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Acute exacerbation of COPD (ECOPD), defined as an event characterized by dyspnea and/or cough and sputum that worsens over less than 14 days , is an important event in the course of COPD because it causes significant deterioration of physical, mental and social health, hastens disease progression, increases the risk of dying and causes a substantial economic loss not only to the patient and his/her family, but also to the society 2