Increased Risk of Incident Chronic Obstructive Pulmonary Disease and Related Hospitalizations in Tuberculosis Survivors: A Population-Based Matched Cohort Study

Background: Tuberculosis (TB) survivors have an increased risk of developing chronic obstructive pulmonary disease (COPD).This study assessed the risk of COPD development and COPD-related hospitalization in TB survivors compared to controls.Methods: We conducted a population-based cohort study of TB survivors and 1:1 age-and sex-matched controls using data from the Korean National Health Insurance Service database collected from 2010 to 2017.We compared the risk of COPD development and COPD-related hospitalization between TB survivors and controls.Results: Of the subjects, 9.6% developed COPD, and 2.8% experienced COPD-related hospitalization.TB survivors had significantly higher COPD incidence rates (36.7/1,000 vs. 18.8/1,000 person-years, P < 0.001) and COPD-related hospitalization (10.7/1,000 vs. 4.3/1,000 person-years, P < 0.001) than controls.Multivariable Cox regression analyses revealed higher risks of COPD development (adjusted hazard ratio [aHR], 1.63; 95% confidence interval [CI], 1.54-1.73)and COPD-related hospitalization (aHR, 2.03; 95% CI, 1.81-2.27) in TB survivors.Among those who developed COPD, the hospitalization rate was higher in individuals with post-TB COPD compared to those with non-TB COPD (10.7/1,000 vs. 4.9/1,000 person-years, P < 0.001), showing an increased risk of COPD-related hospitalization (aHR, 1.84; 95% CI, 1.17-2.92).