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Chronic obstructive pulmonary disease (COPD) is a chronic airway inflammatory disease with high morbidity, high mortality and a serious social and economic burden. Its acute exacerbation (AECOPD) is a critical indicator of the future risk of prognosis because AECOPD can reduce the quality of life, increase ...

Chronic obstructive pulmonary disease (COPD) is a chronic airway inflammatory disease with high morbidity, high mortality and a serious social and economic burden. Its acute exacerbation (AECOPD) is a critical indicator of the future risk of prognosis because AECOPD can reduce the quality of life, increase hospitalization rate, accelerate disease progression, and even result in death. For a long time, the definition of AECOPD has been changing and controversial. It is subjective and difficult to be quantified. In the real world, COPD patients are often unable to fully express their daily symptom fluctuations and the range of recent changes, and it is difficult for respiratory physicians to tell whether the deterioration of respiratory symptoms really exceeds the daily fluctuation range. The detection of acute exacerbation of COPD is difficult due to a lack of clinical operability, which may delay its diagnosis and lead to late treatment, resulting in more serious clinical outcomes.

Early identification of AECOPD has to be among the central strategies for COPD care, and we need effective tools for that. Up to now, there are some questionnaires in use, such as EXACT, CAT, BCSS, and daily diary card. Studies on them are on-going, with the aim of proposing a suitable tool that can be used at the point of care, especially in the primary care settings, to help physicians to detect AECOPD early. However, the cutoff of these questionnaires is not consistent in different studies and cannot reflect the daily variation of symptoms in COPD patients.

In recent years, blood eosinophils have been put to use for prediction of the high-risk population of AECOPD and guiding the steroid usage. However, there is a lack of large sample blood eosinophils data in COPD patients. In addition, defining proper biomarkers using omics methods is of important clinical significance in early diagnosis and management of AECOPD, but we still have a long way to go there.

This Research Topic aims to present the latest progress in the prediction and early diagnosis of AECOPD which include, but are not limited to, the points listed below. We aim to eventually support the prediction of AECOPD and provide guidance on individualized therapy in AECOPD. Original Research Articles and Reviews will be welcome.

- Development and validation of (new) questionnaires
- Development and validation of high-quality prediction models
- Biomarkers and their relationship with the diagnosis, including APRs biomarkers (CRP and neutrophils), etiological biomarkers (PCT), and biomarkers for differential diagnosis (pro BNP or NT-pro-BNP, and X Rays)
- Microbiome and virome in the etiology of AECOPD

Keywords: Prediction, Diagnosis, Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD), Biomarker, questionnaire, Prediction model, microbiome, virome


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