Comorbidity and prognosis in chronic obstructive pulmonary disease

In developed countries, the greatest costs for the health care system are associated with exacerbations of COPD, characterized by heterogeneity of the clinical picture and prognosis of the disease, significant extrapulmonary manifestations and clinical consequences of the interaction of the mechanisms of systemic inflammation and the pathogenesis of comorbid and polymorbid diseases and conditions. More and more results are accumulating indicating a high prevalence and a significant adverse effect on the prognosis of exacerbation of COPD phenotypes with chronic bronchitis syndrome, hypoxemia, respiratory and cardiovascular polymorbid diseases. The mechanism of the formation of comorbidity-polymorbidity is ambiguous. One option is when diseases arise independently of each other, but their combination does not change the picture of pathology and does not significantly affect the prognosis.