Question:
According to the GOLD criteria, very severe COPD is defined by which of the following?
According to the GOLD criteria, very severe COPD is defined by which of the following?
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Very severe (Stage IV) sits at the lowest FEV1 percent predicted threshold.
Updated On: Jun 23, 2026
- FEV1/FVC <70 and FEV1 < 30
- FEV1/FVC <70 and FEV1 < 70
- FEV1/FVC <70 and FEV1 < 50
- Both A and C
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The Correct Option is A
Solution and Explanation
Step 1: COPD diagnosis requires spirometry, and a post-bronchodilator FEV1/FVC ratio less than 0.70 confirms persistent airflow limitation. All severity grades therefore start from this ratio.
Step 2: The GOLD spirometric grades are then set by the FEV1 percent predicted. Stage IV (Very Severe) COPD is defined as FEV1/FVC \(< 70\%\) with FEV1 \(< 30\%\) predicted.
Step 3: Hence option (a), FEV1/FVC less than 70 and FEV1 less than 30, matches the very severe category and is the answer.
Step 4: The distractors are wrong because FEV1 less than 70 corresponds to mild-to-moderate disease, and FEV1 less than 50 (but \(\geq 30\)) defines severe (Stage III), not very severe. So option (a) is correct.
Step 2: The GOLD spirometric grades are then set by the FEV1 percent predicted. Stage IV (Very Severe) COPD is defined as FEV1/FVC \(< 70\%\) with FEV1 \(< 30\%\) predicted.
Step 3: Hence option (a), FEV1/FVC less than 70 and FEV1 less than 30, matches the very severe category and is the answer.
Step 4: The distractors are wrong because FEV1 less than 70 corresponds to mild-to-moderate disease, and FEV1 less than 50 (but \(\geq 30\)) defines severe (Stage III), not very severe. So option (a) is correct.
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