In spite of difficulties in differentiating asthma from COPD, physicians should strive for accurate diagnosis because outcomes may be different.
Our aims were to compare the frequency of hospital admissions (HA) between severe asthmatic (SA) and Gold III-IV COPD subjects receiving disease specific guideline recommended therapy, depict the frequency of prevalent chronic disorders and the laboratorial profile suggesting allergic and eosinophilic phenotypes.
This cross-sectional study comprises one group of SA subjects and another group of Gold III-IV COPD subjects. Subjects answered standard questionnaires, underwent spirometry and provided a peripheral blood sample. We validated the HA that have occurred during the preceding year by review of the report emitted by the hospital. We detected comorbidities by review of current pharmacological therapies.
We enrolled 160 SA and 41 Gold III-IV COPD subjects. As compared with Gold III-IV COPD subjects, SA subjects had lower odds of HA (OR 0.19, 95CI 0.05-0.74) and higher odds of obesity (OR 9.17, 95CI 2.68-31.37), hypertension (OR 2.54, 95CI 1.16-5.57) and diabetes mellitus (OR 5.71, 95CI 1.56-20.85). The frequency of atopic and eosinophilic phenotypes were similar between study groups.
Our results demonstrated that Gold III-IV COPD subjects had worse outcomes as compared to SA subjects. We also observed that the frequency of atopy and high peripheral-blood eosinophil count were similar between study groups. Finally, we exposed aspects of comorbidities related to asthma and COPD that indicate the need of close monitoring the cardiovascular risk in SA subjects above 40 years of age.

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