Patients with severe persistent asthma have symptomatic attacks of cough, difficulty breathing, and wheezing multiple times every day. Severe asthma requires the use of a rescue short-acting beta-agonist inhaler several times every day for attacks.
Severe asthmatics experience onset of symptoms with even minimal activity, which severely limits their activities of daily living.
Symptoms awaken patients from sleep every night, and can occur multiple times per night.
In severe disease, pulmonary function tests demonstrate a significant decrease with a forced expiratory volume in one second (FEV1) less than 60% of predicted normal.
The FEV1:FVC (forced vital capacity) ratio is reduced by more than 5% in severe asthmatics.
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