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Medicina
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New Trends in Chronic Obstructive Pulmonary Disease (COPD)
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New Trends in Chronic Obstructive Pulmonary Disease (COPD)

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Pulmonology".

Deadline for manuscript submissions: 31 July 2026 | Viewed by 4566

Special Issue Editors

Dr. Alberto Fantin

E-Mail Website
Guest Editor Assistant
Department of Pulmonology, University Hospital of Udine (ASUFC), 33100 Udine, Italy
Interests: COPD; spirometry; airway; obstruction; bronchoscopy; pleural diseases
Dr. Ernesto Crisafulli

E-Mail Website
Guest Editor
Respiratory Medicine Unit, Department of Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy
Interests: aspects of rehabilitation treatment (efficacy, phenotypes, predictors, comorbidities) in patients with chronic disabling diseases of the respiratory system, especially COPD; events related to hospital flare-ups/readmissions in patients with COPD; the inflammatory, bacteriological, and clinical aspects of community-acquired pneumonia; the ventilatory response to maximal exercise on cardiopulmonary exercise testing in patients with chronic respiratory diseases (COPD, cystic fibrosis); prevalence and clinical significance of small airway dysfunction in patients with COPD

Special Issue Information

Dear Colleagues,

Chronic Obstructive Pulmonary Disease (COPD) represents a significant and escalating global health burden. Characterised by persistent respiratory symptoms and airflow limitation, COPD is a leading cause of morbidity and mortality worldwide. The disease profoundly affects individuals by diminishing the quality of life, limiting physical activity, and increasing vulnerability to exacerbations and comorbid conditions. On a societal level, COPD imposes considerable economic costs due to healthcare utilisation, hospital admissions, long-term treatment requirements, and loss of productivity. Despite its pervasive impact, COPD remains under-recognised and underdiagnosed, particularly in low-resource settings. Traditionally, the management of COPD has centred on pharmacological interventions aimed at symptom control and exacerbation prevention. However, recent years have witnessed significant advancements in our understanding of the disease's pathophysiology, epidemiology, and management strategies. Emerging trends emphasise a more holistic and personalised approach, integrating pharmacological therapies with non-pharmacological interventions such as pulmonary rehabilitation, nutritional support, psychological counselling, and telemedicine. Moreover, novel diagnostic tools, biomarkers, and digital health technologies are reshaping the landscape of early detection and disease monitoring. Environmental and genetic research has also shed light on risk factors beyond smoking, including air pollution, occupational exposures, and genetic predispositions. This broader perspective is crucial for developing targeted prevention strategies and public health policies. Additionally, the recognition of COPD's heterogeneity has led to the identification of distinct phenotypes and endotypes, paving the way for precision medicine approaches tailored to individual patient profiles. The purpose of this Special Issue is to explore and disseminate the latest developments in COPD research and clinical practice. We invite contributions that address a wide array of topics, including but not limited to novel therapeutic approaches, advances in non-pharmacological management, patient-centred care models, innovations in diagnostic and monitoring technologies, epidemiological studies, and the impact of environmental and genetic factors. We are particularly interested in research that highlights multidisciplinary and integrative approaches to COPD care, as well as studies that consider the challenges and opportunities in diverse healthcare settings globally. By bringing together a broad spectrum of perspectives and expertise, this Special Issue aims to foster a comprehensive understanding of COPD and inspire future research and clinical innovations. We look forward to your valuable contributions to this important discourse.

Dr. Alberto Fantin
Guest Editor Assistant

Dr. Ernesto Crisafulli
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • COPD management
  • pulmonary rehabilitation
  • airflow limitation
  • respiratory symptoms
  • disease monitoring
  • non-pharmacological treatments
  • precision medicine
  • environmental factors
  • exacerbation prevention
  • patient-centered care

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Published Papers (4 papers)

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Research

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16 pages, 698 KB  
Article
Clinical and Functional Heterogeneity of COPD Phenotypes: A Multicenter Study from Turkey (DIPTUR Study)
by Tevfik Ozlu, Ozlem Sengoren Dikis, Fulden Cantas Turkis, Ceren Degirmenci, Ahmet Ilgazlı, Inci Gülmez, Burcu Yalcin, Gulistan Karadeniz, Yasemin Soyler, Hatice Selimoglu Sen, Aysel Sunnetcioglu, Nimet Aksel, Sibel Boga, Nurhan Sarioglu, Haci Ahmet Bircan, Aylin Capraz, Serap Argun Baris, Aycan Yuksel, Umut Sabri Kasapoglu, Sibel Arınc, Esra Yarar, Nur Aleyna Yetkin, Fusun Sahin, Ali Tabaru, Dildar Duman, Gunhan Yavasoglu, Dursun Tatar, Mehmet Karadag, Kadir Coban, Ersin Alkilinc, Ebru Tas, Taha Tahir Bekci, Derya Kizilgoz, Buket Mermit, Murat Kavas, Hakan Alp Yilmazli, Ilknur Basyigit, Esen Sayin Gulensoy, Meltem Agca, Filiz Alkan Baylan, Canan Bol, Berat Uslu and Gamze Celikadd Show full author list remove Hide full author list
Medicina 2026, 62(2), 402; https://doi.org/10.3390/medicina62020402 - 19 Feb 2026
Viewed by 796
Abstract
Background and Objectives: Chronic obstructive pulmonary disease (COPD) is heterogeneous, and phenotype-based classification may better capture differences in clinical burden and healthcare needs beyond standard GOLD categories. We aimed to describe the distribution of GesEPOC COPD phenotypes in Turkey and compare their [...] Read more.
Background and Objectives: Chronic obstructive pulmonary disease (COPD) is heterogeneous, and phenotype-based classification may better capture differences in clinical burden and healthcare needs beyond standard GOLD categories. We aimed to describe the distribution of GesEPOC COPD phenotypes in Turkey and compare their demographic, clinical, functional, radiological, treatment, and healthcare utilization profiles. Materials and Methods: DIPTUR was a multicenter, observational, cross-sectional study conducted prospectively in 26 centers across 17 Turkish cities (October 2019–June 2021). Stable COPD patients (≥40 years; post-bronchodilator FEV1/FVC < 0.7) without exacerbation or major treatment modification within the previous four weeks were enrolled consecutively. Phenotypes were assigned per GesEPOC: exacerbator with emphysema (EE), exacerbator with chronic bronchitis (ECB), asthma–COPD overlap (ACO), and non-exacerbator (NE). Frequent exacerbators were defined as patients who experienced two or more exacerbations during the 12 months preceding enrollment, based on medical records and patient reports. Results: Among 894 patients, phenotype distribution was NE 44.1%, ECB 26.2%, EE 20.5%, and ACO 9.3%. Male predominance was observed across groups (80–89%; p = 0.006). Active smoking was most frequent in ECB (37.6%; p < 0.001), and BMI was lowest in EE (p < 0.001). Comorbidity patterns differed, with hypertension (p < 0.001), diabetes mellitus (p = 0.029), and heart failure (p < 0.001) most prevalent in ECB. Pulmonary function (FEV1 and FVC) was lowest in EE (both p < 0.001), and severe airflow limitation (GOLD III–IV) was most common in EE and ECB (p < 0.001). Dyspnea (mMRC ≥ 2) was more frequent in EE/ECB than in ACO/NE (p < 0.001). Emphysematous changes on thoracic CT predominated in EE (91.7%; p < 0.001). Long-term oxygen therapy was most common in EE (32.4%; p < 0.001). Emergency admissions, hospitalizations, and total length of stay were markedly higher in EE and ECB than in ACO and NE (all p < 0.001). Conclusions: COPD phenotypes in Turkey show substantial heterogeneity in clinical, functional, radiological, and utilization domains. Exacerbator phenotypes—particularly EE and ECB—represent higher-burden groups, supporting phenotype-oriented management and closer monitoring beyond GOLD classification. Full article
(This article belongs to the Special Issue New Trends in Chronic Obstructive Pulmonary Disease (COPD))
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12 pages, 821 KB  
Article
Echocardiographic Evidence of Left Ventricular Dysfunction in COPD: Relationship with Disease Severity
by Rounak Bhattacharjee, Tanushree Deb, Prosenjit Roy, Prithwiraj Bhattacharjee, Israel Maldonado Rosas and Shubhadeep Roychoudhury
Medicina 2025, 61(7), 1260; https://doi.org/10.3390/medicina61071260 - 11 Jul 2025
Cited by 4 | Viewed by 1417
Abstract
Background and Objectives: Chronic obstructive pulmonary disease (COPD) significantly impacts morbidity and mortality, often due to cardiovascular comorbidities that are frequently overlooked. This study examines the prevalence of left ventricular dysfunction in COPD patients and its association with disease severity, hypoxemia, and [...] Read more.
Background and Objectives: Chronic obstructive pulmonary disease (COPD) significantly impacts morbidity and mortality, often due to cardiovascular comorbidities that are frequently overlooked. This study examines the prevalence of left ventricular dysfunction in COPD patients and its association with disease severity, hypoxemia, and exacerbation frequency. Materials and Methods: COPD patients (n = 114) were evaluated using spirometry and transthoracic echocardiography. Statistical analysis utilized Student’s t-test, chi-square test, and multivariable logistic regression with 1000 bootstrapping iterations, considering p < 0.05 as significant differences. Results: Most patients were classified as Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage III (40.4%) and stage IV (44.7%). Diastolic dysfunction was present in 67.5% of the patients (Grade 1: 53.5%, Grade 2: 13. 2%, Grade 3: 0.0.9%), while 18.4% exhibited systolic dysfunction (LVEF < 50%). The prevalence of diastolic dysfunction increased significantly, from 41.2% in GOLD stage II to 92. 2% in GOLD stage IV (p < 0.001). Independent predictors of diastolic dysfunction included GOLD stage IV (Odds Ratio [OR]: 5.39, 95% Confidence Interval [CI]: 1. 42–23.35, p < 0.001), older age (OR: 1.02 per year, 95% CI: 1.01–1.04, p = 0.025), and a history of frequent exacerbations (OR: 1.09 per event, 95% CI: 1.01–1.17, p = 0.039). Systolic dysfunction correlated significantly with GOLD stage IV (OR: 1.83, p = 0.014), oxygen saturation below 88% (OR: 3.12, p = 0.036), and having three or more exacerbations (OR: 4.18, p = 0.008). Conclusions: This study reveals a high prevalence of left ventricular dysfunction in COPD patients, linked to disease severity, hypoxemia, and frequent exacerbations. It supports incorporating complementary echocardiographic assessments in managing advanced COPD, especially for those with frequent exacerbations or oxygen desaturation. Full article
(This article belongs to the Special Issue New Trends in Chronic Obstructive Pulmonary Disease (COPD))
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Review

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20 pages, 1034 KB  
Review
The Evolving Landscape of COPD Typization
by Alberto Fantin, Nadia Castaldo, Giulia Sartori, Claudia di Chiara, Filippo Patrucco, Giuseppe Morana, Vincenzo Patruno and Ernesto Crisafulli
Medicina 2026, 62(3), 564; https://doi.org/10.3390/medicina62030564 - 18 Mar 2026
Viewed by 1068
Abstract
Chronic obstructive pulmonary disease (COPD) represents an escalating global health challenge characterized by profound clinical and biological heterogeneity. Conventional diagnostic paradigms, primarily reliant on spirometric criteria and broad phenotypic labels, often fail to capture the complex molecular mechanisms underlying effective precision medicine. This [...] Read more.
Chronic obstructive pulmonary disease (COPD) represents an escalating global health challenge characterized by profound clinical and biological heterogeneity. Conventional diagnostic paradigms, primarily reliant on spirometric criteria and broad phenotypic labels, often fail to capture the complex molecular mechanisms underlying effective precision medicine. This narrative review synthesizes the evolving landscape of COPD characterization, analyzing the integration of biomarkers, advanced quantitative imaging, and multi-omics technologies. Key developments highlighted include the clinical validation of biologics targeting type 2 inflammation, which reinforce the paradigm shift from generic symptomatic management toward the identification of specific treatable traits. We further explore the role of artificial intelligence and deep learning in enhancing radiological precision and body composition analysis. Ultimately, this work proposes a transition toward a GETomics (Genetics, Environment, and Time) framework as a fundamental prerequisite for transcending the limitations of traditional classification systems and delivering truly personalized care in the 21st century. Full article
(This article belongs to the Special Issue New Trends in Chronic Obstructive Pulmonary Disease (COPD))
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23 pages, 498 KB  
Review
Recognition and Management of Cognitive Impairment in Chronic Obstructive Pulmonary Disease (COPD): Implications of Clinical Confidence
by Rayan A. Siraj
Medicina 2026, 62(3), 438; https://doi.org/10.3390/medicina62030438 - 26 Feb 2026
Viewed by 685
Abstract
Cognitive impairment is a serious comorbidity in chronic obstructive pulmonary disease (COPD), consistently associated with adverse clinical outcomes, including impaired self-management, poor treatment adherence, reduced participation in pulmonary rehabilitation, and increased risk of mortality. Despite this, it remains inconsistently recognised and insufficiently addressed [...] Read more.
Cognitive impairment is a serious comorbidity in chronic obstructive pulmonary disease (COPD), consistently associated with adverse clinical outcomes, including impaired self-management, poor treatment adherence, reduced participation in pulmonary rehabilitation, and increased risk of mortality. Despite this, it remains inconsistently recognised and insufficiently addressed during routine COPD assessment. This narrative review synthesises current evidence on the recognition and management of cognitive impairment in COPD, with a particular focus on understanding why it continues to be under-recognised and inadequately managed in clinical practice. Across care settings, cognitive concerns are commonly identified informally, assessed selectively, or deferred altogether, even when clinicians acknowledge their relevance to respiratory assessment, treatment implementation, and patient engagement. This persistent evidence–practice gap suggests the influence of factors extending beyond disease- or patient-related explanations alone. Emerging evidence indicates that clinician-level determinants, particularly clinical confidence, play a central role in shaping cognitive care practices. Limited clinical confidence appears to mediate the translation of existing knowledge and competence into clinical action, influencing decisions to initiate assessment, communicate cognitive concerns, assume clinical ownership, and pursue follow-up or referral. These confidence-related barriers are further reinforced by educational limitations, time constraints, diagnostic ambiguity, particularly in the early cognitive impairment stage, and the absence of clear operational guidance within COPD-specific frameworks. Conceptualising cognitive care through the lens of clinical confidence provides a coherent explanation for the underrecognition of cognitive impairment in COPD. It also helps account for observed variability in clinical decision-making, highlighting clinical confidence as a modifiable intermediary between knowledge, competence, and practice and a potential target for strengthening integrated, patient-centred COPD care. Full article
(This article belongs to the Special Issue New Trends in Chronic Obstructive Pulmonary Disease (COPD))
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