Signs and Symptoms of COPD

Chronic obstructive pulmonary disease (COPD) is a group of chronic, progressive lung diseases that make breathing difficult. Emphysema and chronic bronchitis are the main types of COPD, and many people have both. The hallmark symptoms of COPD are shortness of breath, chronic cough, and wheezing.

At first, COPD may cause mild symptoms or none at all. Symptoms may become more severe over time and new ones may develop. People with COPD sometimes experience exacerbations (also known as flare-ups) which are periods of time when symptoms suddenly become worse. 

Recognizing the signs and symptoms of COPD can help you get an early diagnosis and begin treatments to help manage symptoms, slow disease progression, and improve your quality of life.

A healthcare provider listening to an older man's breathing as he coughs.

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Common Symptoms

COPD develops gradually, and symptoms usually begin in mid-life (ages 40 and up). However, smoking tobacco is a major risk factor for COPD; people who start smoking earlier in life are more likely to develop COPD symptoms at an earlier age. Symptoms are often mild initially, and some people dismiss them as a normal part of aging. 

Common symptoms of COPD include shortness of breath, chronic cough, frequent respiratory infections, mucus (phlegm) production, chest tightness, wheezing, and fatigue. No two people experience COPD in the same way—symptoms vary from person to person and can range in severity depending on the stage of the disease. 

Shortness of Breath

Shortness of breath (dyspnea) is a key symptom of COPD. This may feel like tightness in the chest, and you may feel like it’s difficult to take a deep breath. Many people with COPD describe the sensation as “air hunger.”

In early-stage COPD, you may struggle to catch your breath, especially during physical activities like climbing stairs. As the disease progresses, you might feel short of breath more often than not, even at rest. 

Chronic Cough 

A cough that is chronic (long-lasting) and persistent can be a sign of COPD. Coughing may disrupt sleep and even cause sore ribs. Some people may attribute the cough to other causes, such as “smoker’s cough,” allergies, or cold and dry weather. 

A cough caused by COPD can produce mucus (sputum or phlegm) or be dry (unproductive). Chronic bronchitis, a type of COPD, is associated with a cough that produces mucus, usually clear or yellowish in color. Green mucus can be a sign of a respiratory infection. Another type of COPD, emphysema, usually causes a dry cough.

Frequent Respiratory Infections 

Frequent respiratory infections such as the common cold, the flu, and pneumonia, are common in people with COPD. This is because many people with COPD have compromised immune systems, and COPD makes it difficult to clear the lungs. These factors make people with COPD more vulnerable to contracting viral and bacterial upper respiratory infections. 

Chest Tightness 

Chest tightness can be described in a number of ways. It may feel like a weight is on your chest, or as though your chest is being squeezed in a too-tight hug. For some people, it may feel as if something is putting pressure on the lungs. No matter how the sensation is described or feels, chest tightness can make it difficult to take a deep breath. In late-stage COPD, it might feel painful to breathe. 


Wheezing is a whistling, squeaky, or crackling sound when a person breathes. With COPD, wheezing occurs when the airways become narrowed or blocked. The wheezing heard is the vibration of the airways when a person inhales or exhales. 


For people with COPD, fatigue can be one of the most distressing symptoms of the disease. COPD-related fatigue is more than just a feeling of tiredness that can be fixed by getting a good night’s sleep. Exhaustion can be all-consuming and prevent people from participating in their daily activities. 

A combination of the physiological and psychological impacts of COPD—such as lack of oxygen, and the emotional toll the disease takes on a person—are thought to play a role in the relationship between COPD and fatigue. 

Assessment and Staging

COPD is assessed using the GOLD system, which stands for the Global Initiative for Chronic Obstructive Lung Disease. The GOLD system assesses factors such as your overarching symptoms, how many times your symptoms have worsened, how many times you've had to go to the hospital due to your COPD, and your spirometry test results.

A spirometry test measures how much air you can exhale and at what speed. It is described in the following metrics:

  • Forced vital capacity (FVC): Measures how much air you can breathe out after taking a deep inhale
  • Forced expiratory volume (FEV-1): Measures how much air you can breathe out in one second

The results of your spirometry will put you in one of four "grades":

  • GOLD 1: Mild
  • GOLD 2: Moderate
  • GOLD 3: Severe
  • GOLD 4: Very severe

Based on your symptoms, your GOLD grade, and your exacerbation risk, your pulmonologist (a doctor who specializes in lung conditions) will also put you in one of four groups, labeled as A, B, C, or D:

  • Group A: Few symptoms, few of exacerbations 
  • Group B: More symptoms, few of exacerbations 
  • Group E: Frequent or severe exacerbations, regardless of symptoms

GOLD 1 Symptoms 

In GOLD 1 (mild) COPD, symptoms can include:

  • Shortness of breath 
  • Intermittent coughing 
  • Mucus production 

At this stage, symptoms may not be noticeable or mild enough to be mistaken for something else easily. For example, people may mistake shortness of breath or fatigue as a symptom of aging or blame their persistent cough on a recent respiratory infection. 

GOLD 2 Symptoms

In GOLD 2 (moderate) COPD, airflow limitations worsen, and symptoms can include: 

  • Shortness of breath on exertion, such as when you’re walking up the stairs
  • Worsening airflow limitations 
  • Chronic cough, which may get worse during exercise, when smoking, and in the morning 
  • Wheezing 
  • Fatigue 

Many people with COPD seek medical attention at this stage when their shortness of breath becomes more noticeable and frequent. Simple tasks like taking a shower or folding laundry, for example, might make a person with GOLD 2 COPD feel winded. 

GOLD 3 Symptoms

GOLD 3 (severe) COPD is characterized by severe airflow limitation. At this stage, exacerbations are more frequent, and hospitalization may be required when symptoms become severe. 

GOLD 3 COPD symptoms can include:

  • Severe shortness of breath 
  • Morning headaches
  • Intensified coughing 
  • Extreme fatigue 
  • Frequent exacerbations 
  • Rapid breathing
  • Recurrent respiratory infections 
  • Swelling in the ankles, legs, and feet
  • Trouble sleeping 

Stage 4 Symptoms

GOLD 4 (very severe) COPD is often called “end-stage” disease. At this stage, the lungs operate at a severely limited capacity, and many people experience symptoms day and night, even at rest. Some people may show signs of respiratory failure or clinical signs of heart failure. At this stage, quality of life is significantly impacted, and exacerbations (flare-ups) can be life-threatening. 

Stage 4 COPD symptoms can include:

  • Difficulty breathing, even at rest
  • Loss of appetite 
  • Rapid weight loss 
  • Rapid heart rate, even at rest 
  • Morning headaches
  • Swelling in the legs, ankles, and feet
  • Confusion

Symptoms in Women 

Though COPD symptoms are the same for people of all genders, research shows that women face a significantly higher symptom burden and have a three times higher risk of developing the disease at a younger age. With COPD, women are more like to experience: 

  • Severe shortness of breath 
  • Anxiety 
  • Persistent depression 
  • More frequent exacerbations (flare-ups) 
  • Severe airflow limitations 
  • Lower quality of life

Assessing Your Symptoms

The COPD Assessment Test, or CAT, was designed to assess COPD's impact on a person's life and how this impact changes over time. It's a 40-question test that can give you and your care team more insight into how COPD is affecting you. This test is self-administered, meaning you can find it online and take it at home.

There is also the mMRC (Modified Medical Research Council) Dyspnea Scale, which is used to assess your level of disability due to dyspnea (shortness of breath). A high mMRC score indicates that your symptoms cause a high level of burden to your life.

When to See a Healthcare Provider

See your healthcare provider if you experience symptoms of COPD or have risk factors for the disease. There is no cure for COPD, but it is treatable. Getting an early diagnosis and starting treatment can help manage your symptoms and slow disease progression to help you maintain a good quality of life. 

When To Seek Emergency Care

Some advanced COPD symptoms may require emergency medical attention. Seek emergency medical attention if you or a loved one experience any of the following: 

  • Blue lips and fingernails 
  • Difficulty speaking 
  • Rapid heart rate 
  • Confusion/delirium 
  • Difficulty waking 

A Quick Review

COPD is a chronic, progressive lung disease characterized by shortness of breath, cough, wheezing, and frequent respiratory infections. As the disease advances, additional symptoms such as difficulty breathing, morning headaches, fatigue, and swelling in the legs, ankles, and feet can occur. COPD exacerbations, or flare-ups, are periods of time when symptoms worsen and may be a sign the disease is progressing.

Talk to your healthcare provider if you have signs or symptoms of COPD, especially if you have any known risk factors. 

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18 Sources uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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