Comorbid asthma - occurrence and associations with patient-related outcomes in COPD: a cohort study.

Authors

Åsa Athlin, Karin Lisspers, Mikael Hasselgren, Björn Ställberg, Hanna Sandelowsky, Maaike Giezeman, Christer Janson, Marta A Kisiel, Gabriella Eliason, Anna Nager, Scott Montgomery, Josefin Sundh

Published in

Scandinavian journal of primary health care. Volume 45. Issue 1. Pages 2747915. Epub Oct 18, 2026.

Abstract

Clinical features of COPD and asthma overlap, complicating differential diagnosis. This study investigated the prevalence of comorbid asthma in COPD patients and its association with patient-related outcomes.
Patients with a doctor's diagnosis of COPD were randomly selected in two cohorts 2005 (n = 1060) and 2014 (n = 1671), from primary and secondary care in Sweden. Data were collected from medical records and patient questionnaires at baseline and at follow-up (2012 and 2022, respectively). Questionnaires included data on exacerbations. Symptoms were assessed using the clinical COPD questionnaire (CCQ). Comorbid asthma was identified through medical records. Ten-year mortality data were obtained from national registers. Logistic and linear regression assessed associations with patient-reported outcomes; Cox regression was applied for mortality analyses.
Comorbid asthma was found in 22% of the 2005 cohort and 9% of the 2014 cohort (p < .001). In both cohorts, it was associated with an increased risk of exacerbations: OR (95% CI) 1.58 (1.07-2.32), p = .02, and 2.20 (1.38-3.52), p < .001, respectively. No associations were found between comorbid asthma and worsening of health status (CCQ). Mortality risk did not differ in the 2005 cohort, HR (95% CI) 0.92 (0.71-1.18), but was lower in the 2014 cohort, HR (95% CI) 0.67 (0.49-0.93), p = .02.
Comorbid asthma in COPD has changed from 22 to 9%, potentially due to improved diagnostics. Comorbid asthma remains clinically relevant due to its association with an increased exacerbation risk.

PMID:
42894311
Bibliographic data and abstract were imported from PubMed on 19 Oct 2026.

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