COPD requires regular monitoring through tests like spirometry to assess the condition’s severity and aid in an individualized treatment plan.

COPD is a progressive lung condition that makes breathing challenging. By regularly monitoring lab values, doctors can help assess the disease’s progression and prescribe the most appropriate treatment.

The most important test to assess the degree of COPD is spirometry. Spirometry is often used to follow the course and response to treatment of COPD

Here’s what to know about spirometry, other potential lab tests that may be used, and how to know when the results are abnormal. It’s best to discuss the results with your doctor.

Several tests may be done to diagnose and monitor COPD, including:

  • Spirometry: This is the most common test used to diagnose and monitor COPD. This lung function test measures how much and fast you can exhale air from your lungs. When the breath is very slow or limited, it may be a sign of COPD, worsening COPD, or another lung condition like asthma. A spirometry test can catch COPD very early, even before any other symptoms are present.
  • Blood tests: Blood tests may sometimes be used to rule out other conditions like anemia (low iron levels) or erythrocytosis (high red blood cell count). They are also more recently being used to assess the levels of inflammation in the blood, which may be indicative of the systemic inflammation characteristic of COPD.
  • Electrocardiogram (ECG) tests: These tests measure the heart’s electrical activity and may sometimes be used to rule out other conditions, such as a heart problem.
  • Pulse oximetries (blood oxygen tests): These tests may sometimes be used to assess the level of oxygen in the blood. Pulse oximetry may be done during rest or during exercise.
  • Chest X-rays and CT scans: These may be used to assess and identify issues with the lungs more closely.
  • Phlegm samples: These may be used to check for a chest infection.

Regular spirometry tests are typically the most integral to assessing shifts in the progression of COPD. Your spirometry test results will tell you two things:

  1. The forced expiratory volume in one second (FEV1) measurement in a spirometry test reveals the volume of air you can exhale in one second.
  2. The expiratory forced vial capacity (FVC) shows the greatest amount of air you can breathe out after inhaling as deeply as possible.

Your doctor will have available the data available to predict the normal values for someone of your age, height, race, and sex. Your doctor may reference these guidelines to determine the severity of the COPD.

Normal resultAbnormal result
FEV180% or more of the predicted valueless than 80% of the predicted value
FVCgreater to or equal to the lower limit of the predicted valueless than the lower limit of the predicted value

An FEV1/FVC ratio of less than 70% may also indicate COPD. People with very severe COPD may have values as low as the 30% range.

In blood tests, people with a high neutrophil-to-lymphocyte ratio (NLR) or eosinophil-to-basophil ratio (EBR) often have greater severity of COPD. These test results reveal the underlying inflammation that’s a hallmark of the condition but are not definitive.

Specific stages of COPD include:

  • Stage 1: This is when your FEV1 is equal to or greater than the predicted normal and your FEV1/FVC ratio is less than 70%. Your symptoms are likely to be very mild or even unnoticeable.
  • Stage 2: This is when your FEV1 is between 50% to 79% of the predicted normal and you have an FEV1/FVC of less than 70%, the condition has progressed. You’re likely to experience more effects like shortness of breath after exercising and a cough.
  • Stage 3: This is when your FEV1 is between 30% to 49% of the normal and your FEV1/FVC ratio is less than 70%. COPD is more severe here and may include symptoms like shortness of breath, exhaustion, and increasing difficulty exercising.
  • Stage 4: This is when your FEV1 is less than 30% of predicted normal or less than 50% with chronic breathing failure. This stage is the most severe and will likely greatly impact your day-to-day quality of life.

Although there’s not yet a cure for COPD, it can be successfully managed with regular monitoring and treatment. COPD treatments may include:

  • Bronchodilators: These help relax and open the airways, though they do come with risks.
  • Inhaled corticosteroids: These also help reduce inflammation in the airways.
  • Oxygen therapy: This therapy helps deliver extra oxygen to the lungs if blood oxygen level is low.
  • Pulmonary rehab: This is an exercise regimen that helps strengthen the breathing muscles and builds cardiovascular endurance.
  • Antibiotics: This can help treat underlying respiratory infections which may be present.

Lifestyle changes that can benefit COPD include:

In more severe cases, surgery may be necessary. Since COPD treatment is highly individualized, talking with a doctor can help to create a multidisciplinary approach that works best for you.

Though COPD is a chronic condition, regular monitoring via labwork can slow the disease’s progression and help doctors develop the most effective treatment plan.

Regular spirometry tests, in particular, can help assess the severity of the condition. A combination of lifestyle changes, pulmonary rehab, and treatments like bronchodilators and corticosteroids can help COPD patients live as fully and well as possible.