RDW is commonly impared in older patients Secondarily to aging factors. usually this may result in a mild megaloblastic anemia larger cells and it’s seen in in the elderly with and without COPD. COPD exacerbations are often brought on by common viral infections seasonly in the winter months. patients with anemia are commonly seen with reasonable immune function. It’s more likely exacerbations are more closely related to close social contacts, continual damage from smoking and poor indoor ventilation.