History of pulmonary tuberculosis affects the severity and clinical outcomes of COPD

Background and objectiveAlthough an association between pulmonary tuberculosis (TB) and chronic obstructive pulmonary disease (COPD) has been suggested, studies on the effect of TB in COPD patients have not been conducted. We aimed to investigate the severity and clinical outcomes of COPD in patients with and without a history of TB. MethodsWe retrospectively reviewed the data of 1784 patients with COPD in the Korean COPD Subtype Study cohort collected from December 2011 to January 2017 and followed up for 3years. ResultsAmong the 1784 patients at baseline, the COPD assessment test (CAT) scores and total St George's Respiratory Questionnaire for COPD (SGRQc) scores were significantly higher in the prior TB group (n=468) than in the non-TB group (n=1316). Lung function and exacerbation prevalence were significantly poorer and higher, respectively, in the prior TB group than in the non-TB group. In a small-sized follow-up study, CAT scores (n=318), SGRQc scores (n=295) and lung function (n=182) remained poorer, and exacerbation prevalence (n=256) remained higher in the prior TB group over 3years. The forced expiratory volume in 1s in the prior TB group declined (-0.57%/year), whereas it improved (+0.93%/year) in the non-TB group (P for changes between the groups=0.076). In the prior TB group, patients showed poorer lung function compared with the non-TB group regardless of having lung lesions visible or not on chest radiographs. ConclusionTB history negatively affected the severity of COPD, and a small-sized follow-up study showed that the changes were sustained for several years. We demonstrated that chronic obstructive pulmonary disease (COPD) patients with a history of tuberculosis (TB) had more severe symptoms, poorer lung function and more frequent exacerbations. The differences were sustained for 3years compared with those with no TB history.