Insights into the Pathophysiology and Therapeutic Targets of Consequences Induced by Polycythemia in COPD

Abstract

ABSTRACT: Polycythemia, characterized by an excess of red blood cells (RBCs), is a common occurrence in individuals with chronic obstructive pulmonary disease (COPD) due to chronic hypoxia resulting from impaired lung function. While polycythemia may have some protective effects for COPD patients on long-term oxygen therapy, it can also increase the risk of life-threatening complications such as pulmonary embolism (PE). This review explores the impact of polycythemia on COPD patients, delving into its epidemiology, risk factors, and potential consequences. The prevalence of polycythemia in COPD varies from 6% to 10.2% in outpatient settings and is associated with factors like smoking, male gender, impaired lung function, and severe hypoxemia. The elevated red blood cell count can thicken the blood, increasing the risk of blood clots and cardiovascular complications. Proper management of polycythemic COPD involves addressing increased blood viscosity, managing thromboembolic risks, and optimizing cardiovascular health. Therapeutic interventions include phlebotomy, low-dose aspirin, and oxygen therapy to reduce complications and improve outcomes. Additionally, new cytoreductive therapies may offer promising treatment options for primary polycythemia. However, further research is required to enhance our understanding and refine care for individuals with polycythemic COPD, with the ultimate goal of mitigating complications, improving quality of life, and enhancing long-term prognosis. Clinicians must remain vigilant in managing polycythemia in COPD to optimize patient outcomes and reduce the burden of associated complications.