Association between tuberculosis and COVID‐19 severity and mortality: A rapid systematic review and meta‐analysis

Gao, Ya; Liu, Ming; Chen, Yamin; Shi, Sheng; Geng, Jie; Tian, Jin Hui

doi:10.1002/jmv.26311

Cited by 130 publications

(131 citation statements)

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“…Another recent study found that active or latent tuberculosis increases susceptibility to SARS‐CoV‐2, and increases disease severity 46 . Similarly, a recent systematic review and meta‐analysis also reported that tuberculosis is associated with increased risk of severe COVID‐19 disease 47 . However, a case series of 20 patients with active tuberculosis from Italy reported a benign course of COVID‐19 co‐infection with a 5% case fatality rate 48 …”

Section: Discussionmentioning

confidence: 96%

Impact of COVID‐19 in patients with concurrent co‐infections: A systematic review and meta‐analyses

Sarkar

Khanna

Singh

2020

Journal of Medical Virology

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The burden and impact of secondary superadded infections in critically ill coronavirus disease 2019 (COVID‐19) patients is widely acknowledged. However, there is a dearth of information regarding the impact of COVID‐19 in patients with tuberculosis, HIV, chronic hepatitis, and other concurrent infections. This review was conducted to evaluate the consequence of severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) infection in patients with concurrent co‐infections based on the publications reported to date. An extensive comprehensive screening was conducted using electronic databases up to 3rd September 2020 after obtaining registration with PROSPERO (CRD420202064800). The observational studies or interventional studies in English, evaluating the impact of SARS‐CoV‐2 in patients with concurrent infections are included for the meta‐analyses. Our search retrieved 20 studies, with a total of 205,702 patients. Patients with tuberculosis (RR = 2.10; 95% CI, 1.75–2.51; I2 = 0%), influenza (RR = 2.04; 95% CI, 0.15–28.25, I2 = 99%) have an increased risk of mortality during a co‐infection with SARS‐CoV‐2. No significant impact is found in people living with HIV (RR = 0.99; 95% CI, 0.82–1.19; I2 = 30%), Chronic hepatitis (RR = 1.15; 95% CI, 0.73–1.81; I2 = 10%). Several countries (Brazil, Paraguay, Argentina, Peru, Colombia, and Singapore) are on the verge of a dengue co epidemic (cumulative 878,496 and 5,028,380 cases of dengue and COVID‐19 respectively). The impact of COVID‐19 in patients of concurrent infections with either tuberculosis or influenza is detrimental. The clinical outcomes of COVID‐19 in HIV or chronic hepatitis patients are comparable to COVID‐19 patients without these concurrent infections.

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Section: Discussionmentioning

confidence: 96%

Impact of COVID‐19 in patients with concurrent co‐infections: A systematic review and meta‐analyses

Sarkar

Khanna

Singh

2020

Journal of Medical Virology

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“…Still, the existent studies showed that TB status might play a role in the development of severe acute respiratory syndrome in SARS-CoV-2 coinfection, considering the cases described in China and India [ 34 ]. A recent meta-analysis [ 35 ] concluded that patients with TB are not more likely to get COVID-19, but TB is associated with a 2.1-fold increased risk of severe COVID-19 disease, although the statistical difference was not significant. Moreover, no increased risk for mortality in coincident COVID-19 and TB was found.…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis and COVID-19: Lessons from the Past Viral Outbreaks and Possible Future Outcomes

Criṣan-Dabija

Grigorescu²,

Pavel³

et al. 2020

Canadian Respiratory Journal

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Background. The threat of contagious infectious diseases is constantly evolving as demographic explosion, travel globalization, and changes in human lifestyle increase the risk of spreading pathogens, leading to accelerated changes in disease landscape. Of particular interest is the aftermath of superimposing viral epidemics (especially SARS-CoV-2) over long-standing diseases, such as tuberculosis (TB), which remains a significant disease for public health worldwide and especially in emerging economies. Methods and Results. The PubMed electronic database was systematically searched for relevant articles linking TB, influenza, and SARS-CoV viruses and subsequently assessed eligibility according to inclusion criteria. Using a data mining approach, we also queried the COVID-19 Open Research Dataset (CORD-19). We aimed to answer the following questions: What can be learned from other coronavirus outbreaks (focusing on TB patients)? Is coinfection (TB and SARS-CoV-2) more severe? Is there a vaccine for SARS-CoV-2? How does the TB vaccine affect COVID-19? How does one diagnosis affect the other? Discussions. Few essential elements about TB and SARS-CoV coinfections were discussed. First, lessons from past outbreaks (other coronaviruses) and influenza pandemic/seasonal outbreaks have taught the importance of infection control to avoid the severe impact on TB patients. Second, although challenging due to data scarcity, investigating the pathological pathways linking TB and SARS-CoV-2 leads to the idea that their coexistence might yield a more severe clinical evolution. Finally, we addressed the issues of vaccination and diagnostic reliability in the context of coinfection. Conclusions. Because viral respiratory infections and TB impede the host’s immune responses, it can be assumed that their lethal synergism may contribute to more severe clinical evolution. Despite the rapidly growing number of cases, the data needed to predict the impact of the COVID-19 pandemic on patients with latent TB and TB sequelae still lies ahead. The trial is registered with NCT04327206, NCT01829490, and NCT04121494.

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“…Recently, two reviews, including a meta-analysis, were conducted with data from case reports and cohorts of co-infected TB/COVID-19 individuals [ 12 , 28 ]. Both studies did not identify a direct association of TB with the worsening of COVID-19, however, it should be noted that these reviews only evaluated the literature available until then, not including the results of the South African cohort, for example [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Pathology of TB/COVID-19 Co-Infection: The phantom menace

2021

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Despite the high number of victims of COVID-19, tuberculosis (TB) remains as the leading cause of death among infectious diseases worldwide. Since the beginning of the pandemic, there is an increasing number of studies trying to elucidate the interactions between Mycobacterium tuberculosis and SARS-CoV-2. The first case reports point to a worsening of respiratory symptoms in co-infected TB/COVID-19 individuals. However, data from the cohort studies has shown some conflicting results. This study proposes to conduct a systematic review on the current literature on TB/COVID-19 co-infection cohorts, evaluating clinical and epidemiological data, focusing on its implications to the immune system. From an immunological perspective, the TB/COVID-19 co-infection has the potential to generate a "perfect storm". The disorders induced by each pathogen to the immune modulation tend to induce an unbalanced inflammatory response, which can promote the progression and worsening of both diseases. Understanding the nature of the interactions between M. tuberculosis and SARS-CoV-2 will be crucial for the development of therapeutic strategies against co-infection.

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Association between tuberculosis and COVID‐19 severity and mortality: A rapid systematic review and meta‐analysis

Cited by 130 publications

References 11 publications

Impact of COVID‐19 in patients with concurrent co‐infections: A systematic review and meta‐analyses

Impact of COVID‐19 in patients with concurrent co‐infections: A systematic review and meta‐analyses

Tuberculosis and COVID-19: Lessons from the Past Viral Outbreaks and Possible Future Outcomes

Pathology of TB/COVID-19 Co-Infection: The phantom menace

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