The Symptoms of the 4 Stages of COPD

Quincy AdamCOPD Learn

Showing lungs x-ray
If you or a loved one has chronic obstructive pulmonary disease (COPD), you have an expectation that your symptoms will develop, increase, and intensify as the disease progresses through the 4 stages of COPD. But you may be asking just what symptoms will show up, and when they’ll occur.

The fact is, everyone’s COPD is different and dependent on the patient’s particular set of conditions, including:

  • Age of patient at the onset of the disease
  • How early your COPD is diagnosed
  • Patient responsiveness to treatment and medications
  • Degree of lung damage
  • Patient’s commitment to lifestyle changes (particularly cessation of smoking)

4 Stages of COPD Go GOLD

Even with the differences in COPD in each patient, it is possible to make some generalizations regarding the symptoms associated with each of the 4 stages (or grades) of COPD. However, the primary means for determining the stage or grade of the disease is the results of your pulmonary function test (PFT), which your doctor will administer. PFT results are expressed as percentages of the exhaled breath or forced vital capacity (FVC) of people with normal lung function. The forced expiratory volume in one second (FEV1) is measured as a percentage of FVC. That’s a lot of technical information, but the bottom line is that the test evaluates your ability to breathe.

Since 1997, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) has collaborated with the National Heart, Lung, and Blood Institute; the National Institutes of Health; and the World Health Organization to raise awareness and shape guidelines for diagnosis and management of COPD. The original 4 stages of COPD are now generally referred to as the GOLD grading system.

Below is an overview of symptoms and their severity at each of the 4 stages or grades of COPD. You can find more documentation, including downloadable 2015 desk references and pocket guides at the GOLD COPD website:

GOLD I—Mild COPD

  • Symptoms: Shortness of breath without coughing or excessive production of mucus. Symptoms may go unnoticed.
  • PFT Results: FEV1 = 80% or more of the exhaled breath of people with normal lung function.
  • Life Expectancy: 18 years for a 65-year-old male non-smoker; 17.4 years for a 65-year-old male former smoker; and 14 years for a 65-year-old male current smoker.1

GOLD II—Moderate COPD

  • Symptoms: Moderate to severe shortness of breath during exercise. Breathlessness may be accompanied by a cough and excessive production of mucus.
  • PFT Results: FEV1 ranges from 50% to 80% of normal lung function.
  • Life Expectancy:1 years for a 65-year-old male non-smoker; 15.9 years for a 65-year-old male former smoker; and 12 years for a 65-year-old male current smoker.2

GOLD III—Severe COPD

  • Symptoms: Increased shortness of breath that may include coughing, mucus or both. Exercising becomes more difficult; fatigue is greater, and quality of life begins to suffer.
  • PFT Results: FEV1 ranges from 30% to 50% of normal lung function.
  • Life Expectancy:5 years for a 65-year-old male non-smoker; 11.7 years for a 65-year-old male former smoker; and 8.5 years for a 65-year-old male current smoker.3

GOLD IV—Very Severe COPD

  • Symptoms: Shortness of breath with breathing difficulties becoming acute and even life threatening. The patient’s quality of life is significantly reduced, exercising is increasingly difficult, and there is significant fatigue and weight loss. You may suffer from morning headaches and swelling of feet and ankles.
  • PFT Results: FEV1 is less than 30% of normal lung function.
  • Life Expectancy: Same as GOLD III (16.5 years for a 65-year-old male non-smoker; 11.7 years for a 65-year-old male former smoker; and 8.5 years for a 65-year-old male current smoker).4

Your symptoms may vary based on the extent of your lung damage, and they may develop at different rates. Early identification of symptoms is critical to your prognosis. It is essential that you make an appointment with your doctor as soon as you think you may have symptoms associated with any of the 4 stages or grades of COPD. What may seem like normal aging may be indications of COPD, and this is especially true if you are a current or former smoker.


1 Robert M Shavelle, David R Paculdo, Scott J Kush, David M Mannino, David J Strauss. Life expectancy and years of life lost in chronic obstructive pulmonary disease: Findings from the NHANES III Follow-up Study. International Journal of COPD 2009:4 137–148. http://www.lifeexpectancy.com/articles/copd.pdf. Accessed 7.23.16.2 Robert M Shavelle, David R Paculdo, Scott J Kush, David M Mannino, David J Strauss. Life expectancy and years of life lost in chronic obstructive pulmonary disease: Findings from the NHANES III Follow-up Study. International Journal of COPD 2009:4 137–148. http://www.lifeexpectancy.com/articles/copd.pdf. Accessed 7.23.16.

3 Robert M Shavelle, David R Paculdo, Scott J Kush, David M Mannino, David J Strauss. Life expectancy and years of life lost in chronic obstructive pulmonary disease: Findings from the NHANES III Follow-up Study. International Journal of COPD 2009:4 137–148. http://www.lifeexpectancy.com/articles/copd.pdf. Accessed 7.23.16.

4 Robert M Shavelle, David R Paculdo, Scott J Kush, David M Mannino, David J Strauss. Life expectancy and years of life lost in chronic obstructive pulmonary disease: Findings from the NHANES III Follow-up Study. International Journal of COPD 2009:4 137–148. http://www.lifeexpectancy.com/articles/copd.pdf. Accessed 7.23.16.