Extrapulmonary Comorbidities in COPD: A Bidirectional and Multimorbid Perspective

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Baha A., Jones P., KÖKTÜRK N.

CYPRUS JOURNAL OF MEDICAL SCIENCES, cilt.11, sa.2, ss.110-119, 2026 (ESCI, TRDizin)

Özet

Chronic obstructive pulmonary disease (COPD) remains among the leading causes of death. The systemic characteristics of COPD are becoming clearer every day, and the importance of comorbidities is increasingly well understood. Comorbidities are one of the main causes of mortality in COPD. Although there are specific guidelines for each disease, there is limited literature explaining the effects of comorbidities on one another. Non-respiratory comorbidities associated with mortality in COPD include cardiovascular disease (CVD), metabolic, musculoskeletal, and psychiatric disorders. Both COPD and these comorbid conditions share a common aetiology and are associated with complex clinical and therapeutic interactions. CVD and metabolic comorbidities are more symptomatic and can be easily recognised by patients and physicians. However, osteoporosis, anxiety, and depression are often asymptomatic, despite the fact that these are more common than other comorbidities. Current data suggest that diagnosis and treatment of comorbidities improve prognosis in COPD. Instead of focusing solely on COPD treatment, we should adopt a holistic approach to patient care. This narrative review aims to summarise the bidirectional relationships between COPD and its most common fatal extrapulmonary comorbidities. Another aim of the study is to compile a substantial body of scattered information to provide clinicians with an overview.