Peter Skyba, Pavol Joppa, Pavol Pobeha, Ružena Tkáčová
Chronic obstructive pulmonary disease (COPD) and its complications represent one of the most frequently discussed issues in respiratory medicine. The pathogenesis and clinical presentation of COPD is not limited to obstructive ventilatory impairment, inflammatory processes and structural remodeling within the lungs. Currently, COPD is considered to represent a multicomponent disease that is associated with several extrapulmonary manifestations such as systemic inflammation and systemic oxidative stress. In addition, COPD increases the risk of several comorbidities including atherosclerosis, ischemic heart disease, cachexia, muscle loss and muscle dysfunction, osteoporosis, anaemia and depression. Systemic manifestations of COPD and its comorbidities contribute to further reduction in the quality of life, and to increased morbidity and mortality in patients with COPD.