Co-infection of COVID-19 and Tuberculosis

Abstract

Tuberculosis and COVID-19 diseases occur more frequently in people with similar risk factors. This study aimed to share the data on active tuberculosis patients during the severe acute respiratory syndrome coronavirus 2 pandemic. MATERIAL AND METHODS:The registration information of TB outpatient clinic between November 1, 2019, and April 20, 2020, was screened. A 7-question survey was administered to the patients who were diagnosed with active tuberculosis and who were agreed to participate in the study. RESULTS:A total of 309 patients with active tuberculosis were evaluated, the average age of the patients was 42.5 ± 18.5 years, and 70% were male. The percentage of having at least 1 comorbidity was 30.4%. The percentage of coronavirus disease 2019 disease in our study population was 1.9%; none of the patients of coronavirus disease 2019 were taken into the intensive care unit or dead due to clinical deterioration and/or respiratory failure. On the other hand, in this process it was announced that 146 457 cases were diagnosed with coronavirus disease 2019 throughout the country, of which 72% had inpatient treatment, 2% died, and 944 patients were still being treated in the intensive care unit, of which 490 were intubated. The positivity ratio of the reverse transcription-polymerase chain reaction test was 20.0% in the study group, while 20.3% in the İstanbul population. CONCLUSION:Tuberculosis patients might be more disadvantageous than the normal population in terms of the risk of exposure to severe acute respiratory syndrome coronavirus 2, but this does not cause an increase in the frequency and severity of coronavirus disease 2019 disease in active tuberculosis patients.

The association of SARS-CoV-2 infection and tuberculosis disease with unfavorable treatment outcomes: A systematic review

“…HIV coinfection was present in >50% of included participants in five of eight studies reporting such data [ 14 , 15 , 17 , 18 , 20 , 21 , 23 ]. Most (n = 10) studies were in adults [ 13 – 15 , 17 – 23 ], while one was in children (median age of 9 years, range 3 to 12 years) [ 16 ]. Two studies contained relevant data on circulating SARS-CoV-2 variants [ 21 , 22 ] and one had data on SARS-CoV-2 vaccination status of participants [ 22 ] (5 studies recruited participants exclusively in 2020, while 6 studies recruited participants in 2021/2022, though only 2 studies beyond June 2021).…”

“…Three studies (38%) recruited participants in 2021 [ 14 , 17 , 19 ]. One study focused on children [ 16 ], while the remainder involved adults [ 13 – 15 , 17 – 19 , 23 ]. Participants were predominantly male, driven mostly by one study consisting of 5409 participants of whom 66% were male ( Table 1 ) [ 19 ].…”

“…Point estimates for odds ratios in the included studies ranged from 0.36 to 1.29. In two studies [ 13 , 16 ], no unfavorable outcomes occurred in either group. Few subgroup analyses were possible with the available data and results remained heterogeneous (see S3 Text ).…”

“…With respect to in-hospital mortality, deaths only occurred in the group with SARS-CoV-2 coinfection in the two studies reporting this outcome [ 18 , 23 ]. Loss to follow-up and treatment failure were relatively uncommon across studies, with no trends to suggest these differed systematically between groups ( Table F and Table G in S1 Text ) [ 13 – 17 ]. In the one study that reported length of hospitalization [ 18 ], it was 17.25 days for coinfected participants, compared to 12.89 days for participants with only TB disease; this difference was statistically significant after adjusting for age, sex, and other co-morbidities (p = 0.048).…”

“…A further 5,472 records were excluded after screening titles and abstracts, leaving 41 unique full texts. Of these 41 full texts, we contacted 21 authors of studies with potentially relevant data, of whom 16 (76%) replied and ultimately 11 (52%) shared data (one author provided data from a different report; Fig 1) [13][14][15][16][17][18][19][20][21][22][23]. Full details on excluded studies are described Table D in S1 Text.…”