Global, regional, and national burden of chronic respiratory diseases and impact of the COVID-19 pandemic, 1990–2023: a Global Burden of Disease study

Oh, Jiyeon, Kim, Soeun, Yim, Yesol, Kim, Min Seo, undefined, undefined, Il Shin, Jae, Jabbar, Ahmed A. J., Aalruz, Hasan, Abbasian, Mohammadreza, Abd Al Magied, Abdallah H. A., ElHafeez, Samar Abd, Abdelkader, Atef, Abdelmagied, Mawada Hassan, Abdi, Parsa, Abdollahifar, Mohammad-Amin, Abdulah, Deldar Morad, Abdullahi, Auwal, Abebaw, Nigusie, Zuñiga, Roberto Ariel Abeldaño, Aboagye, Richard Gyan, Abolhassani, Hassan, Abouzid, Mohamed, Abreu, Lucas Guimarães, Abtahi, Dariush, Farha, Rana Kamal Abu, Abubakar, Ibrahim Jatau, Abu-Gharbieh, Eman, Abukhadijah, Hana J., Aburuz, Salahdein, Abu-Zaid, Ahmed, Acuna, Juan Manuel, Adane, Mesafint Molla, Addo, Isaac Yeboah, Adegboye, Oyelola A., Adekanmbi, Victor, Adetunji, Charles Oluwaseun, Adeyeoluwa, Temitayo Esther, Adha, Rishan, Adhikari, Kishor, Adhikary, Ripon Kumar, Adnani, Qorinah Estiningtyas Sakilah, Afolabi, Aanuoluwapo Adeyimika, Afolabi, Rotimi Felix, Afrashteh, Fatemeh, Afrooghe, Arya, Agrawal, Anurag, Agyemang-Duah, Williams, Ahmad, Aqeel, Ahmad, Muayyad M., Ahmad, Sajjad, Ahmad, Shahzaib, Ahmadi, Ali, Ahmed, Ayman, Ahmed, Haroon, Ahmed, Ibrar, Ahmed, Mohammed, Ahmed, Oli, Ahmed, Sindew Mahmud, Ahmed, Syed Anees, Ajadi, Abdullateef Abiodun, Akhmedullin, Ruslan, Akinosoglou, Karolina, Akkaif, Mohammed Ahmed, Akrami, Ashley E., Hamad, Hanadi Al, Hasan, Syed Mahfuz Al, Alajlani, Muaaz M., Al-Ajlouni, Yazan, Alam, Khurshid, Alam, Mohammad Khursheed, Alam, Nazmul, Al-amer, Rasmieh Mustafa, Al-Eyadhy, Ayman, Algammal, Abdelazeem M., Al-Gheethi, Adel Ali Saeed, Alhalaiqa, Fadwa Naji, Ali, Endale Alemayehu, Ali, Mohammad Daud, Ali, Mohammed Usman, Ali, Rafat, Ali, Syed Shujait, Ali, Waad, Al-Ibraheem, Akram, Alif, Sheikh Mohammad, Al-Jabi, Samah W., Aljofan, Mohamad, Aljunid, Syed Mohamed, Al-Marwani, Sabah, Al-Mekhlafi, Hesham M., Alnaeem, Mohmmad Minwer, Alomari, Mahmoud A., Alqahtani, Jaber S., Alqarni, Abdullah A., Alrawashdeh, Ahmad, Alrousan, Sahel Majed, Alsabri, Mohammed A., Alshahrani, Najim Z., Altaany, Zaid, Altaf, Awais, Altartoor, Khaled, Al-Tawfiq, Jaffar A., Altirkawi, Khalid A., Alvi, Farrukh Jawad, Alvis-Guzman, Nelson, Alwafi, Hassan, Al-Wardat, Mohammad, Al-Worafi, Yaser Mohammed, Aly, Hany, Alyahya, Mohammad Sharif Ibrahim, Alzoubi, Abdallah, Alzoubi, Karem H., Amani, Reza, Amatya, Isha, Amin, Amr, Amu, Hubert, Ancuceanu, Robert, Anderson, Michael, Anil, Abhishek, Ansar, Adnan, Ansari, Mohammed Tahir, Ansari, Sameera, Anuoluwa, Boluwatife Stephen, Anuoluwa, Iyadunni Adesola, Anvari, Saeid, Anwar, Saleha, Anyasodor, Anayochukwu Edward, Apostol, Geminn Louis Carace, Arabloo, Jalal, Arafa, Elshaimaa A., Arafat, Mosab, Aravkin, Aleksandr Y., Areda, Demelash, Armocida, Benedetta, Arooj, Mahwish, Aruleba, Idowu Thomas, Arumugam, Ashokan, Asgedom, Akeza Awealom, Asghariahmadabad, Mona, Ashames, Akram, Ashraf, Muhammad Abdul Basit, Ashraf, Tahira, Asiamah-Asare, Bernard Kwadwo Yeboah, Assefa, Dereje Zewdu, Atreya, Alok, Attia, Engi Farouk, Ausloos, Marcel, Ayana, Lemessa Assefa A., Aziz, Sadat Abdulla, Babandi, Zaharaddeen Shuaibu, Babu, Giridhara Rathnaiah, Badar, Muhammad, Baig, Atif Amin, Barac, Aleksandra, Bardhan, Mainak, Barqawi, Hiba Jawdat, Basharat, Zarrin, Basri, Rehana, Bastan, Mohammad-Mahdi, Tork, Mohammad Amin Bayat, Bayleyegn, Nebiyou Simegnew, Behzadi, Payam, Belayneh, Asnake Gashaw, Bello, Muhammad Bashir, Bello, Olorunjuwon Omolaja, Beloukas, Apostolos, Bemanalizadeh, Maryam, Benzian, Habib, Bernstein, Robert S., Bettencourt, Paulo J. 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Global, regional, and national burden of chronic respiratory diseases and impact of the COVID-19 pandemic, 1990–2023: a Global Burden of Disease study. Nature Medicine 32 , pp. 197-223. 10.1038/s41591-025-04077-9

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Abstract

Chronic respiratory diseases, including chronic obstructive pulmonary disease (COPD), asthma, pneumoconiosis, interstitial lung disease (ILD) and pulmonary sarcoidosis, are major global causes of mortality and morbidity. Although the COVID-19 pandemic has influenced acute respiratory health, its impact on chronic respiratory conditions remains unclear. We estimated the global, regional and national burden of chronic respiratory diseases from 1990 to 2023, including risk factors, and evaluated how these burdens have shifted during the COVID-19 pandemic using the Global Burden of Disease Study 2023. In 2023, chronic respiratory diseases accounted for 569.2 million (95% uncertainty interval (UI), 508.8–639.8) cases and 4.2 million (3.6–5.1) deaths. The age-standardized death rate declined by 25.7% globally from 1990 to 2023 despite an increase in ILD and pulmonary sarcoidosis. Mortality declined in younger males, especially for asthma, whereas older adults experienced a rise in ILD and pulmonary sarcoidosis. Smoking was the primary risk factor for COPD, whereas high body mass index and silica exposure were key risk factors for asthma and pneumoconiosis. During the pandemic, the incidence of chronic respiratory diseases increased modestly, but the decline in mortality rates became more pronounced, highlighting the need for sustained global attention and action to address their long-term burden.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Schools > Medicine
Additional Information:	RRS policy applied
Publisher:	Nature Publishing Group
ISSN:	1078-8956
Date of First Compliant Deposit:	3 February 2026
Date of Acceptance:	27 October 2025
Last Modified:	03 Feb 2026 10:48
URI:	https://orca.cardiff.ac.uk/id/eprint/184352

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