COPD without Basal Airflow Obstruction: Clinical, Anthropometric, and Functional Characteristics

<bold>Introduction:</bold> In clinical practice, physicians are often faced with ambiguous situations, such as when a patient has COPD according to GOLD-2024 (i.e., post-bronchodilator FEV1/FVC < 0.70) without basal airflow obstruction according to ATS/ERS-2022 (i.e., z-score of pre-bronchodilator FEV1/FVC > -1.645). <bold>Aim:</bold> To compare the clinical, anthropometric, and functional characteristics of COPD patients with (GOLD+-ATS/ERS+) and without (GOLD+-ATS/ERS-) basal airflow obstruction. <bold>Methods:</bold> A comparative cross-sectional study was conducted in 2023. Clinical data (e.g., smoking consumption, dyspnea mMRC), age, and anthropometric data (e.g., height, weight, body mass index, and corpulence status) were collected. Spirometry and bronchodilator tests were performed. The study population was divided into two groups: G1 (GOLD+-ATS/ERS+) and G2 (GOLD+-ATS/ERS-). <bold>Results:</bold> Thirty-three male COPD patients were included (15 in G1 and 18 in G2). Both groups were matched for body mass index, corpulence status, smoking consumption, dyspnea, and GOLD level. Compared to G1, G2 was older (65±7 vs.57±9 years, p=0.004, respectively), had higher z-scores for basal FEV1 (−1.44±0.66 vs. -3.03±1.22, p<10-3n respectively), and basal FEV1/FVC (−1.19±0.34 vs. -3.36±1.07; p<10-3, respectively), and had higher post-bronchodilator FEV1/FVC (0.68±0.03 vs. 0.51±0.11 , p<10-3, respectively). <bold>Conclusion:</bold> COPD patients free from basal airflow obstructions seem to be comparable to those with basal airflow obstructions in terms of dyspnea, smoking consumption, and corpulence status. However, they are older, had higher z-scores for basal FEV1 and FEV1/FVC, and exhibit a higher post-bronchodilator FEV1/FVC.