Management of exacerbations of chronic obstructive pulmonary disease with a focus on comorbidities

Exacerbations of chronic obstructive pulmonary disease (COPD) are episodes of worsening of lower respiratory symptoms, especially dyspnea, sputum purulence and cough. They are usually triggered by infective factors, especially respiratory viruses. COPD is associated with considerable co-morbidity and this will also affect the nature and severity of the exacerbations. There are key interactions between exacerbations and co-morbidities including issues of differential diagnosis and higher co-morbidity in patients with the frequent exacerbator phenotype. It is, therefore, essential that any studies of exacerbation prevention in COPD also set out to evaluate the effect on co-morbidity in COPD.