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Risk and temporal order of disease diagnosis of comorbidities in patients with COPD: a population health perspective
  1. Ákos Tényi1,2,
  2. Emili Vela3,
  3. Isaac Cano1,2,
  4. Montserrat Cleries3,
  5. David Monterde4,
  6. David Gomez-Cabrero5,6,7 and
  7. Josep Roca1,2
  1. 1 Hospital Clinic de Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
  2. 2 Center for Biomedical Network Research in Respiratory Diseases (CIBERES), Madrid, Spain
  3. 3 Unitat d’Informació i Coneixement, Servei Catala de la Salut de la Generalitat de Catalunya, Barcelona, Catalunya, Spain
  4. 4 Serveis Centrals, Institut Català de la Salut, Barcelona, Spain
  5. 5 Mucosal and Salivary Biology Division, King’s College London Dental Institute, London, UK
  6. 6 Unit of Computational Medicine, Center for Molecular Medicine, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital and Science for Life Laboratory, Stockholm, Sweden
  7. 7 Translational Bioinformatics Unit, Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain
  1. Correspondence to Dr Josep Roca; jroca{at}


Introduction Comorbidities in patients with chronic obstructive pulmonary disease (COPD) generate a major burden on healthcare. Identification of cost-effective strategies aiming at preventing and enhancing management of comorbid conditions in patients with COPD requires deeper knowledge on epidemiological patterns and on shared biological pathways explaining co-occurrence of diseases.

Methods The study assesses the co-occurrence of several chronic conditions in patients with COPD using two different datasets: Catalan Healthcare Surveillance System (CHSS) (ES, 1.4 million registries) and Medicare (USA, 13 million registries). Temporal order of disease diagnosis was analysed in the CHSS dataset.

Results The results demonstrate higher prevalence of most of the diseases, as comorbid conditions, in elderly (>65) patients with COPD compared with non-COPD subjects, an effect observed in both CHSS and Medicare datasets. Analysis of temporal order of disease diagnosis showed that comorbid conditions in elderly patients with COPD tend to appear after the diagnosis of the obstructive disease, rather than before it.

Conclusion The results provide a population health perspective of the comorbidity challenge in patients with COPD, indicating the increased risk of developing comorbid conditions in these patients. The research reinforces the need for novel approaches in the prevention and management of comorbidities in patients with COPD to effectively reduce the overall burden of the disease on these patients.

  • clinical epidemiology
  • COPD epidemiology
  • systemic disease and lungs
  • COPD ÀÜ mechanisms

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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  • DG-C and JR contributed equally.

  • Contributors Study conception and design: AT, IC, DG-C and JR. Data acquisition: EV, DM and MC. Data analysis: AT, EV, DM and MC. Manuscript preparation: AT, EV, IC, DG-C and JR. Manuscript revision: all authors.

  • Funding This work was supported by the European Commission grant CONNECARE (H2020-689802).

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

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