Introduction

In 2022 a Lancet commission published Etiotype for chronic obstructive pulmonary disease (COPD). They suggested that pulmonary infection is cause of COPD and among them, tuberculosis (TB) has a strong association with development of COPD in non-smoking patients. According to retrospective study, from 1.7% to 15.4% of patients with COPD reported a prior history of TB. However, those studies had difficulty demonstrating causality in the absence of pre-TB and post-TB spirometry, and potential misclassification of TB exposure due to self-reported methods. Therefore, in this study, we aimed to demonstrate how many patients developed COPD among patients who had been treated for TB for more than 6 months and had lung function before anti-TB treatment.

Methods

A multicenter retrospective study was conducted at four South Korean hospital from January 1st 2003 to December 31 2023. Patients who had been treated with anti-TB medication over 6months and had pre-TB and post-TB spirometry were enrolled. Primary end-point was the development of COPD. Secondary end-points included the characteristics of patients who develop COPD.  

Results

Among the 10,965 TB patients, 7,202 and 2,833 patients were excluded because there was no pre-TB spirometry and post-TB spirometry, respectively. 102 (13.6%) developed COPD. COPD development was strongly correlated with smoking history, socio economic status (SES), severity of TB sequlae.

Conclusion

In our study, we found that all TB patients didn?t progress to COPD. The factors which associated with development of COPD were heavy smoking history, low SES, and severe tuberculosis sequelae.