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Frailty as a framework to understand tuberculosis severity, recovery and sequelae
Yoscelina E Martinez-Lopez1, Benjamin W Black1, Jessica Lee2
1School of Public Health, University of Texas Health Science Center at Houston, Brownsville and Houston Campus, Texas, USA.
The Journal of Infectious Diseases
|August 14, 2026
Summary
Tuberculosis (TB) survivors often face long-term health issues. This study proposes frailty as a framework to understand TB
Area of Science:
- Infectious Diseases
- Gerontology
- Physiology
Background:
- Tuberculosis (TB) causes severe systemic illness with lasting consequences.
- Existing TB severity indicators fail to capture the integrated physiological impact.
- Frailty, a syndrome of reduced physiological reserve, is a known predictor of adverse outcomes.
Purpose of the Study:
- To propose frailty as an integrative framework for understanding TB's systemic effects.
- To explore biological mechanisms linking Mycobacterium tuberculosis infection to frailty.
- To assess frailty's potential in improving risk stratification and supportive care for post-TB sequelae.
Main Methods:
- Conceptual framework development.
- Review of biological mechanisms (inflammation, metabolic/endocrine dysregulation).
- Discussion of frailty assessment in clinical practice.
Main Results:
- Frailty offers a comprehensive model for TB severity, recovery, and sequelae.
- Mycobacterium tuberculosis infection may induce frailty through specific biological pathways.
- Frailty assessment can enhance risk stratification and guide personalized care.
Conclusions:
- Frailty provides a novel lens for viewing the systemic impact of TB.
- Understanding TB-associated frailty may reveal mechanisms of resilience and recovery.
- This framework can improve management of long-term TB complications.
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