Hematochemical hallmarks as markers of pulmonary TB severity: A multicenter cross-sectional study
Year: 2025
Type: article
Study design: Observational Study
Abstract: • Multicenter study evaluating hematological markers of tuberculosis severity in Italy. • Anemia and elevated CRP showed moderate sensitivity but limited specificity for severe TB. • Routine blood tests offer some utility but are insufficient as standalone severity markers. • Results emphasize the need for integrated models combining hematological and clinical data. • Findings provide initial insights toward developing risk stratification approaches for TB management. 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. 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. 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. 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.
Authors: 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, Mariangela Niglio, Federica De Gregorio, Gaetano Brindicci, Carmen Rita Santoro, Luigi Ronga, Roberta Papagni, Elda De Vita, Francesco Rosario Paolo Ieva, Loredana Alessio, Gina Gualano, Salvatore Minniti, Giovanni Battista Buccoliero, Sergio Lo Caputo, Sergio Carbonara, Antonio Cascio, Roberto Parrella, Fabrizio Palmieri, Nicola Coppola, Annalisa Saracino
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,470
OpenAlex ID: W4408394275