The Influencing Factors of Extensive Lung Lesions and Cavities in Patients With Non-Tuberculous Mycobacterial Lung Disease

<b>Aims/Background</b> The resolution of non-tuberculous mycobacterial (NTM) lung disease is associated with the extent of pulmonary lesions and the presence of lung cavities. This study aims to identify factors influencing the development of extensive lung lesions and cavities in patients with NTM lung disease, thereby generating valuable insights for the management and treatment of NTM lung disease. <b>Methods</b> Retrospective analysis was conducted on clinical data from 198 hospitalized patients with NTM lung disease at the Department of Tuberculosis, The Second Hospital of Nanjing, between 2022 and 2023. Patient data like age, gender, past medical history, nutritional risk screening 2002 (NRS-2002) score, lymphocyte count, peripheral blood neutrophil-to-lymphocyte ratio (NLR), pulmonary computed tomography (CT) imaging findings (including extent of lung lesions and presence of cavities), and T cell subsets count were gathered through electronic medical records and hospital information system (HIS) system. Univariate and multivariate logistic regression analyses were carried out with extensive lung lesions and cavities as dependent variables and other factors as independent variables. <b>Results</b> Among the 198 patients, 138 (69.7%) exhibited extensive lung lesions, while cavities were observed in 76 individuals (38.4%). Based on the results of logistic regression analysis, a high NLR (OR = 4.685 [1.176-18.663], <i>p</i> = 0.029) and an NRS-2002 score ≥3 (OR = 12.082 [3.726-39.183], <i>p</i> < 0.001) were identified as risk factors for the development of extensive lung lesions in patients with NTM lung disease. Furthermore, elevated NLR (OR = 3.454 [1.483-8.047], <i>p</i> = 0.004) was associated with an increased risk of cavities in patients with NTM lung disease. <b>Conclusion</b> In patients with NTM lung disease, high NLR is the risk factor for extensive lung lesions and formation of pulmonary cavities, whereas malnutrition elevates the risk for prevalent lung lesions. Early intervention and active monitoring of these related indicators are necessary to prevent disease progression and enhance overall cure rates.