Hematochemical hallmarks as markers of pulmonary TB severity: A multicenter cross-sectional study

IF 2 Q3 INFECTIOUS DISEASES

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Pub Date : 2025-03-13 DOI:10.1016/j.jctube.2025.100517

Francesco Di Gennaro , Giacomo Guido , Sergio Cotugno , Francesco Cavallin , Mariantonietta Pisaturo , Lorenzo Onorato , Federica Zimmerhofer , Luca Pipitò , Giuseppina De Iaco , Giuseppe Bruno , Massimo Fasano , Agostina Pontarelli , Annarita Botta , Tiziana Iacovazzi , Rossana Lattanzio , Virginia Di Bari , Gianfranco Panico , Raffaella Libertone , Caterina Monari , Alessia Musto , Annalisa Saracino

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引用次数: 0

Abstract

Background

Identifying accessible and reliable biomarkers for tuberculosis (TB) severity is crucial for improving patient management. This study evaluates hematological findings as potential indicators of TB severity in a large multicenter Italian cohort.

Methods

This retrospective, multicenter, cross-sectional study analyzed hematological parameters (hemoglobin, white blood cells, inflammatory indices, hepatorenal function, albuminuria) in 577 TB patients from 10 Italian centers (2018–2023). Severe TB was defined by at least two criteria: TIMIKA score > 60, sputum conversion time > 21 days, or need for oxygen supplementation. Statistical analyses included receiver operating characteristic curve (AUC) evaluation, calibration curves, and clinical utility.

Results

Of the patients, 30.3 % were classified as severe, 60.2 % as non-severe, and 9.5 % as uncertain. AUC values for predicting severe TB ranged from 0.51 to 0.56 across hematological variables. Anemia and elevated CRP demonstrated sensitivities of 0.71 and 0.74, respectively. Models using continuous or categorical hematological variables achieved AUCs of 0.61 and 0.65, showing poor calibration and limited clinical utility in the 30–60 % threshold range.

Conclusions

Hematological markers, while rapid and cost-effective, demonstrated limited discriminative ability for TB severity. Further studies are required to develop reliable predictive models, integrating additional clinical and molecular data.

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血液化学标志作为肺结核严重程度的标志：一项多中心横断面研究

背景：确定可获得且可靠的结核病严重程度生物标志物对于改善患者管理至关重要。这项研究评估血液学结果作为结核病严重程度的潜在指标在一个大型多中心意大利队列。方法本回顾性、多中心、横断面研究分析了意大利10个中心（2018-2023）577例结核病患者的血液学参数（血红蛋白、白细胞、炎症指标、肝肾功能、蛋白尿）。严重结核病的定义至少有两个标准：TIMIKA评分；60、痰转化时间>；21天，还是需要补氧。统计分析包括受试者工作特征曲线（AUC）评估、校准曲线和临床应用。结果30.3%的患者为重症，60.2%为非重症，9.5%为不确定。预测严重结核病的血液学变量的AUC值在0.51到0.56之间。贫血和CRP升高的敏感性分别为0.71和0.74。使用连续或分类血液学变量的模型的auc分别为0.61和0.65，在30 - 60%的阈值范围内显示出较差的校准和有限的临床效用。结论血液学标志物虽然快速、经济，但对结核病严重程度的鉴别能力有限。需要进一步的研究来建立可靠的预测模型，整合额外的临床和分子数据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Medicine-Pulmonary and Respiratory Medicine

CiteScore

4.00

自引率

5.00%

发文量

审稿时长

30 weeks

期刊介绍： Journal of Clinical Tuberculosis and Mycobacterial Diseases aims to provide a forum for clinically relevant articles on all aspects of tuberculosis and other mycobacterial infections, including (but not limited to) epidemiology, clinical investigation, transmission, diagnosis, treatment, drug-resistance and public policy, and encourages the submission of clinical studies, thematic reviews and case reports. Journal of Clinical Tuberculosis and Mycobacterial Diseases is an Open Access publication.