A Cross-Sectional Study on the Prevalence of Asthma-Chronic Obstructive Pulmonary Disease Overlap in Patients Attending the Pulmonology Outpatient Department at Apollo Institute of Medical Sciences and Research, Chittoor, India

Abstract

Background Bronchial asthma and chronic obstructive pulmonary disease (COPD) exhibit distinct clinical characteristics; nevertheless, it is common to come across patients who display clinical signs of both conditions in clinical settings. The identification of this phenomenon has resulted in the adoption of the term "asthma-COPD overlap" (ACO), which characterizes a set of clinical characteristics rather than defining a singular entity. Different studies have indicated a prevalence of 15 to 55% for ACO. Individuals diagnosed with ACO experience more frequent severe episodes, leading to higher rate of inpatient care, emergency visits, and increased healthcare expenses compared to patients diagnosed with asthma and COPD. The present study was undertaken to determine the prevalence and phenotype of asthma-COPD overlap in patients attending the pulmonology outpatient department at Apollo Institute of Medical Sciences and Research (AIMSR) and District Headquarters Hospital (DHH) in Chittoor, India. Methods This was a prospective cross-sectional study conducted in patients attending the pulmonology department at AIMSR and DHH during May 2025 to August 2026. The demographic details were collected from the patients included in the study. All patients underwent Chest X-ray and pulmonary function test. The observations were tabulated and represented in frequency and percentage. The comparisons based on sex were done and the association was assessed using the Chi-square test and Student's t-test. Results This study included 79 subjects, of which 35 (44%) were females and 44 (56%) were males. Among females, 18 (51.43%) did not have a prior COPD diagnosis, while 17 (48.57%) were diagnosed with COPD. Among males, 14 (31.82%) did not have a prior COPD diagnosis, whereas 30 (68.18%) were diagnosed with COPD. The mean forced expiratory volume in one second to forced vital capacity (FEV1/FVC) ratio was 0.68±0.19 in female subjects and 0.64±0.17 in males. Among previously diagnosed asthmatics, 12 males and 20 females exhibited ACO, while it was seen in 30 males and 17 females in previously diagnosed COPD patients. Conclusion In the present study, the prevalence of ACO based on Global Initiative for Asthma 2016 guidelines in asthmatics was found to be seven in men and 12 in females, but in individuals with COPD, the prevalence was found to be eight in males and three in females.