Low serum complement level is associated with higher mortality in tuberculous meningitis: a retrospective cohort...

Area of Science:

• Neurology
• Immunology
• Infectious Diseases

Background:

• Meningitis is a serious infection affecting the membranes surrounding the brain and spinal cord.
• Distinguishing between tuberculous meningitis (TBM), bacterial meningitis (BM), and viral meningitis (VM) is crucial for appropriate treatment.
• Serum complement levels, key components of the immune system, have not been extensively studied in relation to different meningitis types.

Purpose of the Study:

• To investigate the association between serum complement levels (C3 and C4) and the diagnosis of TBM, BM, and VM.
• To determine the relationship between serum complement levels and mortality in patients diagnosed with TBM.

Main Methods:

• Retrospective analysis of patient data from 2009 to 2019.
• Inclusion of patients with available serum complement levels at admission diagnosed with TBM (n=97), BM (n=31), or VM (n=557).
• Statistical analysis including propensity score matching to compare complement levels between groups.

Main Results:

• Serum complement levels (C3 and C4) were significantly lower in TBM patients compared to VM patients.
• Patients in the lowest quartile of C4 levels had a 2.2 times higher odds of TBM diagnosis.
• TBM patients in the lowest quartile of C3 levels exhibited a significantly higher 90-day mortality rate (HR 19.0).

Conclusions:

• Serum C3 and C4 levels are significantly lower in tuberculous meningitis compared to viral meningitis.
• Lower serum C3 levels are a significant predictor of increased mortality in TBM patients.