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

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

*Autor corresponent d’aquest treball

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Resum

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.

Idioma originalEnglish
Pàgines (de-a)611-623
Nombre de pàgines13
RevistaInfection
Volum52
Número2
DOIs
Estat de la publicacióPublicada - d’abr. 2024

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