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COPD: Symptoms and Patient Groups
COPD symptoms are usually slow to develop and often don't appear until significant damage has occurred. Symptoms can come and go and may vary i...

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COPD: Symptoms & Grades

COPD symptoms can vary depending on the amount of damage in the lungs. Symptoms are usually slow to develop and often don’t appear until significant damage has occurred. Symptoms can also come and go and may vary in intensity.

Common COPD Symptoms

Chronic Cough

A cough is how the body clears the airways and lungs of mucus and other irritants and secretions. Mucus is usually clear. However, in people with COPD, it may be a yellow color. Often the cough is worst first thing in the morning. You may cough more when you exercise or smoke. The cough may persist every day, even if there are no other symptoms of illness such as a cold or the flu.


When you exhale through narrow or obstructed air passages, you will often hear a whistling or musical sound. This is called wheezing. In people with COPD, it is most often caused by excess mucus blocking the airways. Wheezing doesn’t necessarily mean you have COPD. Wheezing is also a symptom of asthma and pneumonia.

Shortness of Breath (Dyspnea)

As the airways in your lungs become inflamed and damaged and begin to constrict, you might find it difficult to breathe or catch your breath. This COPD symptom is most noticeable during increased physical activity. It can make routine daily tasks, such as walking, doing simple household chores, dressing, or bathing, more difficult. At its worst, it can even occur during rest.


If you have difficulty breathing, you often can’t get enough oxygen to your blood and to your muscles. Without the necessary oxygen, your body slows down and fatigue sets in. You may also feel tired because your lungs are working extra hard to get the oxygen in and the carbon dioxide out, thus draining your energy.

Other COPD Symptoms

Frequent Respiratory Infections

Because people with COPD have greater difficulty clearing their lungs of bacteria, viruses, pollutants, dust, and other irritants, they can be at greater risk for lung infections such as colds, flu, and pneumonia. Though it’s difficult to avoid infections altogether, practicing good hygiene and getting the correct vaccinations can reduce your risk.

Weight Loss

If you’ve had COPD for a long time, you may notice that you’ve been losing weight. The extra energy your body requires to breathe and get enough air in and out of the lungs may be burning more calories than your body is taking in, causing you to lose weight. Weight loss may also occur because fatigue and shortness of breath make eating difficult.

Advanced COPD Symptoms

Morning headaches can occur due to higher levels of carbon dioxide in the blood.

Swollen feet and ankles can occur due to increased stress on the heart, which has to work harder to pump blood through the damaged lungs. 

 Grades of COPD

There are four grades of COPD, ranging progressively from mild to very severe. Each grade brings with it different symptoms, and performance on pulmonary function tests (PFTs) typically decreases as the grades progress.

Grade 0

You only get breathless during or after strenuous exercise. 

Grade 1

You get short of breath when hurrying across level surfaces or when walking on a slight incline. There’s not usually a cough or mucus. Many people do not even realize they have a lung problem at this stage. Results of PFT are usually 80 percent or more of the predicted response, according to the Global Initiative for Chronic Obstructive Lung Disease.

Grade 2

You may walk slower than other people your age on level surfaces. You may become breathless when walking on level surfaces and have to stop to catch your breath. You may or may not have a cough or sputum. Many people first seek medical care at this point because of the symptoms. PFT results are 50-80 percent of the expected response.

Grade 3

You stop to regain your breath after only a few minutes of walking on a level surface. Again, you may or may not have a cough, sputum, or both. Exercise is very difficult at this point. Fatigue is increased, and quality of life begins to suffer. Results of PFTs are 30-50 percent of the predicted response.

Grade 4

You are too breathless to leave the house. You may become breathless during everyday activities, such as dressing and undressing. The most severe stage of COPD, this brings with it a significantly reduced quality of life because of shortness of breath. Trouble breathing may even be life-threatening during some episodes. Performance on PFTs are less than 30 percent of the expected response.

COPD is a serious condition that affects life in many ways. Because it is a progressive disease, signs and symptoms may not be noticeable until the condition has considerably worsened. If you are having trouble breathing or notice an unexplained cough, see your doctor for a medical opinion. 

Written by: Joann Jovinelly
Edited by:
Medically Reviewed by: [Ljava.lang.Object;@56339fa3
Published: Sep 8, 2014
Published By: Healthline Networks, Inc.
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