Changes in respiratory function impairment following the treatment of severe pulmonary tuberculosis – limitations for the underlying COPD detection

Figures & data

Table 1 General demographic profile of observed patients

General demographic characteristics of patients
Age (years) (mean ± SD)	Weight (kg) (mean ± SD)	Sex (n/%)		Population settlement (n/%)		Social structure (n/%)
		Male	Female	Urban	Rural	Employed	Retired	Unemplyed
55.8±16.31	62.98±14.35	32/80.0	8/20.0	20/50.0	20/50.0	16/40.0	15/37.5	9/22.5

Abbreviation: SD, standard deviation.

Table 2 The major familial and environmental risks for COPD development among observed patients

Risk factors for COPD
Familial burden for COPD (n/%)	Environmental air pollution exposure ≥15 years (n/%)					Smoking habits (n/%)
	Indoor		Outdoor	Occupational		Smokers Exsmokers			Nonsmokers
11/27.5	7/17.5		2/5.0	12/30.0		27/67.5	1/2.5		12/30.0
Fargestörm score (n/%)						Weight loss (n/%)			No COPD risks (n/%)
Without	Very low	Low	Moderate	High	Very high	≤10 kg	11–20 kg	21–30 kg
1/3.7	1/3.7	2/7.4	4/14.8	8/29.6	11/40.7	4/10.0	21/52.5	15/37.5	11/27.5

Note: Fargestörm score, a score of nicotine dependence level.

Table 3 Clinical signs for COPD among the observed patients

Clinical signs for COPD
Respiratory symptoms and signs (n/%)				Average duration of symptoms in days (mean ± SD)	Positive physical examination on AFO (n/%)	Presence of LRTI (n/%)
Dyspnea Cough Expectoration	Hemoptysis	Fever	Overnight sweating
28/70.0 39/97.5 33/82.5	11/27.5	11/27.5	26/65.0	67.55±54.78	15/37.5	9/22.5

Abbreviations: AFO, airflow obstruction; LRTI, low respiratory tract infection; SD, standard deviation.

Table 4 Comparing the values of serum markers of systemic inflammation

Serum markers of systemic inflammation	I measurement (beginning of the PTB treatment)	II measurement (end [6 months] of the PTB treatment)	Significance*	Difference between measurements
ESR (mm/1 hour)	67.20±30.54	17.85±17.02	Z=5.42; P<0.001	49.35±30.45
Le count (10^9 L)	9.14±4.59	6.81±2.14	Z=3.48; P<0.001	2.33±4.12
CRP (mg/L)	58.45±45.95	7.58±9.23	Z=5.51; P<0.001	50.86±46.09
Fibrinogen (g/L)	7.77±3.52	4.57±1.66	Z=4.29; P<0.001	3.20±3.43

Notes: Le count, leukocyte count in peripheral blood smear.

* Wilcoxon signed rank test. Data presented as mean ± standard deviation unless stated otherwise.

Abbreviations: CRP, C-reactive protein; ESR, erythrocite sedimentation rate; Le, leukocyte; PTB, pulmonary tuberculosis.

Figure 1 Distribution of patients according to the severity of the initially registered restrictive pulmonary ventilation disorder.

Note: Grading of severity was done according to the Official Statement of the European Respiratory Society.¹⁵
Abbreviations: FVC, forced vital capacity; TLC, total lung capacity.

Table 5 Comparing the values of pulmonary ventilation parameters between the measurements made at the beginning, during, and at the end of the PTB treatment with the differences between the same

Lung function parameter	I measurement (beginning of the PTB treatment)	II measurement (2 months of the PTB treatment)	III measurement (6 months of the PTB treatment)	Significance*	Differences between measurements*
					I vs II	II vs III	I vs III
FVC (%)	71.36±13.62	74.25±19.14	77.39±15.36	I vs III: P<0.01	−2.88±15.48	−3.14±12.44	−6.02±13.96
FEV1 (%)	73.54±16.33	72.77±17.85	71.99±20.08	No significance	0.77±10.22	0.78±8.23	1.55±12.17
FEV1/FVC ×100%	80.93±8.59	76.16±7.51	74.46±10.47	I vs II: P<0.001; I vs III: P<0.001	4.76±6.75	1.70±7.48	6.46±9.00
TLC (%)	79.5±10.10	–	80.30±15.91	No significance	–	–	−0.80±13.05

Notes: FEV₁/FVC ×100%, percentage ratio of FEV₁/FVC. Data presented as mean ± standard deviation.

* One-way ANOVA and Tukey’s post hoc test.

Abbreviations: ANOVA, analysis of variance; FEV₁, forced expiratory volume in the first second; FVC, forced vital capacity; PTB, pulmonary tuberculosis; TLC, total lung capacity; –, no measurement made.

Figure 2 Significant factors of impact on the FEV₁ (%) values upon the TB treatment completion.

Notes: Linear regression analysis; (A) indoor living environment and occupational air pollution exposure impact on the FEV₁ (%); (B), radiographic score, Le count and CRP serum level at the beginning of the TB treatment impact on the FEV₁ (%); Le count, leukocyte count in peripheral blood smear.
Abbreviations: CRP, C-reactive protein; FEV₁, forced expiratory volume in the first second; Le, leukocyte; TB, tuberculosis.

Figure 3 Predictors for the AFO occurrence and development upon the TB treatment completion.

Notes: Univariate logistic regression analysis; Le count, leukocyte count in peripheral blood smear.
Abbreviations: AFO, airflow obstruction; CRP, C-reactive protein; Le, leukocyte; OR, odds ratio; TB, tuberculosis.

Figure 4 The impact of initial radiological extent of pulmonary TB lesions (Snider’s radiological score) at the beginning of TB treatment and sputum conversion rate on culture as major risk factors for the AFO development upon the TB treatment completion.

Note: Multivariate logistic regression analysis.
Abbreviations: AFO, airflow obstruction; OR, odds ratio; TB, tuberculosis.

Official Statement of the European Respiratory SocietyStandardized lung function testingEur Respir J1993161100

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