The blood neutrophil count after 1 month of treatment predicts the radiological severity of lung disease at treatment end

Chest. 2021 Jul 28:S0012-3692(21)01490-2. doi: 10.1016/j.chest.2021.07.041. Online ahead of print.ABSTRACTBACKGROUND: Post-tuberculous lung disease confers significant morbidity. However, the determinants of persistent lung damage in tuberculosis are not well established. We investigated associations between tuberculosis-associated radiological changes and socio-demographic factors, surrogates of bacillary burden and blood inflammatory markers at initiation of therapy and after 1 month.RESEARCH QUESTION: What are the predictors of radiological severity at the end of tuberculosis treatment for tuberculosis?STUDY DESIGN AND METHODS: We collected data from patients treated for drug sensitive pulmonary tuberculosis at our centre over a 5.5-year period. We recorded age, sex, ethnicity, smoking status, symptom duration, sputum smear grade, time to culture positivity and blood results (C-reactive protein and neutrophil count) at baseline and after 1 month of treatment. Chest x-rays performed at baseline, 2 months and end of treatment were assessed independently by two radiologists and scored using a validated system. Relationships between predictor variables and radiological outcomes were assessed using linear or binary logistic regression.RESULTS: We assessed 154 individuals, mean age 37 years, 63% male. In multivariate analysis, baseline radiological severity correlated with sputum smear grade (p=0.003) and neutrophil count (p<0.001). At end of treatment, only the 1-month neutr...
Source: Chest - Category: Respiratory Medicine Authors: Source Type: research