St George's, University of London

Academic Institute

Julia Critchley - Chief Investigator - St George'sUniversity of LondonJulia Critchley - Corresponding Applicant - St George'sUniversity of LondonDerek Cook - Collaborator - St George'sUniversity of LondonIain Carey - Collaborator - St George'sUniversity of LondonLawrence Phillips - Collaborator - Emory University Medical SchoolMary Rhee - Collaborator - Emory UniversityMatthew Magee - Collaborator - Emory UniversitySara Auld - Collaborator - Emory UniversityStephen DeWilde - Collaborator - St George'sUniversity of LondonTess Harris - Collaborator - St George'sUniversity of LondonUmar Chaudhry - Collaborator - St George'sUniversity of London

CPRD463

It is well accepted that having chronic diseases like diabetes can increase the chance of developing some infectious diseases like tuberculosis. However, very few studies have evaluated whether having a serious infectious disease such as tuberculosis might increase the likelihood of subsequently developing some other chronic diseases (like diabetes, heart attacks and strokes, and other respiratory problems) even after a patient with tuberculosis has been successfully treated and cured. Using data from GP practices, hospitals and the Office of National Statistics (which reports information on deaths) in the UK we will be investigating the links between having tuberculosis disease and a patient’s future risk of developing diabetes, pulmonary disease (e.g. asthma or chronic obstructive pulmonary disease), and cardiovascular diseases (like strokes and heart attacks). We will identify people who have had tuberculosis in the past using these health care records and then follow them through time to see if they develop any of these key chronic conditions. Because the datasets in the UK are very large and complete, we will be able to examine whether other factors (including age, sex, smoking status, obesity, ethnicity, or other health conditions) seem to also affect these risks. This will help us identify which patients with tuberculosis might be at the highest risk of future illness and therefore design appropriate screening and other interventions and health care services to help improve their future long-term health. We will also assess the risk of being hospitalised or dying from COVID-19 for people with previous TB disease.

Globally Tuberculosis accounts for more deaths due to infectious disease than any other pathogen; around 1.5 million in 2018. Antimicrobial treatment for TB is highly effective, but may result in long-term consequences for TB survivors considered bacteriologically cured. These include chronic inflammation, insulin resistance, lipid dysregulation, and systemic glucose intolerance [1] which predispose to type 2 diabetes mellitus (DM) and CVD. TB-attributable lung damage may also lead to pulmonary impairment and lifelong respiratory disability. This proposal will improve understanding of the relationship between TB disease and subsequent risks of DM, pulmonary disease and CVD, and identify targets for preventing non-communicable diseases (NCDs) among TB patients. We will also assess COVID-19 hospitalisation and mortality risk for our cohort of post-TB patients.

24/03/2021

Release