Importance of acute exacerbations in the evolution of COPD

Chronic obstructive pulmonary disease (COPD) is a chronic disease with high social, health and economic costs. Numerous parameters and composite indexes reflect its clinical course, amongst which acute bronchial exacerbations play a major role. Viral and bacterial infections are the frequent source of exacerbation, causing inflammation of the lower airways and progressive airways remodelling. In some patients, bacterial and viral colonisation, also in stable COPD, increases the frequency and severity of exacerbations. The local and systemic inflammatory conditions in stable phases and exacerbations play a fundamental role in the decline of physical exercise capacity and daily activities, causing a faster lung function decline, a worsening of quality of life and increasing COPD related mortality.