Pub Date : 2022-08-30DOI: 10.1101/2022.08.30.22279374
B. Sossen, A. Richards, Torben Heinsohn, B. Frascella, Federica Balzarini, A. Oradini-Alacreu, A. Odone, E. Rogozińska, Brit Häcker, F. Cobelens, Katharina Kranzer, R. Houben, H. Esmail
BACKGROUND Key stages in TB disease can be delineated by radiology, microbiology and symptoms, but transition between relevant stages remains unclear. We sought to quantify progression and regression across the spectrum of TB disease by systematically reviewing studies of individuals with untreated TB undergoing follow up. METHODS We searched PubMED, EMBASE and Web of Science until December 31st 1960, the Index Medicus between 1895 and 1945, and extensive investigator collections without date restriction - in English and German. Eligible studies were observational cohorts and clinical trials, presenting adults/adolescents with TB or recent TB exposure, undergoing follow-up for at least 12 months without therapeutic intervention. Two authors independently reviewed titles/abstracts and full texts for inclusion. Quality was assessed with a modified Newcastle-Ottawa Score, excluding highly biased studies. Summary estimates were extracted to align with TB disease transitions in a conceptual model, and we used meta-analysis of proportions with random-effects to synthesise the extracted data. This study is registered with PROSPERO (CRD42019152585). FINDINGS 10477 titles were screened and 1648 full texts reviewed. 223 met inclusion criteria. 109 were excluded for high risk of bias and 90 did not have extractable data. 24 studies (34 cohorts) were included. Progression from microbiologically negative to positive disease in those with radiographic TB evidence occurred at an annualized rate of 9.71% (95% CI:6.17-13.34) with active TB imaging, and 1.06% (95% CI:0.31-1.82) with inactive TB imaging. Reversion from microbiologically-positive to -undetectable in prospective cohorts occurred at an annualized rate of 12.40% (95% CI: 6.81-17.99). Studies reported symptoms poorly not allowing for direct estimation of transitions for subclinical (asymptomatic, culture positive) disease. INTERPRETATION We present the risk of progression in those with radiographic evidence of disease and the rate of self-cure for microbiologically positive disease to inform global disease burden estimates, clinical guidelines and policy decisions.
{"title":"The Natural History of Untreated Pulmonary Tuberculosis in Adults: A Systematic Review and Meta-Analysis","authors":"B. Sossen, A. Richards, Torben Heinsohn, B. Frascella, Federica Balzarini, A. Oradini-Alacreu, A. Odone, E. Rogozińska, Brit Häcker, F. Cobelens, Katharina Kranzer, R. Houben, H. Esmail","doi":"10.1101/2022.08.30.22279374","DOIUrl":"https://doi.org/10.1101/2022.08.30.22279374","url":null,"abstract":"BACKGROUND Key stages in TB disease can be delineated by radiology, microbiology and symptoms, but transition between relevant stages remains unclear. We sought to quantify progression and regression across the spectrum of TB disease by systematically reviewing studies of individuals with untreated TB undergoing follow up. METHODS We searched PubMED, EMBASE and Web of Science until December 31st 1960, the Index Medicus between 1895 and 1945, and extensive investigator collections without date restriction - in English and German. Eligible studies were observational cohorts and clinical trials, presenting adults/adolescents with TB or recent TB exposure, undergoing follow-up for at least 12 months without therapeutic intervention. Two authors independently reviewed titles/abstracts and full texts for inclusion. Quality was assessed with a modified Newcastle-Ottawa Score, excluding highly biased studies. Summary estimates were extracted to align with TB disease transitions in a conceptual model, and we used meta-analysis of proportions with random-effects to synthesise the extracted data. This study is registered with PROSPERO (CRD42019152585). FINDINGS 10477 titles were screened and 1648 full texts reviewed. 223 met inclusion criteria. 109 were excluded for high risk of bias and 90 did not have extractable data. 24 studies (34 cohorts) were included. Progression from microbiologically negative to positive disease in those with radiographic TB evidence occurred at an annualized rate of 9.71% (95% CI:6.17-13.34) with active TB imaging, and 1.06% (95% CI:0.31-1.82) with inactive TB imaging. Reversion from microbiologically-positive to -undetectable in prospective cohorts occurred at an annualized rate of 12.40% (95% CI: 6.81-17.99). Studies reported symptoms poorly not allowing for direct estimation of transitions for subclinical (asymptomatic, culture positive) disease. INTERPRETATION We present the risk of progression in those with radiographic evidence of disease and the rate of self-cure for microbiologically positive disease to inform global disease burden estimates, clinical guidelines and policy decisions.","PeriodicalId":326030,"journal":{"name":"The Lancet. Respiratory medicine","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127913840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-01DOI: 10.1016/S2213-2600(22)00211-9
D. Munblit, D. Buonsenso, L. Sigfrid, S. Vijverberg, C. Brackel
{"title":"Post-COVID-19 condition in children: a COS is urgently needed","authors":"D. Munblit, D. Buonsenso, L. Sigfrid, S. Vijverberg, C. Brackel","doi":"10.1016/S2213-2600(22)00211-9","DOIUrl":"https://doi.org/10.1016/S2213-2600(22)00211-9","url":null,"abstract":"","PeriodicalId":326030,"journal":{"name":"The Lancet. Respiratory medicine","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114337414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-01DOI: 10.1016/s2213-2600(22)00165-5
S. Stick, Alexia Foti, R. Ware, H. Tiddens, B. Clements, D. Armstrong, H. Selvadurai, A. Tai, P. Cooper, C. Byrnes, Y. Belessis, C. Wainwright, A. Jaffe, P. Robinson, L. Saiman, P. Sly
{"title":"The effect of azithromycin on structural lung disease in infants with cystic fibrosis (COMBAT CF): a phase 3, randomised, double-blind, placebo-controlled clinical trial.","authors":"S. Stick, Alexia Foti, R. Ware, H. Tiddens, B. Clements, D. Armstrong, H. Selvadurai, A. Tai, P. Cooper, C. Byrnes, Y. Belessis, C. Wainwright, A. Jaffe, P. Robinson, L. Saiman, P. Sly","doi":"10.1016/s2213-2600(22)00165-5","DOIUrl":"https://doi.org/10.1016/s2213-2600(22)00165-5","url":null,"abstract":"","PeriodicalId":326030,"journal":{"name":"The Lancet. Respiratory medicine","volume":"25 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132090208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-01DOI: 10.1016/S2213-2600(22)00180-1
H. Montgomery, F. Hobbs, F. Padilla, Douglas Arbetter, A. Templeton, S. Seegobin, Kenneth Kim, Jesus Abraham Simón Campos, R. Arends, Bryan H Brodek, Dennis Brooks, Pedro Garbes, J. Jiménez, G. Koh, Kelly W Padilla, K. Streicher, R. Viani, V. Alagappan, M. Pangalos, M. Esser, Wakana Tania Daria Daniel Kevin Carolina Ayoade Elena Jor Abe Adan De Varona Adiatullina Aguilar Zapata Ahle, Wakana Abe, Tania Adan De Varona, Daria Adiatullina, Daniel Aguilar Zapata, Kevin M Ahlers, C. Aimo, Ayoade Akere, E. Akimova, J. Alatorre Alexander, Logan Aldrich, I. Ali García, Karim Ali García, Lee Allison, R. Alonso Zúñiga, Ivan Aloysius, J. Altclas, A. Alvarisqueta, M. Antila, Camila Anton, Elisabet Árboix Alamo, S. Arora, Ramón Alejandro Avilés Felix, Natalya Bakhtina, V. Barbero-Becerra, Armando Barragán-Reyes, Alejandro Barreira, M. Barrett, J. Beran, Nikolett Berki, Viktoria Berki, R. Betten, C. Binelli, Lenka Brunzová, Cecilia Bussolari, Karianna Byargeon, Justyna Bytnar, C. Camberos, Pedro Campos Corzo, Grazia Can
{"title":"Efficacy and safety of intramuscular administration of tixagevimab–cilgavimab for early outpatient treatment of COVID-19 (TACKLE): a phase 3, randomised, double-blind, placebo-controlled trial","authors":"H. Montgomery, F. Hobbs, F. Padilla, Douglas Arbetter, A. Templeton, S. Seegobin, Kenneth Kim, Jesus Abraham Simón Campos, R. Arends, Bryan H Brodek, Dennis Brooks, Pedro Garbes, J. Jiménez, G. Koh, Kelly W Padilla, K. Streicher, R. Viani, V. Alagappan, M. Pangalos, M. Esser, Wakana Tania Daria Daniel Kevin Carolina Ayoade Elena Jor Abe Adan De Varona Adiatullina Aguilar Zapata Ahle, Wakana Abe, Tania Adan De Varona, Daria Adiatullina, Daniel Aguilar Zapata, Kevin M Ahlers, C. Aimo, Ayoade Akere, E. Akimova, J. Alatorre Alexander, Logan Aldrich, I. Ali García, Karim Ali García, Lee Allison, R. Alonso Zúñiga, Ivan Aloysius, J. Altclas, A. Alvarisqueta, M. Antila, Camila Anton, Elisabet Árboix Alamo, S. Arora, Ramón Alejandro Avilés Felix, Natalya Bakhtina, V. Barbero-Becerra, Armando Barragán-Reyes, Alejandro Barreira, M. Barrett, J. Beran, Nikolett Berki, Viktoria Berki, R. Betten, C. Binelli, Lenka Brunzová, Cecilia Bussolari, Karianna Byargeon, Justyna Bytnar, C. Camberos, Pedro Campos Corzo, Grazia Can","doi":"10.1016/S2213-2600(22)00180-1","DOIUrl":"https://doi.org/10.1016/S2213-2600(22)00180-1","url":null,"abstract":"","PeriodicalId":326030,"journal":{"name":"The Lancet. Respiratory medicine","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126614952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-01DOI: 10.1016/s2213-2600(22)00184-9
R. Houben, H. Esmail, F. Cobelens, C. M. Williams, A. Coussens
{"title":"Tuberculosis prevalence: beyond the tip of the iceberg.","authors":"R. Houben, H. Esmail, F. Cobelens, C. M. Williams, A. Coussens","doi":"10.1016/s2213-2600(22)00184-9","DOIUrl":"https://doi.org/10.1016/s2213-2600(22)00184-9","url":null,"abstract":"","PeriodicalId":326030,"journal":{"name":"The Lancet. Respiratory medicine","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115544365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-01DOI: 10.1016/s2213-2600(22)00134-5
B. Knox-Brown, Andreia F Amaral, Peter M Burney
{"title":"Concerns about PRISm.","authors":"B. Knox-Brown, Andreia F Amaral, Peter M Burney","doi":"10.1016/s2213-2600(22)00134-5","DOIUrl":"https://doi.org/10.1016/s2213-2600(22)00134-5","url":null,"abstract":"","PeriodicalId":326030,"journal":{"name":"The Lancet. Respiratory medicine","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123869451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-01DOI: 10.1016/S2213-2600(22)00217-X
Chengliang Yang, Hedi Zhao, S. Tebbutt
{"title":"A glimpse into long COVID and symptoms","authors":"Chengliang Yang, Hedi Zhao, S. Tebbutt","doi":"10.1016/S2213-2600(22)00217-X","DOIUrl":"https://doi.org/10.1016/S2213-2600(22)00217-X","url":null,"abstract":"","PeriodicalId":326030,"journal":{"name":"The Lancet. Respiratory medicine","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129389921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-01DOI: 10.1016/S2213-2600(22)00062-5
A. Horsley, C. Brightling, J. Davies, R. Djukanović, L. Heaney, T. Hussell, S. Marciniak, L. Mcgarvey, J. Porter, Thomas Wilkinson, L. Ho
{"title":"Early-phase clinical trials in a pandemic: learning from the response to COVID-19","authors":"A. Horsley, C. Brightling, J. Davies, R. Djukanović, L. Heaney, T. Hussell, S. Marciniak, L. Mcgarvey, J. Porter, Thomas Wilkinson, L. Ho","doi":"10.1016/S2213-2600(22)00062-5","DOIUrl":"https://doi.org/10.1016/S2213-2600(22)00062-5","url":null,"abstract":"","PeriodicalId":326030,"journal":{"name":"The Lancet. Respiratory medicine","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130813336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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