To investigate the clinical characteristics and biomarker patterns of COPD in never-smokers compared to smoking-related COPD.
Key Findings:
Never-smokers with COPD reported more wheeze (44% vs 18%) and productive cough (39% vs 19%) compared to never-smokers with normal lung function.
30% of never-smokers with COPD had a COPD Assessment Test score ≥ 10, indicating poorer health status.
Airflow limitation was milder in never-smokers with COPD (mean postbronchodilator FEV1 87% of predicted) compared to ex-smokers (78%) and current smokers (79%).
43% of never-smokers with COPD had IgE sensitization to airborne allergens and higher FeNO levels (22 ppb).
Self-reported asthma was more common among never-smokers with COPD (40% vs 12%).
Interpretation:
COPD in never-smokers presents distinct clinical features and inflammatory markers compared to smoking-related COPD, suggesting a need for different diagnostic and management approaches.
Limitations:
Strict spirometric criteria may limit generalizability.
Limited age range of participants.
Conclusion:
Never-smokers with COPD may represent a distinct clinical phenotype requiring tailored diagnostic and clinical follow-up.
