Understanding the 4 Stages of COPD

The GOLD Grading System Classifies Disease Severity

Doctor listening to patient's cough
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If you've been diagnosed with chronic obstructive pulmonary disease (COPD), the next step will be understanding the stages of COPD. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) grading system classifies the disease into four grades according to its severity. Your doctor will determine the amount of damage present in your lungs using a spirometry test, which will provide a disease grade to guide your initial COPD treatment plan.

Here's what you need to know about the four GOLD stages of COPD.

Grade 1: Mild COPD

Many people with mild COPD having some airflow limitation, but may be unaware that their lung function has started to decline. You may not yet have any COPD symptoms, or you may have symptoms of chronic cough and excessive mucus. People at this stage are not likely to associate symptoms with the disease process and therefore, rarely seek treatment.

Grade 2: Moderate COPD

At this stage, airflow limitation worsens and you may start to notice symptoms, particularly shortness of breath upon exertion along with cough and sputum production. Symptoms may seem more problematic to people at this point, and this is when most people typically seek medical treatment.

Grade 3: Severe COPD

Once the disease has advanced to this stage, limitation of airflow significantly worsens, shortness of breath becomes more evident and COPD exacerbation is common.

If you reach this stage, you may notice a decrease in your activity tolerance and you may fatigue more quickly than usual.

Grade 4: Very Severe COPD

By the time a COPD patient's disease is classified as grade four, their quality of life is greatly impaired and COPD exacerbations are life threatening.

Airflow limitation is severe and chronic respiratory failure is often present at this stage. Respiratory failure could lead to complications with your heart, such as cor pulmonale and your COPD could be fatal.

Who Needs Spirometry?

Being a current or former smoker places you at high risk for COPD. That said, if you still smoke, you are strongly encouraged to quit. Additionally, if you have any COPD-related respiratory symptoms, like shortness of breath, increased mucus or a cough that won't go away, you should talk with your doctor about getting a spirometry test to confirm or negate a diagnosis of COPD.

Changing the Outcome of Your Disease

It is important that people with COPD understand that the COPD grading system is only meant to be used as a guideline. What's more important is how well you take care of yourself and how you feel.

There are steps that you can take to prevent COPD from advancing more rapidly that may also change the course of your disease. Find out How to Keep Your COPD From Getting Worse.


Global Strategy for the Diagnosis, Management and Prevention of COPD. The Global Initiative for Obstructive Lung Disease. Revised 2011.

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