Post-tuberculosis lung impairment: systematic review and meta-analysis of spirometry data from 14 621 people

Author:

Ivanova Olena,Hoffmann Verena Sophia,Lange Christoph,Hoelscher Michael,Rachow Andrea

Abstract

BackgroundA substantial proportion of tuberculosis patients remain with pulmonary symptoms and reduced physical capacity despite successful treatment. We performed a systematic review to analyse the burden of post-tuberculosis lung impairment measured by lung function testing.MethodsWe searched the PubMed database for articles published between database inception and November 2020 and performed meta-analyses to estimate the prevalence, type and severity of lung impairment among drug-susceptible and multidrug-resistant tuberculosis survivors. Methodological quality of included studies was assessed using the Newcastle–Ottawa scale.Results54 articles were included in this review. For subjects with former drug-susceptible tuberculosis, the combined estimated mean was 76.6% (95% CI 71.6–81.6) of predicted for forced expiratory volume in 1 s (FEV1) and 81.8% (95% CI 77.4–86.2) for forced vital capacity (FVC). In former patients with multidrug-resistant tuberculosis, it was 65.9% (95% CI 57.1–74.7) for FEV1and 76.0% (95% CI 66.3–85.8) for FVC, respectively. The analysis of impairment types in former patients with drug-susceptible and multidrug-resistant tuberculosis showed that 22.0%versus19.0% had obstructive, 23.0%versus22.0% restrictive and 15.0%versus43.0% had mixed impairment type, respectively. In the majority of studies, at least 10–15% of tuberculosis survivors had severe lung impairment.ConclusionsThis systematic review showed long-term abnormal spirometry results in a significant proportion of tuberculosis survivors.

Publisher

European Respiratory Society (ERS)

Subject

Pulmonary and Respiratory Medicine

Reference94 articles.

1. World Health Organization . Global Tuberculosis Report 2021. www.who.int/publications/digital/global-tuberculosis-report-2021 Date last updated: 14 October 2021.

2. Post-tuberculosis mortality and morbidity: valuing the hidden epidemic;Quaife;Lancet Respir Med,2020

3. Post-tuberculosis lung health: perspectives from the First International Symposium;Allwood;Int J Tuberc Lung Dis,2020

4. Long-term all-cause mortality in people treated for tuberculosis: a systematic review and meta-analysis;Romanowski;Lancet Infect Dis,2019

5. Long-term survival and cause-specific mortality of patients newly diagnosed with tuberculosis in São Paulo state, Brazil, 2010–15: a population-based, longitudinal study;Ranzani;Lancet Infect Dis,2020

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