Pulmonary Sarcoidosis in Qatar: Clinical Features, Diagnostic Profile and Treatment Patterns in a Multi-Ethnic Population.

introductionSarcoidosis data from the Middle East are limited, and regional studies have been predominantly single-ethnicity, leaving phenotyping in the region's diverse expatriate populations unexplored. We characterised pulmonary sarcoidosis across ethnic groups in Qatar and examined temporal trends over 9 years.

methodsRetrospective cohort study of adults with pulmonary sarcoidosis managed at Hamad Medical Corporation, the principal public-sector provider in Qatar, between 2015 and 2023. The primary ethnic comparison was Arab versus South Asian. Because diffusion capacity (DLCO) was differentially ascertained, sensitivity analyses assessed the potential impact of missing data.

resultsWe included 156 patients (64.7% male; median age 45 years; Arab 45.5%, South Asian 41.0%). Stage II predominated (67.3%); Stage IV was present in 15.4%. Histologic confirmation was achieved in 83.3%, primarily by EBUS-TBNA (single-procedure yield 94.3%). Corticosteroids were prescribed in 61.5%. South Asian patients were younger (43 vs. 50 years; p = 0.003), more frequently male (80% vs. 54%; p = 0.002), and reported constitutional symptoms more often (18.8% vs. 5.6%; p = 0.031). Among patients with available measurements, South Asians had lower median DLCO (78.0% vs. 90.5% predicted; p = 0.014); however, DLCO was measured in only 48.4% versus 70.4% of South Asian and Arab patients, respectively (p = 0.014), limiting interpretation. Asymptomatic presentation increased from 22% in 2015-2019 to 62% in 2020-2021 and 42% in 2022-2023.

conclusionIn Qatar's first pulmonary sarcoidosis cohort, disease was predominantly Stage II, with high EBUS-TBNA yield. South Asians had more constitutional symptoms; lower DLCO was observed but requires prospective confirmation. Pandemic-era imaging may have increased incidental detection.