Lung health after tuberculosis: clinical and functional assessment in post-pulmonary tuberculosis Egyptian patients

Abstract
Background
Some of the pulmonary tuberculous patients who completed their medication course experience lung function impairment which may influence their quality of life. However, the pattern and nature of post-tuberculosis lung impairment are still not identified. Thus, the aim of this study was to determine the type and degree of lung physiology changes in previously treated tuberculous patients which latter may affect their quality of life, thus helping clinicians for early diagnosis of lung impairment, especially in tuberculous endemic areas.

Results
Adults (≥18 years) who were treated from first attack pulmonary tuberculosis were included in the study. Demographic data, respiratory symptoms, smoking history, comorbidities, Medical Research Council dyspnea score (MRC), spirometry, chest radiography, and oxygen saturation were collected. One hundred ninety-seven participants were finally included in the study. The mean age was 49.50±13.26 years with males representing 75.6% of total patients. MRC dyspnea scale grading showed that about 13.2% and 5.1% of patients suffer from dyspnea grade II and grade III, respectively. Main respiratory symptoms were cough in 38.1%, sputum production in 24.9%, and hemoptysis in 6.6% cases. Normal spirometry was documented in 53.3%, obstructive pattern in 31.98%, and mixed pattern in 7.11%, whereas 7.61% cases had a restrictive pattern. According to ATS staging of obstructive pattern, 27 patients (42.8%) had mild obstruction, 22 (34.9%) patients had moderate obstruction, 13 (20.6%) patients had moderate to severe obstruction, and one patient (1.6%) had severe obstruction.

Conclusions
Impairment of respiratory function after tuberculosis is one of the causes of chronic lung disease that is underestimated, especially in endemic countries. This impairment in function occurs early in the course of the diseases and even without symptoms, affecting the quality of life. Thus, clinicians should encourage patients for an earlier visit to a respiratory clinic for follow-up and further management if needed. Guidelines for the management of cured tuberculous patients are urgently needed.

Trial registration
ClinicalTrials.gov, NCT05097638. Registered on October 28, 2021—retrospectively registered