Spectrum and Prevalence of Comorbidities in Stable COPD Patients Attending a Chest Clinic in Nigeria.

Abstract

Background: COPD comorbidities have a significant impact on prognosis. There is underdiagnosis of comorbidities in sub-Saharan Africa. The study aimed to assess the prevalence and spectrum of comorbidities in stable COPD patients, and compare the pattern of comorbidities in COPD caused by biomass smoke (B-COPD) with tobacco smoking (T-COPD) in a Nigerian hospital's chest clinic.

Methods: This was a cross-sectional clinico-laboratory study. Standardized instruments and questionnaire administration followed by spirometry and laboratory blood tests were used to obtain relevant clinical information and identify comorbidities, and 94 (31.3%) of them were assessed retrospectively.

Results: All 75 patients had multiple comorbidities; 8(10.7%) had two comorbidities, and 67 (89.3 %) had ≥ 3 comorbidities. The mean comorbidity count was 4.2 in males and 3.8 in females (p=0.130). The prevalence of haematologic, neurologic, cardiovascular, psychological, musculoskeletal, and infectious conditions were 86.7%, 76.0%, 61.3%, 49.7%, 34.7%, and 33.3%, respectively. The leading comorbidities were anaemia (65; 86.7%), impaired sleep quality (57; 76%) and systemic hypertension (42; 56%). None of the subjects had polycythemia. One-third (25; 33.3%) had osteoarthritis, 23(30.7%) had anxiety, 26(34.7%) had dyslipidemia, and 13(17%) had depression. 10(13.3%) were underweight, and 9(10.7%) had pulmonary TB. Less than 10% had obesity, HIV infection and renal impairment. Anaemia was more prevalent in male patients compared to female patients (97.7% vs. 71.9%), whereas osteoarthritis was more prevalent in female patients compared to male patients (53.1% vs 18.6%). Systemic hypertension, anxiety, and HIV were significantly more frequent in COPD caused by tobacco (T-COPD) than in COPD caused by biomass smoke (B-COPD). Osteoarthritis was more common in B-COPD than in T-COPD.

Conclusion: The study shows that most COPD patients had multimorbidity, and anaemia, impaired sleep quality and systemic hypertension were the leading comorbidities. Systemic hypertension is commoner in tobacco-related COPD. This study highlights the need for healthcare providers to be aware of these differences in comorbidity patterns compared to those in developed nations when caring for COPD patients. WAJM 2025; 42 (8): 642-651.