Clinical effects of TB sequelae in patients with COPD

BACKGROUND: TB is a risk factor for chronic obstructive pulmonary disease (COPD) development and causes the global burden of COPD to increase. The impact of TB sequelae on COPD has been ignored for years.

OBJECTIVE: To determine the prevalence of TB sequelae in patients with COPD and investigate the effect of TB sequelae on COPD clinic burden.

METHODS: A total of 172 patients who attended the chest diseases outpatient clinic were included in the study. Detailed anamneses of their TB were taken, and pulmonary function tests were performed. The COPD Assessment Test (CAT) questionnaire was administered to determine the health status, and the modified Medical Research Council (mMRC) scale was used to assess the severity of dyspnoea. Thorax computed tomography images were reviewed. The patients were divided into two groups based on the presence of TB sequelae. All data from the two groups were compared.

RESULTS: Of 172 patients with COPD, 66 (38%) had TB sequelae; 28 (46%) patients with TB sequelae had no history of TB. Two patients with TB history had no TB sequelae. The group with TB sequelae had lower body mass index (P < 0.001), more emergency admissions (P = 0.018), and higher CAT and mMRC scores (P = 0.002 and P = 0.004, respectively). In the group with TB sequelae, bronchiectasis was more common (P = 0.001).

CONCLUSION: In patients with COPD, TB sequelae are very common and increase the COPD clinic burden. The presence of TB sequelae causes an increase in the use of healthcare services by patients with COPD and, therefore, an increase in the burden of COPD. Prevention, early diagnosis and timely treatment of TB are therefore very important.