Clinical and instrumental characteristics of chronic obstructive pulmonary disease in combination with bronchial asthma

The phenotype combining features of bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD) (asthma-COPD overlap) remains poorly understood, complicating diagnosis and treatment. This study aims to fill these gaps by conducting a detailed analysis of the characteristics of this phenotype (asthma-COPD overlap) in comparison with isolated forms of COPD and BA. Objective. To study the characteristics of COPD in combination with asthma — asthma-COPD overlap. Material and methods. A retrospective analysis was performed of 180 patient medical records (2022—2023), divided into three groups: a group with a combination of asthma and COPD symptoms (asthma-COPD overlap, n=60), asthma (n=60), and COPD (n=60). Results. Patients with a combination of asthma and COPD symptoms had the shortest duration of illness but the longest duration of hospitalization. Like patients with COPD, they were characterized by a high frequency of emergency hospitalizations, long smoking history, severe dyspnea (3—4 on the mMRC scale), and frequent complications (emphysema). The smoker index in patients with this phenotype was lower than in COPD but higher than in asthma. External respiration function (ERF) indicators (vital capacity (VC), functional vital capacity (FVC), forced expiratory volume in one second (FEV1)) in patients with asthma-COPD overlap were comparable to COPD and lower than in asthma. Saturation in patients in this group was the lowest among the groups. Peak expiratory flow (PEF) and Tiffeneau index values were closer to asthma than to COPD. Conclusion. The study results showed that asthma-COPD overlap is more severe than isolated COPD and asthma, as evidenced by reduced FEV1, severe hypoxemia, and a high frequency of complications. These data are consistent with current understanding of mixed obstruction in asthma-COPD overlap. Although standardized methods and strict criteria increase reliability, the retrospective design and small sample size limit interpretation. The identified features of asthma-COPD overlap require the development of differentiated approaches to diagnosis and treatment, which is consistent with the general trend toward personalized therapy for chronic respiratory diseases.