired for a prolonged period of time.

If you’re having trouble walking, feeling confused, or have clammy skin, it’s important to get medical assistance.

Can COPD exacerbation be treated?

Mild and moderate COPD exacerbations may often be treated at home, while severe episodes might require hospitalization.

At-home treatments can include medications, lifestyle and dietary adjustments, and engaging in and keeping a record of self-care activities.

Hospital treatments might include oxygen therapy, mechanical ventilation, and medications.

COPD exacerbations are very serious. They may cause permanent lung damage, lower your quality of life, and increase your risk of mortality. Having one exacerbation may also heighten the severity and frequency of future exacerbations. Prevention is very important.

If you have COPD or suspect any early signs of an exacerbation, speak with a doctor.