Hematochemical hallmarks as markers of pulmonary TB severity: A multicenter cross-sectional study
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, c...
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Elsevier
2025-05-01
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| Series: | Journal of Clinical Tuberculosis and Other Mycobacterial Diseases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405579425000087 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Francesco Di Gennaro |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-da8917f2a89b4107864a662a9cbe161d |
| institution | DOAJ |
| issn | 2405-5794 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Elsevier |
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| series | Journal of Clinical Tuberculosis and Other Mycobacterial Diseases |
| spelling | doaj-art-da8917f2a89b4107864a662a9cbe161d2025-08-20T02:55:07ZengElsevierJournal of Clinical Tuberculosis and Other Mycobacterial Diseases2405-57942025-05-013910051710.1016/j.jctube.2025.100517Hematochemical hallmarks as markers of pulmonary TB severity: A multicenter cross-sectional studyFrancesco Di Gennaro0Giacomo Guido1Sergio Cotugno2Francesco Cavallin3Mariantonietta Pisaturo4Lorenzo Onorato5Federica Zimmerhofer6Luca Pipitò7Giuseppina De Iaco8Giuseppe Bruno9Massimo Fasano10Agostina Pontarelli11Annarita Botta12Tiziana Iacovazzi13Rossana Lattanzio14Virginia Di Bari15Gianfranco Panico16Raffaella Libertone17Caterina Monari18Alessia Musto19Mariangela Niglio20Federica De Gregorio21Gaetano Brindicci22Carmen Rita Santoro23Luigi Ronga24Roberta Papagni25Elda De Vita26Francesco Rosario Paolo Ieva27Loredana Alessio28Gina Gualano29Salvatore Minniti30Giovanni Battista Buccoliero31Sergio Lo Caputo32Sergio Carbonara33Antonio Cascio34Roberto Parrella35Fabrizio Palmieri36Nicola Coppola37Annalisa Saracino38Clinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Bari, ItalyClinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Bari, Italy; Corresponding author.Clinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Bari, ItalyIndependent Statistician, Solagna, ItalyDepartment of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, Naples, Via L. Armanni 5, 80131 Naples, ItalyDepartment of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, Naples, Via L. Armanni 5, 80131 Naples, ItalyInfectious and Tropical Disease Unit - Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G D’Alessandro”, University of Palermo 90127 Palermo, ItalyInfectious and Tropical Disease Unit - Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G D’Alessandro”, University of Palermo 90127 Palermo, ItalyClinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Bari, ItalyInfectious disease, Saint Giuseppe Moscati Hospital, Taranto, ItalyUOC Malattie Infettive - ASL BA PO Della Murgia Altamura (BA), ItalyRespiratory Infectious Disease Unit, AORN dei Colli, Cotugno Hospital, Naples, ItalyRespiratory Infectious Disease Unit, AORN dei Colli, Cotugno Hospital, Naples, ItalyUOC Malattie Infettive - ASL BA PO Della Murgia Altamura (BA), ItalyClinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Bari, ItalyRespiratory Infectious Diseases Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, ItalyUOC Malattie Infettive, Osp. V. Emanuele II, ASL BT, Bisceglie, BT, ItalyRespiratory Infectious Diseases Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, ItalyDepartment of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, Naples, Via L. Armanni 5, 80131 Naples, ItalyUOC Malattie Infettive P.O. Perrino Brindisi, ItalyDepartment of Medical and Surgical Sciences, Infectious Diseases Unit, University of Foggia, Foggia, ItalyDepartment of Medical and Surgical Sciences, Infectious Diseases Unit, University of Foggia, Foggia, ItalyClinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Bari, ItalyClinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Bari, ItalyClinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Bari, ItalyClinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Bari, ItalyClinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Bari, ItalyDepartment of Medical and Surgical Sciences, Infectious Diseases Unit, University of Foggia, Foggia, ItalyDepartment of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, Naples, Via L. Armanni 5, 80131 Naples, ItalyRespiratory Infectious Diseases Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, ItalyUOC Malattie Infettive P.O. Perrino Brindisi, ItalyInfectious disease, Saint Giuseppe Moscati Hospital, Taranto, ItalyDepartment of Medical and Surgical Sciences, Infectious Diseases Unit, University of Foggia, Foggia, ItalyUOC Malattie Infettive, Osp. V. Emanuele II, ASL BT, Bisceglie, BT, ItalyInfectious and Tropical Disease Unit - Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G D’Alessandro”, University of Palermo 90127 Palermo, ItalyRespiratory Infectious Disease Unit, AORN dei Colli, Cotugno Hospital, Naples, ItalyRespiratory Infectious Diseases Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, ItalyDepartment of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, Naples, Via L. Armanni 5, 80131 Naples, ItalyClinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Bari, ItalyBackground: 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.http://www.sciencedirect.com/science/article/pii/S2405579425000087TB controlHematochemical markersDisease progressionPrognostic factorsAnemia |
| spellingShingle | 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 Hematochemical hallmarks as markers of pulmonary TB severity: A multicenter cross-sectional study Journal of Clinical Tuberculosis and Other Mycobacterial Diseases TB control Hematochemical markers Disease progression Prognostic factors Anemia |
| title | Hematochemical hallmarks as markers of pulmonary TB severity: A multicenter cross-sectional study |
| title_full | Hematochemical hallmarks as markers of pulmonary TB severity: A multicenter cross-sectional study |
| title_fullStr | Hematochemical hallmarks as markers of pulmonary TB severity: A multicenter cross-sectional study |
| title_full_unstemmed | Hematochemical hallmarks as markers of pulmonary TB severity: A multicenter cross-sectional study |
| title_short | Hematochemical hallmarks as markers of pulmonary TB severity: A multicenter cross-sectional study |
| title_sort | hematochemical hallmarks as markers of pulmonary tb severity a multicenter cross sectional study |
| topic | TB control Hematochemical markers Disease progression Prognostic factors Anemia |
| url | http://www.sciencedirect.com/science/article/pii/S2405579425000087 |
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