1. Shortness of breath: This is one of the hallmark symptoms of COPD. In end-stage COPD, shortness of breath becomes more frequent and severe, even during minimal physical activity or at rest. Patients may find it difficult to perform everyday tasks, such as walking or getting dressed, without experiencing extreme breathlessness.

2. Chronic cough: A persistent cough is common in COPD, and it often worsens as the disease progresses. In end-stage COPD, the cough tends to be more severe and may be accompanied by increased mucus production. It can be challenging to clear the airways, leading to frequent episodes of coughing.

3. Wheezing: Wheezing is characterized by a high-pitched whistling sound during breathing. It occurs due to the narrowing of the airways and can be more noticeable during physical exertion or when the individual is experiencing a flare-up or exacerbation.

4. Fatigue and weakness: End-stage COPD can leave patients feeling constantly tired and weak. This is partly due to the increased effort required to breathe, as well as the body's reduced oxygen levels. Fatigue can greatly impact a person's ability to engage in daily activities and may lead to feelings of depression or anxiety.

5. Rapid weight loss: As the disease progresses, the body's energy expenditure increases due to the increased effort required to breathe. This, coupled with a decreased appetite and reduced physical activity, can lead to unintended weight loss in end-stage COPD patients.

6. Swelling in the legs and feet: Severe COPD can cause fluid retention in the body, leading to swelling in the lower extremities. This is known as peripheral edema and is often a sign of advanced disease.

7. Exacerbations: End-stage COPD patients are more prone to frequent exacerbations or acute flare-ups. These episodes can cause a sudden worsening of symptoms and may require hospitalization. Exacerbations can be triggered by infections, environmental factors, or exposure to irritants.

It is important to note that these symptoms can vary from person to person, and some individuals may experience additional symptoms not mentioned above. If you or a loved one are experiencing any of these symptoms or suspect you may have end-stage COPD, it is crucial to consult with a healthcare professional for an accurate diagnosis and appropriate management.

In conclusion, end-stage COPD is characterized by severe symptoms such as persistent shortness of breath, chronic cough, wheezing, fatigue, rapid weight loss, swelling in the legs and feet, and frequent exacerbations. Early detection and comprehensive management are essential to improve the quality of life for individuals with end-stage COPD. Seeking medical attention and following a personalized treatment plan can help alleviate symptoms and provide support in coping with the challenges of this advanced stage of the disease.