Mustaq Adnan1, Syed Nesar Ahmed2, Bulbul Parveen2, Md. Khairul Hassan Jessy3, Bashir Ahmed3, Krishna Chandra Ganguly3

Abstract
Global Strategy for the Diagnosis, Management and Prevention of COPD 2019 is a consensus report
which has been publishing periodically since 2001 by an international panel of health professionals from
respiratory medicine, socioeconomics, public health and education comprising the Global Initiative for
Chronic Obstructive Lung Disease (GOLD). The GOLD documents aim to incorporate latest evidence and
expert consensus and are intended for use as “strategy documents” for implementation of effective care for
chronic obstructive lung disease (COPD) on a global level. The GOLD 2019 report defines COPD as a
“common, preventable and treatable disease that is characterized by persistent respiratory symptoms and
airflow limitation that is due to airway and/or alveolar abnormalities, usually caused by significant exposure
to noxious particles or gases”, with the criteria of “persistent respiratory symptoms” being a new and
controversial inclusion since 2017. The treatment recommendations are made on the basis of a review of
the latest literature along with the availability of newer pharmacotherapy options and directed by symptom
burden and health care utilization. Apart from the change in definition, a major shift in the recommendations
is the exclusion of severity of airflow limitation as one of the major factors in guiding therapy. We review the
salient features of the GOLD 2019 document and provide commentary on features that merit further discussion
based on our clinical experience and practice as well as literature review.
Keywords: Acute Exacerbation of COPD (AECOPD), Chronic Obstructive Pulmonary Disease (COPD),
Long-Acting Beta Agonist (LABA), Long-Acting Muscarinic Antagonist (LAMA).
Abbreviations: GOLD = Global Initiative for Chronic Obstructive Lung Disease, CAT = COPD Assessment
Test, FEV1 = Forced Expiratory Volume In One Second, FVC = Forced Vital Capacity, ICS = Inhaled
Corticosteroid, mMRC = modified Medical Research Council, NIPPV = Noninvasive Positive Pressure
Ventilation, SaO2 = Resting Oxygen Saturation.

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