A longitudinal prospective study of active tuberculosis in a Western Europe setting: insights and findings
Por:
Romero-Tamarit A, Vallès X, Munar-García M, Espinosa-Pereiro J, Saborit N, Tortola MT, Stojanovic Z, Roure S, Antuori A, Cardona PJ, Soriano-Arandes A, Martin-Nalda A, Espiau M, de Souza-Galvão ML, Jiménez MÁ, Noguera-Julian A, Molina I, Casas X, Domínguez-Álvarez M, Jové N, Gogichadze N, L Fonseca K, Arias L, Millet JP, Sánchez-Montalvá A and Vilaplana C
Publicada:
1 abr 2024
Ahead of Print:
1 feb 2024
Resumen:
PurposeThis 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.MethodsPeople 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.ResultsThe 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.ConclusionsIP 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.
Filiaciones:
Romero-Tamarit A:
Unitat de Tuberculosi Experimental, Germans Trias i Pujol Research Institute (IGTP), Can Ruti Campus, Ctra. del Canyet, S/N, 08916, Badalona, Spain
Autonomous University of Barcelona, Bellaterra, Spain
Vallès X:
Unitat de Tuberculosi Experimental, Germans Trias i Pujol Research Institute (IGTP), Can Ruti Campus, Ctra. del Canyet, S/N, 08916, Badalona, Spain
North Metropolitan International Health Program (PROSICS), Badalona, Spain
Territorial Clinical Directorate on Infectious Diseases and International Health Clinical Division within the Northern Metropolitan Management of the Catalan Institute of Health, Badalona, Spain
Fundació Lluita Contra les Infeccions, Hospital Germans Trias i Pujol, Badalona, Spain
Munar-García M:
Unitat de Tuberculosi Experimental, Germans Trias i Pujol Research Institute (IGTP), Can Ruti Campus, Ctra. del Canyet, S/N, 08916, Badalona, Spain
Pompeu Fabra University, Barcelona, Spain
Espinosa-Pereiro J:
Infectious Diseases Department, Vall d'Hebrón University Hospital, Universitat Autónoma de Barcelona, Barcelona, Spain
International Health Program of the Catalan Institute of Health (PROSICS), Barcelona, Spain
CIBER of Infectious Disease (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
Saborit N:
Infectious Diseases Department, Vall d'Hebrón University Hospital, Universitat Autónoma de Barcelona, Barcelona, Spain
Tortola MT:
CIBER of Infectious Disease (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
Microbiology Department, Hospital Vall d'Hebron, Barcelona, Spain
Mycobacterial Infection Study Group from the Spanish Society of Clinical Microbiology and Infectious Diseases (GEIM-SEIMC), Barcelona, Spain
Stojanovic Z:
Pneumology Department, Hospital Universitari Germans Trias I Pujol, Badalona, Spain
CIBER Respiratory Diseases (CIBERES), Instituto de Salud?Carlos III, 28029, Madrid, Spain
Roure S:
Unitat de Tuberculosi Experimental, Germans Trias i Pujol Research Institute (IGTP), Can Ruti Campus, Ctra. del Canyet, S/N, 08916, Badalona, Spain
North Metropolitan International Health Program (PROSICS), Badalona, Spain
Territorial Clinical Directorate on Infectious Diseases and International Health Clinical Division within the Northern Metropolitan Management of the Catalan Institute of Health, Badalona, Spain
Fundació Lluita Contra les Infeccions, Hospital Germans Trias i Pujol, Badalona, Spain
Infectious Diseases Department, Germans Trias i Pujol Hospital and Research Institute, 08916, Badalona, Spain
Antuori A:
CIBER Respiratory Diseases (CIBERES), Instituto de Salud?Carlos III, 28029, Madrid, Spain
Microbiology Department, Northern Metropolitan Clinical Laboratory, Hospital Universitari Germans Trias I Pujol, Badalona, Spain
Cardona PJ:
Unitat de Tuberculosi Experimental, Germans Trias i Pujol Research Institute (IGTP), Can Ruti Campus, Ctra. del Canyet, S/N, 08916, Badalona, Spain
Autonomous University of Barcelona, Bellaterra, Spain
CIBER Respiratory Diseases (CIBERES), Instituto de Salud?Carlos III, 28029, Madrid, Spain
Microbiology Department, Northern Metropolitan Clinical Laboratory, Hospital Universitari Germans Trias I Pujol, Badalona, Spain
Soriano-Arandes A:
Paediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Vall d'Hebron, Barcelona, Spain
Martin-Nalda A:
Paediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Vall d'Hebron, Barcelona, Spain
Espiau M:
Paediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Vall d'Hebron, Barcelona, Spain
de Souza-Galvão ML:
Infectious Diseases Department, Vall d'Hebrón University Hospital, Universitat Autónoma de Barcelona, Barcelona, Spain
Jiménez MÁ:
Infectious Diseases Department, Vall d'Hebrón University Hospital, Universitat Autónoma de Barcelona, Barcelona, Spain
Noguera-Julian A:
Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria, Servei de Malalties Infeccioses i Patologia Importada, Institut de Recerca Pediàtrica Sant Joan de Déu, 08950, Barcelona, Spain
CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud?Carlos III, 28029, Madrid, Spain
Departament de Cirurgia i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, 08036, Barcelona, Spain
Red de Investigación Traslacional en Infectología Pediátrica RITIP, 28029, Madrid, Spain
Molina I:
Serveis Clínics de Barcelona, Barcelona, Spain
Casas X:
Serveis Clínics de Barcelona, Barcelona, Spain
Domínguez-Álvarez M:
Hospital del Mar, Barcelona, Spain
Jové N:
Hospital del Mar, Barcelona, Spain
Gogichadze N:
Unitat de Tuberculosi Experimental, Germans Trias i Pujol Research Institute (IGTP), Can Ruti Campus, Ctra. del Canyet, S/N, 08916, Badalona, Spain
Autonomous University of Barcelona, Bellaterra, Spain
L Fonseca K:
Unitat de Tuberculosi Experimental, Germans Trias i Pujol Research Institute (IGTP), Can Ruti Campus, Ctra. del Canyet, S/N, 08916, Badalona, Spain
CIBER Respiratory Diseases (CIBERES), Instituto de Salud?Carlos III, 28029, Madrid, Spain
Arias L:
Unitat de Tuberculosi Experimental, Germans Trias i Pujol Research Institute (IGTP), Can Ruti Campus, Ctra. del Canyet, S/N, 08916, Badalona, Spain
CIBER Respiratory Diseases (CIBERES), Instituto de Salud?Carlos III, 28029, Madrid, Spain
Millet JP:
CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud?Carlos III, 28029, Madrid, Spain
Serveis Clínics de Barcelona, Barcelona, Spain
Epidemiology Service, Barcelona Public Health Agency, Barcelona, Spain
Sánchez-Montalvá A:
Infectious Diseases Department, Vall d'Hebrón University Hospital, Universitat Autónoma de Barcelona, Barcelona, Spain
International Health Program of the Catalan Institute of Health (PROSICS), Barcelona, Spain
CIBER of Infectious Disease (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
Mycobacterial Infection Study Group from the Spanish Society of Clinical Microbiology and Infectious Diseases (GEIM-SEIMC), Barcelona, Spain
Vilaplana C:
Unitat de Tuberculosi Experimental, Germans Trias i Pujol Research Institute (IGTP), Can Ruti Campus, Ctra. del Canyet, S/N, 08916, Badalona, Spain. cvilaplana@igtp.cat
Autonomous University of Barcelona, Bellaterra, Spain. cvilaplana@igtp.cat
Territorial Clinical Directorate on Infectious Diseases and International Health Clinical Division within the Northern Metropolitan Management of the Catalan Institute of Health, Badalona, Spain. cvilaplana@igtp.cat
CIBER Respiratory Diseases (CIBERES), Instituto de Salud?Carlos III, 28029, Madrid, Spain. cvilaplana@igtp.cat
Microbiology Department, Northern Metropolitan Clinical Laboratory, Hospital Universitari Germans Trias I Pujol, Badalona, Spain. cvilaplana@igtp.cat
Green Submitted, hybrid
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