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Comorbidities of COPD

Arnaud Cavaillès, Graziella Brinchault-Rabin, Adrien Dixmier, François Goupil, Christophe Gut-Gobert, Sylvain Marchand-Adam, Jean-Claude Meurice, Hugues Morel, Christine Person-Tacnet, Christophe Leroyer, Patrice Diot
European Respiratory Review 2013 22: 454-475; DOI: 10.1183/09059180.00008612
Arnaud Cavaillès
1Dept of Pulmonology, Institut du Thorax, CHU de Nantes, Nantes, 2Dept of Pulmonology, Hôpital Pontchaillou, Rennes, 11Université Européenne de Bretagne, UBO, EA3878 (GETBO) IFR 148, Rennes, 3Dept of Pulmonology, CHR d’Orléans, Orléans, 4Dept of Pulmonology, Centre Hospitalier Le Mans, Le Mans, 5Dept of Internal Medicine and Pulmonology, University Hospital La Cavale Blanche, Brest, 6Universite François Rabelais de Tours, INSERM U1100, Tours, 12Universite François Rabelais de Tours, EA6305, Tours, 7Dept of Pulmonology, CHU de Tours, Tours, 8Dept of Pulmonology, Centre hospitalier de l'Université de Poitiers, Poitiers, 9Dept of Pulmonology, Hôpital Broussais Hospital, Saint-Malo, and 10Dept of Pulmonology, CHU Angers, Angers, France.
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  • For correspondence: arnaud.cavailles@chu-nantes.fr
Graziella Brinchault-Rabin
1Dept of Pulmonology, Institut du Thorax, CHU de Nantes, Nantes, 2Dept of Pulmonology, Hôpital Pontchaillou, Rennes, 11Université Européenne de Bretagne, UBO, EA3878 (GETBO) IFR 148, Rennes, 3Dept of Pulmonology, CHR d’Orléans, Orléans, 4Dept of Pulmonology, Centre Hospitalier Le Mans, Le Mans, 5Dept of Internal Medicine and Pulmonology, University Hospital La Cavale Blanche, Brest, 6Universite François Rabelais de Tours, INSERM U1100, Tours, 12Universite François Rabelais de Tours, EA6305, Tours, 7Dept of Pulmonology, CHU de Tours, Tours, 8Dept of Pulmonology, Centre hospitalier de l'Université de Poitiers, Poitiers, 9Dept of Pulmonology, Hôpital Broussais Hospital, Saint-Malo, and 10Dept of Pulmonology, CHU Angers, Angers, France.
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Adrien Dixmier
1Dept of Pulmonology, Institut du Thorax, CHU de Nantes, Nantes, 2Dept of Pulmonology, Hôpital Pontchaillou, Rennes, 11Université Européenne de Bretagne, UBO, EA3878 (GETBO) IFR 148, Rennes, 3Dept of Pulmonology, CHR d’Orléans, Orléans, 4Dept of Pulmonology, Centre Hospitalier Le Mans, Le Mans, 5Dept of Internal Medicine and Pulmonology, University Hospital La Cavale Blanche, Brest, 6Universite François Rabelais de Tours, INSERM U1100, Tours, 12Universite François Rabelais de Tours, EA6305, Tours, 7Dept of Pulmonology, CHU de Tours, Tours, 8Dept of Pulmonology, Centre hospitalier de l'Université de Poitiers, Poitiers, 9Dept of Pulmonology, Hôpital Broussais Hospital, Saint-Malo, and 10Dept of Pulmonology, CHU Angers, Angers, France.
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François Goupil
1Dept of Pulmonology, Institut du Thorax, CHU de Nantes, Nantes, 2Dept of Pulmonology, Hôpital Pontchaillou, Rennes, 11Université Européenne de Bretagne, UBO, EA3878 (GETBO) IFR 148, Rennes, 3Dept of Pulmonology, CHR d’Orléans, Orléans, 4Dept of Pulmonology, Centre Hospitalier Le Mans, Le Mans, 5Dept of Internal Medicine and Pulmonology, University Hospital La Cavale Blanche, Brest, 6Universite François Rabelais de Tours, INSERM U1100, Tours, 12Universite François Rabelais de Tours, EA6305, Tours, 7Dept of Pulmonology, CHU de Tours, Tours, 8Dept of Pulmonology, Centre hospitalier de l'Université de Poitiers, Poitiers, 9Dept of Pulmonology, Hôpital Broussais Hospital, Saint-Malo, and 10Dept of Pulmonology, CHU Angers, Angers, France.
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Christophe Gut-Gobert
1Dept of Pulmonology, Institut du Thorax, CHU de Nantes, Nantes, 2Dept of Pulmonology, Hôpital Pontchaillou, Rennes, 11Université Européenne de Bretagne, UBO, EA3878 (GETBO) IFR 148, Rennes, 3Dept of Pulmonology, CHR d’Orléans, Orléans, 4Dept of Pulmonology, Centre Hospitalier Le Mans, Le Mans, 5Dept of Internal Medicine and Pulmonology, University Hospital La Cavale Blanche, Brest, 6Universite François Rabelais de Tours, INSERM U1100, Tours, 12Universite François Rabelais de Tours, EA6305, Tours, 7Dept of Pulmonology, CHU de Tours, Tours, 8Dept of Pulmonology, Centre hospitalier de l'Université de Poitiers, Poitiers, 9Dept of Pulmonology, Hôpital Broussais Hospital, Saint-Malo, and 10Dept of Pulmonology, CHU Angers, Angers, France.
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Sylvain Marchand-Adam
1Dept of Pulmonology, Institut du Thorax, CHU de Nantes, Nantes, 2Dept of Pulmonology, Hôpital Pontchaillou, Rennes, 11Université Européenne de Bretagne, UBO, EA3878 (GETBO) IFR 148, Rennes, 3Dept of Pulmonology, CHR d’Orléans, Orléans, 4Dept of Pulmonology, Centre Hospitalier Le Mans, Le Mans, 5Dept of Internal Medicine and Pulmonology, University Hospital La Cavale Blanche, Brest, 6Universite François Rabelais de Tours, INSERM U1100, Tours, 12Universite François Rabelais de Tours, EA6305, Tours, 7Dept of Pulmonology, CHU de Tours, Tours, 8Dept of Pulmonology, Centre hospitalier de l'Université de Poitiers, Poitiers, 9Dept of Pulmonology, Hôpital Broussais Hospital, Saint-Malo, and 10Dept of Pulmonology, CHU Angers, Angers, France.
1Dept of Pulmonology, Institut du Thorax, CHU de Nantes, Nantes, 2Dept of Pulmonology, Hôpital Pontchaillou, Rennes, 11Université Européenne de Bretagne, UBO, EA3878 (GETBO) IFR 148, Rennes, 3Dept of Pulmonology, CHR d’Orléans, Orléans, 4Dept of Pulmonology, Centre Hospitalier Le Mans, Le Mans, 5Dept of Internal Medicine and Pulmonology, University Hospital La Cavale Blanche, Brest, 6Universite François Rabelais de Tours, INSERM U1100, Tours, 12Universite François Rabelais de Tours, EA6305, Tours, 7Dept of Pulmonology, CHU de Tours, Tours, 8Dept of Pulmonology, Centre hospitalier de l'Université de Poitiers, Poitiers, 9Dept of Pulmonology, Hôpital Broussais Hospital, Saint-Malo, and 10Dept of Pulmonology, CHU Angers, Angers, France.
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Jean-Claude Meurice
1Dept of Pulmonology, Institut du Thorax, CHU de Nantes, Nantes, 2Dept of Pulmonology, Hôpital Pontchaillou, Rennes, 11Université Européenne de Bretagne, UBO, EA3878 (GETBO) IFR 148, Rennes, 3Dept of Pulmonology, CHR d’Orléans, Orléans, 4Dept of Pulmonology, Centre Hospitalier Le Mans, Le Mans, 5Dept of Internal Medicine and Pulmonology, University Hospital La Cavale Blanche, Brest, 6Universite François Rabelais de Tours, INSERM U1100, Tours, 12Universite François Rabelais de Tours, EA6305, Tours, 7Dept of Pulmonology, CHU de Tours, Tours, 8Dept of Pulmonology, Centre hospitalier de l'Université de Poitiers, Poitiers, 9Dept of Pulmonology, Hôpital Broussais Hospital, Saint-Malo, and 10Dept of Pulmonology, CHU Angers, Angers, France.
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Hugues Morel
1Dept of Pulmonology, Institut du Thorax, CHU de Nantes, Nantes, 2Dept of Pulmonology, Hôpital Pontchaillou, Rennes, 11Université Européenne de Bretagne, UBO, EA3878 (GETBO) IFR 148, Rennes, 3Dept of Pulmonology, CHR d’Orléans, Orléans, 4Dept of Pulmonology, Centre Hospitalier Le Mans, Le Mans, 5Dept of Internal Medicine and Pulmonology, University Hospital La Cavale Blanche, Brest, 6Universite François Rabelais de Tours, INSERM U1100, Tours, 12Universite François Rabelais de Tours, EA6305, Tours, 7Dept of Pulmonology, CHU de Tours, Tours, 8Dept of Pulmonology, Centre hospitalier de l'Université de Poitiers, Poitiers, 9Dept of Pulmonology, Hôpital Broussais Hospital, Saint-Malo, and 10Dept of Pulmonology, CHU Angers, Angers, France.
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Christine Person-Tacnet
1Dept of Pulmonology, Institut du Thorax, CHU de Nantes, Nantes, 2Dept of Pulmonology, Hôpital Pontchaillou, Rennes, 11Université Européenne de Bretagne, UBO, EA3878 (GETBO) IFR 148, Rennes, 3Dept of Pulmonology, CHR d’Orléans, Orléans, 4Dept of Pulmonology, Centre Hospitalier Le Mans, Le Mans, 5Dept of Internal Medicine and Pulmonology, University Hospital La Cavale Blanche, Brest, 6Universite François Rabelais de Tours, INSERM U1100, Tours, 12Universite François Rabelais de Tours, EA6305, Tours, 7Dept of Pulmonology, CHU de Tours, Tours, 8Dept of Pulmonology, Centre hospitalier de l'Université de Poitiers, Poitiers, 9Dept of Pulmonology, Hôpital Broussais Hospital, Saint-Malo, and 10Dept of Pulmonology, CHU Angers, Angers, France.
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Christophe Leroyer
1Dept of Pulmonology, Institut du Thorax, CHU de Nantes, Nantes, 2Dept of Pulmonology, Hôpital Pontchaillou, Rennes, 11Université Européenne de Bretagne, UBO, EA3878 (GETBO) IFR 148, Rennes, 3Dept of Pulmonology, CHR d’Orléans, Orléans, 4Dept of Pulmonology, Centre Hospitalier Le Mans, Le Mans, 5Dept of Internal Medicine and Pulmonology, University Hospital La Cavale Blanche, Brest, 6Universite François Rabelais de Tours, INSERM U1100, Tours, 12Universite François Rabelais de Tours, EA6305, Tours, 7Dept of Pulmonology, CHU de Tours, Tours, 8Dept of Pulmonology, Centre hospitalier de l'Université de Poitiers, Poitiers, 9Dept of Pulmonology, Hôpital Broussais Hospital, Saint-Malo, and 10Dept of Pulmonology, CHU Angers, Angers, France.
1Dept of Pulmonology, Institut du Thorax, CHU de Nantes, Nantes, 2Dept of Pulmonology, Hôpital Pontchaillou, Rennes, 11Université Européenne de Bretagne, UBO, EA3878 (GETBO) IFR 148, Rennes, 3Dept of Pulmonology, CHR d’Orléans, Orléans, 4Dept of Pulmonology, Centre Hospitalier Le Mans, Le Mans, 5Dept of Internal Medicine and Pulmonology, University Hospital La Cavale Blanche, Brest, 6Universite François Rabelais de Tours, INSERM U1100, Tours, 12Universite François Rabelais de Tours, EA6305, Tours, 7Dept of Pulmonology, CHU de Tours, Tours, 8Dept of Pulmonology, Centre hospitalier de l'Université de Poitiers, Poitiers, 9Dept of Pulmonology, Hôpital Broussais Hospital, Saint-Malo, and 10Dept of Pulmonology, CHU Angers, Angers, France.
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Patrice Diot
1Dept of Pulmonology, Institut du Thorax, CHU de Nantes, Nantes, 2Dept of Pulmonology, Hôpital Pontchaillou, Rennes, 11Université Européenne de Bretagne, UBO, EA3878 (GETBO) IFR 148, Rennes, 3Dept of Pulmonology, CHR d’Orléans, Orléans, 4Dept of Pulmonology, Centre Hospitalier Le Mans, Le Mans, 5Dept of Internal Medicine and Pulmonology, University Hospital La Cavale Blanche, Brest, 6Universite François Rabelais de Tours, INSERM U1100, Tours, 12Universite François Rabelais de Tours, EA6305, Tours, 7Dept of Pulmonology, CHU de Tours, Tours, 8Dept of Pulmonology, Centre hospitalier de l'Université de Poitiers, Poitiers, 9Dept of Pulmonology, Hôpital Broussais Hospital, Saint-Malo, and 10Dept of Pulmonology, CHU Angers, Angers, France.
1Dept of Pulmonology, Institut du Thorax, CHU de Nantes, Nantes, 2Dept of Pulmonology, Hôpital Pontchaillou, Rennes, 11Université Européenne de Bretagne, UBO, EA3878 (GETBO) IFR 148, Rennes, 3Dept of Pulmonology, CHR d’Orléans, Orléans, 4Dept of Pulmonology, Centre Hospitalier Le Mans, Le Mans, 5Dept of Internal Medicine and Pulmonology, University Hospital La Cavale Blanche, Brest, 6Universite François Rabelais de Tours, INSERM U1100, Tours, 12Universite François Rabelais de Tours, EA6305, Tours, 7Dept of Pulmonology, CHU de Tours, Tours, 8Dept of Pulmonology, Centre hospitalier de l'Université de Poitiers, Poitiers, 9Dept of Pulmonology, Hôpital Broussais Hospital, Saint-Malo, and 10Dept of Pulmonology, CHU Angers, Angers, France.
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Abstract

By 2020, chronic obstructive pulmonary disease (COPD) will be the third cause of mortality. Extrapulmonary comorbidities influence the prognosis of patients with COPD. Tobacco smoking is a common risk factor for many comorbidities, including coronary heart disease, heart failure and lung cancer. Comorbidities such as pulmonary artery disease and malnutrition are directly caused by COPD, whereas others, such as systemic venous thromboembolism, anxiety, depression, osteoporosis, obesity, metabolic syndrome, diabetes, sleep disturbance and anaemia, have no evident physiopathological relationship with COPD. The common ground between most of these extrapulmonary manifestations is chronic systemic inflammation.

All of these diseases potentiate the morbidity of COPD, leading to increased hospitalisations and healthcare costs. They can frequently cause death, independently of respiratory failure. Comorbidities make the management of COPD difficult and need to be evaluated and treated adequately.

Footnotes

  • Support statement: The study was supported by Novartis Pharma AG (Paris, France).

  • Conflict of interest: Disclosures can be found alongside the online version of this article at err.ersjournals.com

  • Provenance: Submitted article, peer reviewed.

  • Received December 28, 2012.
  • Accepted February 22, 2013.
  • ©ERS 2013

ERR articles are open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 3.0.

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Comorbidities of COPD
Arnaud Cavaillès, Graziella Brinchault-Rabin, Adrien Dixmier, François Goupil, Christophe Gut-Gobert, Sylvain Marchand-Adam, Jean-Claude Meurice, Hugues Morel, Christine Person-Tacnet, Christophe Leroyer, Patrice Diot
European Respiratory Review Dec 2013, 22 (130) 454-475; DOI: 10.1183/09059180.00008612

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Comorbidities of COPD
Arnaud Cavaillès, Graziella Brinchault-Rabin, Adrien Dixmier, François Goupil, Christophe Gut-Gobert, Sylvain Marchand-Adam, Jean-Claude Meurice, Hugues Morel, Christine Person-Tacnet, Christophe Leroyer, Patrice Diot
European Respiratory Review Dec 2013, 22 (130) 454-475; DOI: 10.1183/09059180.00008612
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  • Article
    • Abstract
    • Introduction
    • Cardiovascular comorbidities
    • Lung cancer
    • Anxiety and depression disorders
    • Osteoporosis
    • Malnutrition
    • Obesity
    • Metabolic syndrome and diabetes
    • Sleep disturbance
    • Anaemia
    • Lung fibrosis
    • Comorbidities and COPD exacerbation
    • Conclusion
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