Post-tuberculosis Lung Impairment: Systematic Review and Meta-analysis of Spirometry Data from 14 621 People

Overview

Journal Eur Respir Rev

Specialty Pulmonary Medicine

Date 2023 Apr 19

PMID 37076175

Authors

Olena Ivanova

Verena Sophia Hoffmann

Christoph Lange

Michael Hoelscher

Andrea Rachow

Affiliations

Soon will be listed here.

Abstract

Background: A 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.

Methods: We 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.

Results: 54 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 (FEV) 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 FEV and 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% 19.0% had obstructive, 23.0% 22.0% restrictive and 15.0% 43.0% had mixed impairment type, respectively. In the majority of studies, at least 10-15% of tuberculosis survivors had severe lung impairment.

Conclusions: This systematic review showed long-term abnormal spirometry results in a significant proportion of tuberculosis survivors.

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