We do see patients with COPD having various grades of clubbing.
Most of them (>95%) do not show any evidence of lung cancer or
associated ILD on X-ray or HRCT. All of these patients had low SpO2
and low DLCO. Probably chronic hypoxia leads to clubbing in COPD
patients. Interestingly I never saw a severe asthma patient with
chronic hypoxia developing clubbing.