How to Recognize COPD Complications

Some complications may be due to the damage from COPD, while others may be due to an unrelated illness that’s made worse by the condition.

COPD can put you at risk of developing a variety of complications. Some of these complications are just more likely to happen when you have COPD, while others can be the result of damage to the airways due to COPD.

Let’s talk about COPD complications, possible symptoms, and when to see a doctor.

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What are COPD complications?

The American Lung Association states that COPD complications might worsen your condition or cause new symptoms that can be severe and even life threatening.

Complications can happen because of COPD or because of the damage to the lungs caused by COPD.

According to the National Heart, Lung, and Blood Institute, COPD can sometimes make conditions or infections that aren’t directly related worse. COPD can also make you more likely to develop certain illnesses, and the symptoms you experience as part of those illnesses may be more severe than in people without COPD.

Here are some of the complications of COPD and how to recognize symptoms:

Pneumonia

Pneumonia is an infection of the lungs. It causes inflammation in the lungs’ air sacs, which fill with pus or fluid, making it difficult for oxygen to get into the bloodstream.

Pneumonia can cause mild to severe symptoms, including:

• difficulty breathing
• cough
• chills
• fever

COPD makes the lungs more vulnerable to pneumonia, which can become a life threatening illness in some people. The American Lung Association advises that if you’re experiencing symptoms of pneumonia, you should see a doctor ASAP.

Research from 2018 suggests that within the first year of diagnosis, people with COPD are 16 times more likely to develop pneumonia than those without COPD.

Pneumonia treatments

Treating pneumonia usually depends on if a virus, bacteria, or fungus caused it. Treatment options typically include:

• antibiotics
• antivirals
• antifungal medications
• over-the-counter (OTC) medications to help with fever and aches

If you’re experiencing severe pneumonia, you might be hospitalized. In the hospital, you might receive antibiotics and fluids through an IV. You may also be given oxygen therapy. In some cases, a ventilator may be required.

The American Lung Association recommends contacting a doctor immediately if you experience:

• difficulty breathing
• blue lips and fingers
• chest pain
• high fever
• a severe cough with mucus that’s getting worse

Acute respiratory distress syndrome

Acute respiratory distress syndrome (ARDS) is a serious and sometimes life threatening condition that causes low blood oxygen levels.

ARDS stops the lungs from filling with enough air, depriving the bloodstream of oxygen. Symptoms can include:

• shortness of breath or rapid breathing
• low blood oxygen
• bubbling, clicking, or rattling sounds in the lungs when breathing

This condition can worsen quickly. That’s why seeking medication attention is important if you’re experiencing these symptoms.

Oxygen therapy given in a hospital or other medical facility, or even at home, is the main treatment for ARDS.

Other treatments may be used to ease symptoms and prevent more complications, including:

• ventilation
• medications to relieve symptoms, like antibiotics, sedatives, and muscle relaxants
• physical therapy
• IV fluids

Bronchiectasis

COPD can trigger bronchiectasis, a chronic condition where the airways (aka bronchi) are permanently widened and damaged.

Research from 2022 suggests that up to 40% of people with COPD also have bronchiectasis. Having both conditions increases the risk of a COPD exacerbation (or flare) and is also linked to severe obstructions of the airways.

Bronchiectasis symptoms may worsen with time and may include:

• pain in the chest
• shortness of breath
• coughing up yellow or green mucus daily
• chills or fever
• wheezing or whistling when breathing
• fatigue
• coughing up mucus with blood

If you cough up blood or have severe shortness of breath, this is considered a medical emergency. A diagnosis of bronchiectasis means you’ll see a doctor more regularly.

Treatment involves managing conditions like COPD, preventing lung infections, and removing excess lung mucus. Specific treatment options may include:

• antibiotics
• medications that thin mucus
• devices that clear the airway
• physical therapy

Heart failure

According to the 2024 Global Initiative for Chronic Obstructive Lung Disease (GOLD) Report, 20–70% of people living with COPD experience heart failure. This means that the heart can’t pump enough blood or oxygen to other organs in the body.

Heart failure may not cause symptoms right away, but when it does it may include:

• difficulty breathing when lying down
• shortness of breath
• fatigue
• weakness
• weight gain
• swelling in the legs, feet, ankles, or stomach

Treatments may include:

• medications to remove excess sodium and fluid from the body
• medication to slow your heart rate
• medication to relax blood vessels
• lifestyle changes, including regular exercise, limiting alcohol, and quitting smoking

If you notice symptoms getting worse or have any new symptoms, always speak with a doctor.

Influenza (aka the flu)

Anyone can get the flu, but the American Lung Association links COPD to an increased risk of complications from it.

Symptoms from the flu can mimic the common cold, but the flu lasts longer and can make you feel much worse. The CDC recommends anyone living with COPD get an annual flu vaccine.

Research from 2022 found that influenza in people with COPD could increase the risk of:

• pneumonia
• COPD exacerbations or flares
• respiratory failure
• ischemic stroke

If you get the flu, your doctor will likely want to monitor your health or prescribe medications to prevent COPD complications.

RSV

Respiratory syncytial virus (RSV) is another respiratory virus that causes cold-like symptoms.

Most people who don’t have COPD recover from the illness in a couple of weeks, but COPD might increase your chances of having a more severe infection.

The CDC recommends preventive vaccines for RSV for adults ages 60 years and older.

Symptoms of RSV include:

• cough
• sneeze
• runny nose
• a decrease in appetite
• wheezing
• fever

A mild case of RSV can be treated at home with the usual cold and flu meds. If you have a more severe case, you might receive:

• oxygen
• ventilation
• IV fluids
• suction of mucus from your airways

Takeaway

If you’re living with COPD, you have a higher chance of developing some illnesses — and when you get them, you can have worse symptoms than someone without COPD.

Pneumonia, ARDS, bronchiectasis, influenza, and RSV are examples of complications that could happen directly from COPD or indirectly but made worse by COPD.

If you’re concerned about any symptoms you may be experiencing, reach out to a member of your treatment team for support.