COPD and the Solar System:Introducing the Chronic Obstructive Pulmonary Disease Comorbidome

Chronic obstructive pulmonary disease (COPD) is increasingly recognized as the pulmonary component of a more complex syndrome characterized by structural abnormalities of the airways (bronchiolitis) and lung (emphysema), and also by concomitant disorders (comorbidities) such as cardiovascular disease, metabolic syndrome, osteoporosis, depression, cancer, and inflammatory bowel disease. These comorbidities influence not only the severity of the symptoms and the quality of life of individual patients, but also the risk of hospitalization and eventually death. In turn, COPD is a frequent and important comorbidity of these same chronic conditions (e.g., ischemic heart disease, chronic heart failure, arrhythmia, osteoporosis, and metabolic syndrome). Indeed, only a minority of patients with COPD die of respiratory failure; most die of other conditions, particularly cardiovascular disease, pneumonia, thromboembolism, and cancer (mainly lung cancer)