Introduction COPD is often accompanied by one or more comorbidities. In mild COPD, these comorbidities are independently related to a higher risk of mortality. In patients with severe COPD, the impact of comorbidities on survival has not been explored.

Aim To study the effect of comorbidities on survival and quality of life (QoL) in severe COPD.

Methods Data were prospectively collected from COPD patients who visited our hospital for evaluating their eligibility for a bronchoscopic lung volume reduction treatment, and were included in the Groningen Severe COPD Cohort (NCT04023409). Comorbidity data were assembled, and QoL was assessed using the Saint George?s respiratory questionnaire (SGRQ). Patients without comorbidities were compared to patients having at least 3 comorbidities.

Results In total, 947 patients were included (mean FEV1% 29±10) of whom 242 (26%) died, with a median follow-up time of 1228 days (range 2-2411). Patients had a median of 3 (range 0-14) comorbidities. No significant differences were observed in survival time between patients without versus at least 3 comorbidities (P=0.310, see figure 1). However, patients with at least 3 comorbidities did have significantly worse QoL (SGRQ 60±13 versus 55±14, P<0.001).

Conclusions Our results suggest that having multiple comorbidities in severe COPD reduces QoL, but does not influence survival.