The Global Initiative for Chronic Obstructive Lung Disease (GOLD) has updated its annual 2023 GOLD Report on COPD diagnosis, management, and prevention. The report proposed new definitions for both the disease and for exacerbations, suggested new “etiotypes” to classify COPD causes, and notably altered the ABCD assessment tool used to classify COPD patients’ disease severity.

Some key updates and changes for this year’s report include:

  • A revised definition of COPD
    • “COPD is a heterogeneous lung condition characterized by chronic respiratory symptoms (dyspnea, cough, sputum production, exacerbations) due to abnormalities of the airways (bronchitis, bronchiolitis) and/or alveoli (emphysema) that cause persistent, often progressive airflow obstruction.” 1
  • Additional section on chronic bronchitis
  • A new table with proposed “Etiotypes” for COPD, including:1
    • COPD-G (genetically determined)
    • COPD-D (abnormal lung development)
    • COPD-C (cigarette smoking)
    • COPD-P (biomass and air pollution)
    • COPD-I (infections)
    • COPD-A (with asthma)
    • COPD-U (unknown cause)
  • Using computed tomography lung imaging for patients with stable COPD
  • Updated CDC vaccination recommendations
  • Tele-rehabilitation
  • Current and proposed surgical and bronchoscopic Interventions
  • Revisions to the ABCD Assessment Tool, which has been amended to an “ABE” Assessment Tool
    • GOLD groups A & B remain unchanged while groups C & D are merged into an “E” group, “to recognize the clinical relevance of exacerbations”1
  • Updated recommendations on initial and follow-up pharmacological treatment, specifically the positioning of LABA+LAMA and of LABA+ICS has been changed
  • New definition of COPD exacerbation
    • “An event characterized by increased dyspnea and/or cough and sputum that worsens in <14 days which may be accompanied by tachypnea and/or tachycardia and is often associated with increased local and systemic inflammation caused by infection, pollution, or other insult to the airways.”1

Read the full report at the GOLD website.


  1. Global Strategy for Prevention, Diagnosis and Management of COPD: 2023 Report. Global Initiative for Chronic Obstructive Lung Disease. Updated 2023.