A longitudinal prospective study of active tuberculosis in a Western Europe setting: insights and findings

Author:

Romero-Tamarit Arantxa,Vallès Xavier,Munar-García María,Espinosa-Pereiro Juan,Saborit Núria,Tortola Ma. Teresa,Stojanovic Zoran,Roure Sílvia,Antuori Adrián,Cardona Pere-Joan,Soriano-Arandes Antoni,Martin-Nalda Andrea,Espiau María,de Souza-Galvão Maria Luiza,Jiménez Ma. Ángeles,Noguera-Julian Antoni,Molina Israel,Casas Xavier,Domínguez-Álvarez Marisol,Jové Neus,Gogichadze Nino,L. Fonseca Kaori,Arias Lilibeth,Millet Joan-Pau,Sánchez-Montalvá Adrián,Vilaplana Cristina

Abstract

Abstract Purpose This study investigates the potential of inflammatory parameters (IP), symptoms, and patient-related outcome measurements as biomarkers of severity and their ability to predict tuberculosis (TB) evolution. Methods People with TB were included prospectively in the Stage-TB study conducted at five clinical sites in Barcelona (Spain) between April 2018 and December 2021. Data on demographics, epidemiology, clinical features, microbiology, and Sanit George Respiratory Questionnaire (SGRQ) and Kessler-10 as Health-Related Quality of Life (HRQoL) were collected at three time points during treatment. C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), neutrophil/lymphocyte, and monocyte/lymphocyte ratios (NLR and MLR), complement factors C3, C4, and cH50, clinical and microbiological data, and HRQoL questionnaires were assessed at baseline, 2 months, and 6 months. Their ability to predict sputum culture conversion (SCC) and symptom presence after 2 months of treatment was also analysed. Results The study included 81 adults and 13 children with TB. The CRP, ESR, NLR, and MLR values, as well as the presence of symptoms, decreased significantly over time in both groups. Higher IP levels at baseline were associated with greater bacillary load and persistent symptoms. Clinical severity at baseline predicted a delayed SCC. Kessler-10 improved during follow-up, but self-reported lung impairment (SGRQ) persisted in all individuals after 6 months. Conclusions IP levels may indicate disease severity, and sustained high levels are linked to lower treatment efficacy. Baseline clinical severity is the best predictor of SCC. Implementing health strategies to evaluate lung function and mental health throughout the disease process may be crucial for individuals with TB.

Funder

Spanish Government-FEDER Funds

European Union’s Horizon 2020 research and innovation programme

Catalan Government

Spanish Society of Pneumology and Thoracic Surgery

Publisher

Springer Science and Business Media LLC

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