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Originally published Nov. 7, 2023

Last updated April 6, 2026

Stages of COPD

Ayesha Ali, NP

Medically reviewed by:
Ayesha Ali, NP

A COPD diagnosis can make you feel anxious and uncertain, which is completely understandable. Your providers will work with you to find the right treatments and make you feel comfortable as you progress through each stage.

Chronic obstructive pulmonary disease (COPD) is a common lung disease that affects around 6% of U.S. adults.1 It has four stages that range from mild to very severe.2 Knowing what to expect at every stage can help you navigate COPD and feel more in control of your health and treatment plan.

What is COPD?

COPD is an umbrella term for a series of chronic respiratory diseases. Emphysema and chronic bronchitis are the most common types of COPD.3 This condition develops gradually over time when the lungs or airways become damaged.

Lung damage promotes inflammation. Inflammation can lead to swelling and irritation of the airways, making it difficult to breathe. Cough, wheezing, fatigue and tightness in the chest are other common symptoms of COPD.4

COPD is divided into four stages. This allows doctors to determine its severity and develop the best possible treatment plan. At this time, there are no definitive cures for COPD. However, it can be managed effectively when detected and treated early.

What are the 4 stages of COPD?

The four stages of COPD are mild, moderate, severe and very severe.2 The stage of COPD you have can be determined based on your symptoms, medical history and test results.5

Spirometry is the main test used to diagnose COPD. This test measures the amount of air you breathe out, as well as the speed of the air you blow out. Other methods used to diagnose COPD include X-ray, CT scan and other lung function tests.5

Stage 1: Mild COPD

Also known as early COPD, stage 1 is the mildest form of this disease. You may have mild symptoms, or none at all. Some people experience shortness of breath when exercising or walking on an incline.2

Smoking cessation and short-acting bronchodilators are the most common treatments for mild COPD.6, 7

Quitting smoking can often improve your symptoms and reduce mortality. This is the only treatment required for COPD without symptoms.6 Bronchodilators are medicines that relax the muscles around your airways to help you breathe more easily. These are typically prescribed in stage 1 COPD with mild symptoms.7

Stage 2: Moderate COPD

Increased coughing and noticeable shortness of breath are common symptoms of moderate COPD. Shortness of breath may occur during any activity, such as walking on a flat surface or for long periods.2

Symptoms of stage 2 COPD can be managed using flu vaccines, long-acting bronchodilators or pulmonary rehabilitation. According to the Centers for Medicare & Medicaid Services (CMS), pulmonary rehab programs can help you breathe better, become stronger and live more independently.8

Ensifentrine may also be prescribed for moderate COPD, which combines a bronchodilator with a nonsteroidal medicine to reduce inflammation and mucus.9

Stage 3: Severe COPD

Shortness of breath happens more frequently during stage 3 COPD, even at rest. Any symptoms you experience during stages 1 and 2 typically become more severe during stage 3. You may also experience other COPD symptoms at this time, including wet cough, fatigue, whistling and heaviness in the chest.4

Bronchodilators, steroids and oxygen therapy are common treatments for severe COPD. These treatments reduce swelling and inflammation in the airways to help you breathe more easily. Antibiotics may also be prescribed if your symptom flares are being caused by an underlying infection.7

Stage 4: Very severe COPD

Also known as end-stage COPD, stage 4 is the most severe. Your daily activities may be severely limited, and you may have less energy than in previous stages.2 Lung capacity is below 30% in very severe COPD, which indicates your blood is being deprived of oxygen. This increases the risk for chronic respiratory failure, as well as heart failure.

Treatments for stage 4 COPD are similar to those used during other stages. By stage 4, the goal is to make you feel as comfortable as possible. Additional treatments include palliative care and surgery, including lung transplant surgery.

Risk factors for COPD

Smoking is the primary cause of COPD, and its leading risk factor.10 Three in four people with COPD are current smokers or have a history of smoking.

The chemicals and irritants in tobacco products can damage both the lungs and airways. Smoking cessation is usually the first line of treatment for COPD.

Other COPD risk factors include10:

  • Exposure to lung irritants. Air pollution, secondhand smoke and chemical fumes in workplaces may contribute to COPD.
  • Age. COPD is more common in people aged 40 and older.
  • Infections. HIV and tuberculosis may increase your COPD risk.
  • Alpha-1 antitrypsin (AAT) deficiency. This genetic condition runs in families and increases the risk for COPD.
  • Asthma. One in five people with COPD also has asthma.11

The importance of getting tested for COPD

Being tested for COPD can pave the way for early detection and treatment. The earlier COPD can be treated, the better your outcome may be.

Consider getting screened for COPD if you have a history of smoking or if COPD runs in your family. Your doctor may ask you about the following as part of COPD screening12:

  • Current smoking status and smoking history
  • Family medical history
  • Your level of exposure to chemicals, irritants and pollutants
  • Current symptoms, if any
  • History of hospitalizations or flare-ups related to COPD
  • Changes to your energy or activity levels due to COPD symptoms
  • Noticeable triggers or patterns related to symptoms
  • Comorbid disorders, such as heart disease or diabetes

Your provider may run additional tests to confirm or rule out COPD. Spirometry remains the most effective diagnostic method, which requires you to blow forcefully into a mouthpiece at least three times.13 This testing method is painless and takes about 30 to 45 minutes to complete.

Tips for living with COPD

COPD is a chronic condition that cannot be cured or reversed. However, it is possible to effectively manage COPD by adopting these healthy and practical behaviors.14

  • Don’t smoke. Smoking can worsen COPD symptoms and cause it to progress more quickly. Stop smoking as soon as possible, and ask your doctor about the latest cessation treatments if you need help quitting. Nicotine replacement, medications and talk therapy are good options.
  • Eat highly nutritious foods. Breathing difficulties can affect your appetite and make the act of eating less appealing. To avoid nutritional deficiencies, try eating smaller amounts of nutritious foods, including fruits, vegetables and fish.
  • Avoid foods that cause bloating. Bloating can put extra pressure on your diaphragm, worsening breathing problems. Some foods that may cause bloating include beans, broccoli, cauliflower and fried foods.
  • Wear comfortable, loose-fitting clothing. Loose clothing can make it easier for you to breathe, move around and feel comfortable.
  • Avoid exposure to lung irritants. Secondhand smoke, gas fumes and cleaning products are examples of irritants that can worsen your symptoms.
  • Use medications properly. Many patients with COPD avoid using inhalers due to uncertainty about how to use them correctly. If you need guidance, ask your provider for help.
  • Exercise regularly. Exercise can increase your lung capacity and strengthen your lung muscles. Start with mild activities in the beginning, and gradually work your way to a higher intensity level.

A COPD diagnosis can make you feel anxious and uncertain, which is completely understandable. Your providers will work with you to find the right treatments and make you feel comfortable as you progress through each stage. COPD treatment plans will be personalized for you based on your symptoms and stage, and may change at any time.

Make an appointment with your doctor if you think you may have COPD. Our doctors at WellMed will work with you to create a personalized treatment plan. Contact WellMed today at (888) 781-WELL or visit our website to find a doctor near you.

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