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Meta-Analysis
. 2023 Apr 19;32(168):220221.
doi: 10.1183/16000617.0221-2022. Print 2023 Jun 30.

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

Olena Ivanova  1   2   3 , Verena Sophia Hoffmann  4   3 , Christoph Lange  5   6   7   8 , Michael Hoelscher  9   2 , Andrea Rachow  9   2
Affiliations
Meta-Analysis

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

Olena Ivanova et al. Eur Respir Rev. .

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 (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 FEV1 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% versus 19.0% had obstructive, 23.0% versus 22.0% restrictive and 15.0% versus 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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Conflict of interest statement

Conflict of interest: The authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flow chart diagram of studies for the systematic review (PRISMA). FVC: forced vital capacity; FEV1: forced expiratory volume in 1 s.
FIGURE 2
FIGURE 2
Forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) for drug-susceptible tuberculosis studies. #: Countries: Brazil, Uruguay, Mexico, Chile and Venezuela.
FIGURE 3
FIGURE 3
Forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) for multidrug-resistant tuberculosis studies.
FIGURE 4
FIGURE 4
Type of ventilation disorder for drug-susceptible tuberculosis studies. #: Countries: Brazil, Uruguay, Mexico, Chile and Venezuela.
FIGURE 5
FIGURE 5
Type of ventilation disorder for multidrug-resistant tuberculosis studies.
See this image and copyright information in PMC

Comment in

References

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