Abstract:
Background. Chronic obstructive pulmonary disease (COPD) is a multisystem condition
frequently associated with numerous comorbidities. These comorbid conditions influence
the clinical expression of the disease, functional severity, and prognosis. The integrative
approach is essential for evaluating comorbidity burden.
Objective(s). To evaluate the impact of comorbidities on the clinical, functional and imaging
severity of COPD, aiming to support the development of a multidimensional prognostic
stratification.
Materials and methods. An analytical, cross-sectional observational study was conducted
on a sample of patients diagnosed with COPD and comorbidities, divided equally into two
subgroups based on spirometric severity (GOLD stages 1-2 and GOLD stages 3-4). Clinical
parameters, laboratory data, comorbidity scores and high-resolution CT findings were
assessed.
Results. The analysis revealed a higher prevalence of cardiovascular, metabolic and
respiratory comorbidities in the subgroup with more severe COPD. Composite clinical scores
showed consistent associations with spirometric severity and were useful in evaluating
exacerbation frequency and hospitalization burden. HRCT imaging evaluation identified
both pulmonary and extrapulmonary abnormalities such as bronchiectasis, emphysema,
coronary artery calcifications and osteoporosis, which were more frequently encountered
in advanced stages and carried significant prognostic implications. These findings highlight
the heterogeneity of COPD.
Conclusion(s). Integrating clinical, functional, imaging data and validated comorbidity
scores, ensures a more accurate assessment of COPD burden. This multidimensional
approach supports improved risk stratification and personalized care. These findings
highlight the need to implement structured assessment tools.
