Learn About COP
COP is a lung condition affecting the small airways (bronchioles) and alveoli (tiny air sacs). The cause is unknown.
It used to be known as idiopathic bronchiolitis obliterans organizing pneumonia (BOOP).
- COP is a form of organizing pneumonia (OP).
- Although “pneumonia” is in the name, COP is not an infection.
- The term “cryptogenic” in the name means that no specific cause is known.
- In most cases, gradual onset of shortness of breath and dry cough are the most common symptoms.
- COP is usually treated with oral steroids.
What Is COP?
COP is a rare condition. Swirls of inflammation block the very small airways (bronchioles) and air sacs in the lung (alveolar sacs). Its cause is unknown. COP used to be called bronchiolitis obliterans organizing pneumonia, or “BOOP,” but this term is no longer used.
How COP Affects Your Body
Symptoms can begin gradually, over a few weeks to months. COP often seems like a flu-like illness. Most patients have
If the disease progresses, shortness of breath can happen even at rest. Rarely, patients may have:
- chest pain
- joint pain
- night sweats
- coughing up blood
How Serious Is COP?
COP can cause severe lung damage. It may require hospitalization.
Significant improvement usually occurs with proper treatment. People should be monitored; recurrences are common. Most people recover after weeks or months with steroid treatment, such as prednisone.
COP Symptoms, Causes, and Risk Factors
What Are Symptoms of COP?
The most common symptoms are:
- persistent (2–4 months), nonproductive cough
- low-grade fever
- general feeling of not feeling well (malaise)
- shortness of breath
- loss of appetite
- weight loss
What Are Risk Factors?
The cause of COP is unknown. Men and women are equally affected. The average age of COP diagnosis is 50 to 60 years old. A condition similar to COP may occur as a side effect of certain medications.
When to See Your Doctor
The faster you get treatment, the faster you will improve. This is especially true for:
- the very young
- people older than 65
- anyone with other long-lasting (chronic) health problems, such as asthma
See your doctor if you have a persistent (2–4 months), nonproductive cough, or shortness of breath that does not go away.
Diagnosing and Treating COP
COP (formerly called BOOP) is a rare disease of unknown cause. It is usually diagnosed by ruling out other diseases. Sometimes the signs, symptoms, radiograph, and biopsy findings of COP may occur as side effects of medications. It must be determined whether the condition is caused by a medication. Stopping that treatment will help treat the disease.
What to Expect
Your doctor will ask you many questions about your health. This is to get a detailed patient history. There will likely be several tests before a diagnosis is given.
How COP Is Diagnosed
Diagnosis is usually made with:
- a clinical evaluation
- a detailed patient history
- identification of characteristic findings
Your doctor may also order specialized tests such as:
How COP Is Treated
Sometimes COP will go away on its own. In most cases some form of treatment is required. The treatment of choice is corticosteroids, such as prednisone. Cytotoxic drugs, such as cyclophosphamide, may be used to treat COP if there is no improvement with corticosteroids.
Note: COP does not respond to antibiotics.
Living With COP
Most recover after weeks or months of treatment with a steroid such as prednisone, or treatment of the underlying cause. In some people, the disease may progress despite treatment.
What to Expect
Most people with COP will need treatment—most commonly with a steroid like prednisone. Improvement is often seen within a few days or weeks. In some cases, COP may recur as the dosage of medication is reduced. If this happens, patients will need another course of treatment.
Managing of Disease
People with COP have an excellent prognosis. If treated with a corticosteroid, it is vital to take it as prescribed. Your doctor may suggest a flu vaccine and pneumococcal vaccine every year.
Follow-up testing may be suggested especially for people who have a relapse.
The Lung Association’s Living with Lung Disease Support Community connects patients and caregivers with others facing this disease. You can also call their Lung HelpLine at 1-800-LUNGUSA. A trained professional can answer your questions and connect you with support.
Questions to Ask Your Doctor About COP
Making notes before your appointment, as well as taking a family member or friend, can help.
- Do I have COP?
- What tests will I need?
- What are the symptoms?
- Does COP only affect the lungs?
- What is the treatment?
- Is it necessary to be admitted to the hospital, or can I be treated at home?
- What is the chance of relapse?
- Are there alternative treatments if the first one fails?
- Could there be any complications from COP or its treatment?
Roberto Carbone, MD, FCCP
Date Last Reviewed