Received:15.09.2025
Accepted: 19.01.2026
Published online: 20.03.2026
UDC: 616.2-06
DOI: 10.26212/2227-1937.2026.27.86.006
COMORBID CONDITIONS IN PULMONOLOGY PRACTICE: GLOBAL EXPERIENCE AND THE EXPERIENCE OF KAZAKHSTAN (LITERATURE REVIEW)
Amangeldi D.E.¹, Aitmagambet A.E.¹, Saduakassova N.A.¹², Sadirkhanov R.Sh.¹³, Kuralova M.B.¹⁴, Azhikhanova A.Zh.¹
¹ Kazakhstan Medical University “School of Public Health”, Almaty, Kazakhstan
² Children’s City Clinical Infectious Diseases Hospital, Almaty, Kazakhstan
³ Kausar Plus Clinic, Almaty, Kazakhstan
⁴ Almaty Sema Hospital, Almaty, Kazakhstan
Introduction. Comorbidity, defined as the presence of two or more chronic diseases in a single patient, is a key challenge in modern pulmonology, as chronic obstructive pulmonary disease (COPD) and bronchial asthma are frequently associated with cardiovascular, metabolic, and neuropsychological conditions. Comorbid diseases significantly affect the clinical course, frequency of exacerbations, hospitalizations, mortality, and quality of life, while also limiting therapeutic
options. In recent years, the focus has shifted toward the concept of multimorbidity and the treatable traits approach, which is particularly relevant for countries with transition economies, including the Republic of Kazakhstan, given the high prevalence of risk factors and the limited number of local studies.
Objective. To analyze current data (2018–2025) on the prevalence, structure, and clinical significance of comorbid conditions in patients with chronic respiratory diseases and to summarize international experience and available publications reflecting the situation in the Republic of Kazakhstan.
Materials and Methods. A systematic literature review was conducted in accordance with PRISMA guidelines. Searches were performed in PubMed (including PubMed Central), Google Scholar, and CyberLeninka for the period 2016–2025. Studies were selected according to predefined inclusion and exclusion criteria, followed by an analysis of study design, sample characteristics, types of comorbidities, and their impact on clinical outcomes.
Results. Comorbid conditions are observed in most patients with COPD and bronchial asthma and are predominantly represented by cardiovascular, metabolic, and psycho-emotional disorders, which significantly worsen the course of and control over respiratory disease. The formation of stable multimorbidity clusters is associated with increased mortality and hospitalization rates. In the Republic of Kazakhstan, a high prevalence of risk factors, a predominance of cardiovascular comorbidities, and insufficient control of asthma and COPD are observed against a background of limited national epidemiological data.
Discussion. Comorbidity is a key characteristic of chronic respiratory diseases and has a substantial impact on prognosis and quality of life. In Kazakhstan, its significance is further amplified by the high prevalence of risk factors and limited access to specialized care, highlighting the need for an integrated multidisciplinary approach and further prospective studies.
Conclusion. The high prevalence of comorbid conditions in chronic respiratory diseases and their significant impact on clinical outcomes justify the need for a comprehensive multidisciplinary approach, strengthened screening, and the development of national epidemiological research in the Republic of Kazakhstan.
Keywords: comorbidity, multimorbidity, chronic obstructive pulmonary disease (COPD), bronchial asthma, chronic respiratory diseases.
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