Chronic obstructive pulmonary disease (COPD) is a complex and progressive chronic lung disorder. Typically, COPD includes emphysema and chronic bronchitis. COPD is characterized by the restriction of airflow into and out of the lungs. The obstruction of airflow makes breathing difficult. The causes of COPD include smoking, long-term exposure to air pollutants and a rare genetic disorder. To understand the severity of COPD and how it affects people’s lives, doctors developed stages/grades of COPD. Here is the information you need to know about mild through end-stage COPD.

How are the Stages/Grades of COPD Determined?

The two most common ways to determine the stages/grades of COPD include the GOLD Staging System and the BODE Index.

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) developed the GOLD Staging System. In the GOLD System, the forced expiratory volume in one second (FEV1) measurement from a pulmonary function test is used to place COPD into stages/grades. Often, doctors also consider your COPD symptoms.

The BODE Index stands for body mass, obstruction of airflow, dyspnea (difficulty breathing) and exercise capacity. Doctors use the BODE Index to better understand how COPD affects your life and the severity of your symptoms.

Other types of lung function tests may also be needed to help doctors figure out your stage or grade of COPD. These tests include gas diffusion tests, 6-minute walk tests, body plethysmography and spirometry.

What are the Stages of COPD?

COPD has four stages (also known as grades). The grades of COPD range from mild to very severe. COPD affects everyone differently. Because COPD is a progressive lung disorder, it will worsen over time. Your doctor will categorize your COPD stage/grade based on your COPD symptoms and results from your lung function tests.

For some people, the stages/grades of COPD develop slowly, but for some, the disease progresses rapidly. Seeing your doctor regularly is important, even if you’re feeling well. Your doctor will track your condition over time. This means that your doctor may recommend you have multiple pulmonary function tests, chest x-rays, CT scans and other types of testing.

Your doctor can keep track of how well your lungs and COPD treatment plan are working, so he or she can modify your treatment plan as your stage/grade of COPD changes. As the stages/grades of COPD increase, airflow becomes more limited.

The Stages / Grades of COPD:

  • Mild COPD or Stage/Grade 1—Mild COPD with a FEV1 about 80 percent or more of normal.
  • Moderate COPD or Stage/Grade 2—Moderate COPD with a FEV1 between 50 and 80 percent of normal.
  • Severe COPD or Stage/Grade 3—Severe emphysema with a FEV1 between 30 and 50 percent of normal.
  • Very Severe COPD or Stage/Grade 4—Very severe or End-Stage COPD with a lower FEV1 than Stage (Grade) 3, or people with low blood oxygen levels and a Stage (Grade) 3 FEV1.

What Happens in Mild Stage COPD?

The first category is stage/grade 1 or mild stage COPD. In this early grade of COPD, people may not realize that they have a problem yet. Many people continue with their daily activities with slight limitations to their breathing. Some people experience a cough and phlegm.

It’s important to see a doctor and receive a diagnosis as early as possible. This way you and your doctor can work together to develop an individualized COPD treatment plan.

What Happens in Moderate Stage COPD?

During the moderate stage of COPD or stage/grade 2, many people notice more coughing and mucus production. People tend to seek medical care for limitations in breathing and increased symptoms.

At this point in your condition, your doctor may prescribe bronchodilators to help you breathe better. Your doctor may also recommend pulmonary rehabilitation. Participating in a pulmonary rehab program helps people with lung diseases learn how to breathe and function better. It combines exercise, education and support, and you work with a team of doctors, nurses and medical specialists.

What Happens in Severe Stage COPD?

Stage/Grade 3 or severe stage COPD has a large impact on people’s quality of life. Lung function continues to decline, and breathing becomes more difficult. Typically, COPD symptoms make it challenging to enjoy your favorite activities or to perform daily tasks. During this level, many people feel more fatigue and have difficulty exercising.

Your doctor may prescribe corticosteroids to help reduce inflammation, combination inhalers and other kinds of medications or therapies.

What Happens in Very Severe or End-Stage COPD?

End-stage COPD or stage/grade 4 is classified as very severe and often affects quality of life profoundly. Flare-ups and breathing issues may become life threatening. Your doctor may add to your existing COPD treatment plan or change it based on your needs.

By end-stage COPD, many people have trouble receiving enough oxygen. Low blood oxygen levels can lead to serious health conditions such as hypoxia or hypoxemia, cyanosis and other problems. When low blood oxygen levels occur, your doctor may prescribe oxygen therapy to help ensure your body receives adequate oxygen.

Taking Care of You and Your Lungs

Stages of COPD: Mild through End-Stage COPD

Understanding the stages (grades) of COPD is one of the first steps you can take in becoming more proactive in your healthcare. As your COPD progresses, continue working with your doctor to modify your treatment plan as needed. Take note of any changes you notice in your symptoms, what triggers your symptoms to worsen and how COPD affects your ability to do daily activities. See your doctor immediately if you feel unwell or have changes in your health.

In combination with your current treatment plan, consider talking with your doctor about alternative therapies, such as lifestyle changes, herbs and supplements or cellular therapy. Interestingly, cellular therapy aims to improve overall lung health, potentially allowing you to Breathe Easier and improve your quality of life. If you or a loved one has COPD, emphysema, chronic bronchitis or another chronic lung disease and would like to learn more about cellular therapy, contact us at 866-638-4776. Our dedicated team of Patient Care Specialists and Board-Certified Medical Providers is here to help ensure a smooth patient experience on your journey to BREATHE EASIER.


Medical Disclaimer: This content is for educational and informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Please consult with a physician with any questions that you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you read in this article. We strive for 100% accuracy, but errors may occur, and medications, protocols, and treatment methods may change over time.