Pulmonary comorbidities may be broadly classified according to their anatomical site along the respiratory tract. These conditions can affect function of the upper airways comprising the nasal cavity and sinuses; the middle airway comprising the pharynx and larynx; and the lower airways, including the trachea, primary bronchi and small airways.
Disorders of the upper, middle, and lower airways all add to the complexity of severe asthma management. Pulmonary and upper airway disorders may present alternative diagnoses to asthma or may co-exist with asthma.
Pulmonary comorbidities can contribute to the perception and severity of asthma symptoms, affect lung inflammation and function and alter response to treatment. Identification of pulmonary comorbidities is an important consideration in asthma assessment.
Pulmonary comorbidities can result in:
- Poor asthma control
- Reduced quality of life
- Increased asthma attacks / exacerbations
- Increased healthcare utilisation
- Increased medication use
- Worse airflow limitation
Multidimensional assessment of severe asthma allows for the recognition of these comorbidities and has been shown to improve patient outcomes (Clark et al. 2017). Management of individual comorbidities can improve the symptoms resulting from that particular condition, asthma symptoms more broadly and/or response to treatment.
You can click on each comorbidity below for further detail: