What are the 4 stages of COPD?

From mild & low risk to very severe & high risk


COPD is the acronym that stands for Chronic obstructive pulmonary disease, an umbrella term for a group of lung conditions that results in breathing difficulties. COPD includes emphysema and chronic bronchitis. Emphysema is a condition which is characterised by damage to the air sacs in the lungs and chronic bronchitis is a condition characterised by long term inflammation of the airways in the lungs. Around 300 million people are estimated to have this condition around the world. 


COPD usually presents with classical symptoms of breathlessness and cough. Over time, breathing might become more difficult, worsening over time and the limit of your normal daily activities might decrease. 

Main COPD symptoms are:

  • Persistent coughing (sometimes with phlegm) - might resemble a smokers cough
  • Shortness of breath - especially during active periods
  • Chest infections
  • Wheezing during breathing  

COPD does improve with treatment and without treatment, the condition can become progressively worse. COPD sufferers might also experience periods of flare up or “exacerbations” when their medications are not optimised or if they are fighting an infection. 

COPD causes 

COPD is a common condition in smokers and normally people do not realise they suffer from this condition. The main condition that causes COPD is smoking as it leads to the lungs becoming inflamed, damaged and narrowed. However, while most COPD sufferers have a long smoking history, people who do not smoke might be diagnosed with it though this is rarer. The more you smoke, the increased likelihood of you developing COPD. 

4 Stages of COPD

The level of severity of COPD can be broken down into 4 stages. The stages are determined by the GOLD scoring system that assesses COPD during the Refined ABCD Assessment tool. The tool considers 3 things:

  • Spirometry results (a test that measures your lung function and airflow obstruction)
  • Your symptoms and the impact it has on your life
  • Your risk of having a COPD exacerbation 

Using these results, your COPD will be classified into Grade 1 to Grade 4 and a letter Grade A to D. These results provide your doctor with valuable information that will help them monitor and treat your COPD. 

The number grades provide your doctor with information about the level of airflow obstruction by analysing the results from the spirometry test. Spirometry is a simple breathing test that measures 2 things: the total volume of air you breathe out in one go (referred to as forced vital capacity or FVC) and the amount of air that you breathe out in 1 second of a hard exhale (called the forced expiratory volume in 1 second or FEV1). 

A diagnosis of COPD is made if the FEV1/FVC is less than 70%. The number grades are classified accordingly. 

Grade 1    Mild              FEV1 is 80% or higher
Grade 2    Moderate     FEV1 is between 50% and 79%
Grade 3    Severe         FEV1 is between 30% and 49%
Grade 4    Very severe  FEV1 is less than 30%

While this information is of value to your doctor in understanding how obstructed your airways are, assessing your flare-up risk and severity of symptoms using the letter grades will provide them with a wider understanding of their condition.

The letter grades are classified accordingly:

Group A         Low flare-up risk, few symptoms 
Group B         Low flare-up risk, more symptoms
Group C         High-flare up risk, fewer symptoms 
Group D         High flare-up risk, more symptoms

Treatment of COPD 

Unfortunately, COPD is a chronic progressive lifelong condition and does not have a cure. However, there are treatments out there that can slow down the progression of the disease and alleviate the symptoms such as cough and wheezing. The big way to prevent COPD or the progression of COPD is by stopping smoking. While reducing smoking does also have its benefits, stopping smoking is still highly recommended. Dr Felix offers a smoking cessation therapy called Champix

Other medications include steroid inhalers and medications to help ease breathing. Sometimes, some patients are referred to pulmonary rehabilitation (a program of lung exercises and education) and for a small group of people, a lung transplant might be an option. 

Dr Felix offers a range of COPD treatments such as Carbocisteine, Fostair and Trimbow. If you would like to purchase some COPD medications through Dr Felix, fill out an online consultation form which will be reviewed by a trained professional. Once reviewed, the medication will be sent straight to your doorstep in discreet plain packaging.

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