If a patient presents with typical COPD symptoms but has normal spirometry, how is their disease staged?

In the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification, staging is based on the severity of airflow limitation as measured by spirometry along with the presence of symptoms. If a patient exhibits typical symptoms of chronic obstructive pulmonary disease (COPD), such as chronic cough or sputum production, but spirometry results are normal (i.e., there is no evidence of airflow limitation), they are classified as GOLD stage 0.

This stage is recognized as at-risk or mild disease, indicating that the patient does not meet the criteria for COPD according to spirometric values but may still be experiencing respiratory symptoms. The classification underscores the importance of recognizing potential COPD patients who may need monitoring and preventive care even if their lung function tests are currently normal.

Thus, when a patient presents with symptoms typical of COPD yet has normal spirometry, they align with the criteria for being in GOLD stage 0. This emphasizes the need for clinicians to consider patients presenting with COPD-like symptoms even when objective testing does not confirm the disease, allowing for earlier intervention and management strategies.