Spirometry results after treatment for pulmonary tuberculosis: comparison between patients with and without previous lung disease: a multicenter study

Abstract

Objective: To compare patients with and without previous lung disease, in terms of the spirometry results after they had been treated for pulmonary tuberculosis (PTB) and cured, as well as to analyze risk factors related to functional severity. Methods: This was a cross-sectional, multicenter study conducted at four referral centers in Brazil. Patients were divided into two groups: those with a history of lung disease or smoking (LDS+ group); and those with no such history (LDS− group). Patients underwent spirometry (at least six months after being cured). Sociodemographic and clinical data were collected. Results:A total of 378 patients were included: 174 (46.1%) in the LDS+ group and 204 (53.9%) in the LDS− group. In the sample as a whole, 238 patients (62.7%) had spirometric changes. In the LDS+ group, there was a predominance of obstructive lung disease (in 33.3%), whereas restrictive lung disease predominated in the LDS− group (in 24.7%). Radiological changes were less common in the LDS− group than in the LDS+ group (p < 0.01), as were functional changes (p < 0.05). However, of the 140 (79.1%) LDS− group patients with a normal or minimally altered chest X-ray, 76 (54%) had functional changes (p < 0.01). The risk factors associated with functional severity in the LDS− group were degree of dyspnea (p = 0.03) and moderate or severe radiological changes (p = 0.01). Conclusions: Impaired pulmonary function is common after treatment for PTB, regardless of the history of lung disease or smoking. Spirometry should be suggested for patients who develop moderate/severe dyspnea or relevant radiological changes after treatment for PTB.

Previous tuberculosis infection associated with increased frequency of asthma and respiratory symptoms in a Nordic–Baltic multicentre population study

“…A multinational population-based cross-sectional study conducted in 19 sites, as well as a cross-sectional study conducted in India, found a positive association between TB and obstructive pulmonary diseases [ 10 , 18 ]. One study conducted in Brazil reported reduced pulmonary function after the treatment of pulmonary TB [ 19 ]. In contrast, a study carried out in Sudan to estimate the prevalence of asthma among TB patients concluded that TB infection was associated with a lower prevalence of asthma [ 20 ].…”

Pulmonary functional assessment: longitudinal study after treatment of pulmonary tuberculosis

“…Recruited patients answered a standardized questionnaire comprising questions on sociodemographic and clinical data, gender, age (≥ 18 years), history of smoking habit and comorbidities. Some of these patients participated in a previous study by the same authors 9 . The sociodemographic variables were self-declared skin color/ethnicity (white or non-white) and marital status (single or stable union).…”

“…In a systematic review, after the evaluation of 156 articles, obstruction was mentioned in 52 (33%) 6 , and even in countries with low incidences of PTB, respiratory diseases are frequent after treatment of PTB 7 . The proportion of obstruction is variable and was related to the extent of radiological changes 8,9 . On the other hand, the restriction has been the most frequent disorder in recently published studies, observed in 52 to 68% [10][11][12] .…”

“…On the other hand, the restriction has been the most frequent disorder in recently published studies, observed in 52 to 68% [10][11][12] . A multicentric study in Brazil, that evaluated the functional changes in patients treated for PTBafter excluding smoking patients and those with respiratory diseases prior to PTB treatment, the restriction has also been the predominant change 9 .…”

Tuberculosis series 2020

“…Even after the appropriate treatment of tuberculosis, pulmonary sequelae can impair pulmonary function and quality of life. 14 - 16 A multicenter cross-sectional study, conducted in Brazil and included in this tuberculosis series, 17 compared pulmonary tuberculosis patients with and without previous lung disease, in terms of post-treatment spirometry changes. The authors showed that lung function impairment is common after treatment of pulmonary tuberculosis, regardless of whether the patient has a history of smoking or previous lung disease.…”