We reported some two weeks ago that COPD is related to auto-immune diseases. Many people confuse COPD with asthma, because of similar symptomology- but the frequency of symptoms and disease reversibility are radically different.  COPD is exacerbated by respiratory tract infections, while asthma is triggered by allergens, exercise, or cold air; the former is manifested later in life (or after smoking) and routinely have lower lung function and are rarely symptom free.  And, while COPD is the fourth largest cause of death, the prevalence of asthma (after the age of 18) has been considered much lower.

Drs. Lotvall, Ekerljung, and Lundback at the University of Goteberg (Sweden), just published some dismaying results in Respiratory Research. The report, involving some 18,067 subjects between the ages of 16 and 75 near the university, indicates that severe asthma is far more common (2.1% incidence) than we thought- and that nasal congestion may be one of the primary symptoms for same. As such, physicians should begin testing for asthma when patients complain of chronic sinusitis (runny nose and nasal congestion which were the two primary cohort symptoms) and/or reduced smell for at least 12 weeks during the last year.

The authors described severe asthma as any combination of physician diagnosed asthma, asthma related prescriptions, shortness of breath, recurrent wheeze, and cold-related symptoms.  They found that the prevalence of allergic rhinitis, nasal blockage and rhinorrhea (runny nose) was 37%; 65% of those diagnosed with asthma had allergic rhinitis.

What this really means is that we can now use these new indicators as a means to preclude worse events for these patients- such as hospitalizations, which are very expensive- and for children cover some 15 to 20% of their hospitalization events.

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