Pulmonary Tuberculosis in Coronavirus Disease-19 Patients: A Report of Two Cases from Nigeria

Gbenga, Tekobo Abiodun; Oloyede, Taofeek; Ibrahim, Olayinka Rasheed; Sanda, Abdallah; Suleiman, Bello Mohammed

doi:10.3889/oamjms.2020.5298

Cited by 9 publications

(8 citation statements)

References 8 publications

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“…We identified information concerning treatment after discharge for 10 patients; 8 of them received ATT and 2 received treatment for existing comorbidity. Although there was no doubt that the regimens for TB and COVID-19 coinfected patients were highly heterogeneous, we still could identify four main paradigms about treatment during hospitalisation: (1) simultaneous antiviral treatment and ATT,19–21 23–26 28 30 31 34 35 39–41 43–45 49 51 (2) only ATT,22 26 32 33 35 36 46–48 (3) only antiviral treatment,18 24 26 27 38 44 50 (4) no antiviral treatment and ATT 37. Check online supplemental tables 4 and 5 for detailed information about the treatment.…”

Section: Resultsmentioning

confidence: 96%

“…Until 19 March 2021, there were 35 case reports from 17 countries, including India,18–22 Indonesia,23 China,24–28 Saudi Arabia,29 30 Qatar,31 32 Singapore,33 Turkey,34 35 Haiti,36 Argentina,37 USA,38–41 Brazil,42 43 Panama,44 Nigeria,45 46 South Africa,47 48 Morocco,49 Italy50 51 and France 52. Totally, 55 cases were described in these 35 reports.…”

Section: Resultsmentioning

confidence: 99%

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Global prevalence, treatment and outcome of tuberculosis and COVID-19 coinfection: a systematic review and meta-analysis (from November 2019 to March 2021)

et al. 2022

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IntroductionThe COVID-19 outbreak poses a significant threat to the patients with tuberculosis (TB). TB and COVID-19 (TB–COVID) coinfection means the disease caused by both Mycobacterium tuberculosis and SARS-CoV-2 infection. Currently, the prevalence status, treatment and outcomes of the coinfection are poorly characterised. We aimed to systematically review the evidence on this topic and provide comprehensive information to guide the control and treatment of TB–COVID coinfection.MethodsAn extensive screening was conducted using six electronic databases to search eligible studies from 1 November 2019 to 19 March 2021. Prevalence rate, treatment and outcomes of TB–COVID coinfection were extracted. Random-effects models were used to calculate mean fatality rates of coinfection with 95% CIs. The risks of bias were assessed with the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Study Reporting Prevalence Data and JBI Critical Appraisal Checklist for Case Report. A meta-analysis was conducted for subgroups on in-hospital fatality rate.ResultsForty-two studies were included into the analysis (35 case reports and 7 retrospective cohort studies). Nineteen countries reported coinfected patients, including high and low TB prevalence countries. The only study revealing prevalence rate came from West Cape Province, South Africa (people aged above 20 years, 0.04% until 1 June 2020 and 0.06% until 9 June 2020). The treatment regimens for coinfected patients were highly heterogeneous. The mean overall and in-hospital fatality rates of coinfection were 13.9% (95% CI: 1.6% to 26.2%) and 17.5% (95% CI: 8.9% to 26.0%). The mean in-hospital fatality rates for high-income countries (Italy and Argentina) and low/middle-income countries (LMICs) (India, Philippines, South Africa) were 6.5% (95% CI: −0.8% to ~13.9%) and 22.5% (95% CI: 19.0% to ~26.0%).ConclusionTB–COVID coinfection is common globally, and the coinfected patients suffer from higher fatality risk than patients with normal COVID-19. Outcomes shared significant differences between high-income countries and LMICs.PROSPERO registration numberCRD42021253660.

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Section: Resultsmentioning

confidence: 96%

Section: Resultsmentioning

confidence: 99%

Global prevalence, treatment and outcome of tuberculosis and COVID-19 coinfection: a systematic review and meta-analysis (from November 2019 to March 2021)

et al. 2022

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“…However, the case reports and case series (18 studies, 46 cases) identified in the review did highlight certain themes of interest. First, these studies demonstrated that persons admitted for COVID-19 may be diagnosed with active TB during the hospitalization precipitated by COVID-19 [ 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 ]. Final clinical outcomes at the conclusion of TB treatment were generally not reported.…”

Section: Resultsmentioning

confidence: 99%

“…Second, corticosteroid therapy was used in some persons with COVID-19 and TB co-infection. Some reports cited a TB-specific indication for corticosteroids, namely central nervous system TB [ 42 , 43 ], while others reported the use of corticosteroids as primary therapy for COVID-19 [ 33 , 38 , 45 ]. Third, persons with COVID-19 and TB co-infection presented with various comorbidities (HIV, diabetes mellitus, chronic kidney disease) [ 34 , 37 , 44 , 46 ] and complications: hepatotoxicity [ 33 , 35 ]; extension of the duration of standard TB treatment to 9 months [ 32 ]; drug-resistant TB [ 34 , 47 , 48 ]; extrapulmonary TB [ 42 , 43 , 48 ]; and death [ 33 , 38 , 48 ].…”

Section: Resultsmentioning

confidence: 99%

Clinical Outcomes of Individuals with COVID-19 and Tuberculosis during the Pre-Vaccination Period of the Pandemic: A Systematic Review

Jhaveri

Fung

LaHood

et al. 2022

JCM

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Background: Tuberculosis, like COVID-19, is most often a pulmonary disease. The COVID-19 pandemic has severely disrupted tuberculosis services in myriad ways: health facility closures, lockdowns, travel bans, overwhelmed healthcare systems, restricted export of antituberculous drugs, etc. The effects of the shared risk on outcomes of the two diseases is not known, particularly for the first year of the pandemic, during the period before COVID-19 vaccines became widely available. Objective: We embarked on a systematic review to elucidate the consequences of tuberculosis on COVID-19 outcomes and of COVID-19 on tuberculosis outcomes during the pre-vaccination period of the pandemic. Methods: The systematic review protocol is registered in PROSPERO. We conducted an initial search of PubMed, Embase, Web of Science, WHO coronavirus database, medRxiv, bioRxiv, preprints.org, and Google Scholar using terms relating to COVID-19 and tuberculosis. We selected cohort and case–control studies for extraction and assessed quality with the Newcastle-Ottawa scale. Results and Conclusion: We identified 2108 unique abstracts published between December 2019 and January 2021. We extracted data from 18 studies from 8 countries. A total of 650,317 persons had a diagnosis of COVID-19, and 4179 had a diagnosis of current or prior tuberculosis. We explored links between tuberculosis and COVID-19 incidence, mortality, and other adverse outcomes. Nine studies reported on mortality and 13 on other adverse outcomes; results on the association between tuberculosis and COVID-19 mortality/adverse outcomes were heterogenous. Tuberculosis outcomes were not fully available in any studies, due to short follow-up (maximum of 3 months after COVID-19 diagnosis), so the effects of COVID-19 on tuberculosis outcomes could not be assessed. Much of the rapid influx of literature on tuberculosis and COVID-19 during this period was published on preprint servers, and therefore not peer-reviewed. It offered limited examination of the effect of tuberculosis on COVID-19 outcomes and even less on the effect of COVID-19 on tuberculosis treatment outcomes.

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“…Pulmonary TB patients presented with fever, productive cough, night sweating, weight loss, hemoptysis, dyspnea, fatigue, and loss of appetite (Shanmuganathan and Shanmuganathan, 2015). Some people with COVID-19 were referred to the hospital with characteristic TB symptoms, such as fever, night sweats, weight loss, reduced appetite, and cough with occasional blood-streaked sputum, and further evaluations and tests confirmed the simultaneous presence of MTB and SARS-CoV-2 organisms (Cutler et al, 2020;Gbenga et al, 2020;Singh et al, 2020;Tham et al, 2020;Yadav and Rawal, 2020;Baskara et al, 2021;Musso et al, 2021;Pillay and Magula, 2021). As lung damage caused by TB increases the body's susceptibility to getting infected with other airborne infections, it can be considered that TB can be a risk factor for exacerbating the severity of COVID-19 patients (Mousquer et al, 2020).…”

Section: Clinical Features Of Tuberculosis/ Covid-19 Coinfectionsmentioning

confidence: 99%

Mycobacterium tuberculosis and SARS-CoV-2 Coinfections: A Review

et al. 2022

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BackgroundTuberculosis (TB) is still one of the most important causes of death worldwide. The lack of timely attention on TB diagnosis and treatment during the coronavirus disease 2019 (COVID-19) pandemic is a potential threat to health issues and may have severe consequences for patients and health systems. There is not much information on the management of TB during this period. Here, we reviewed the current literature to evaluate the rate of Mycobacterium tuberculosis and severe acute respiratory syndrome coronavirus 2 coinfections and interactions between these infectious agents.MethodsSeveral databases, including Web of Science, Scopus, and MEDLINE (via PubMed), were searched for original articles addressing TB and COVID-19 diseases published from December 2019 to April 2021.ResultsOf 3,879 articles, 57 articles were included in this study, and among 106,033 patients affected by COVID-19, 891 also had TB. Overall, investigators found a consistent increase in C-reactive protein, D-dimer (especially in patients with severe clinical manifestation), erythrocyte sedimentation rate, lactate dehydrogenase, alanine aminotransferase, and a reduction of lymphocytes. The respiratory symptoms of TB/COVID-19 patients were similar to those of TB patients, but the risk of developing pulmonary TB increased in COVID-19 patients. Also, the mortality rate in TB/COVID-19 patients was higher than that in patients affected only by COVID-19 or TB.ConclusionSome reports indicated worsening respiratory symptoms and even activation of latent TB after COVID-19 or vice versa. It seems that both active and previously treated TB constituted a risk factor for COVID-19 in terms of severity and mortality, regardless of other underlying diseases and patient status. Health systems should not neglect TB during this era of the ongoing COVID-19 pandemic by setting up appropriate diagnostic and clinical management algorithms.

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Pulmonary Tuberculosis in Coronavirus Disease-19 Patients: A Report of Two Cases from Nigeria

Cited by 9 publications

References 8 publications

Global prevalence, treatment and outcome of tuberculosis and COVID-19 coinfection: a systematic review and meta-analysis (from November 2019 to March 2021)

Global prevalence, treatment and outcome of tuberculosis and COVID-19 coinfection: a systematic review and meta-analysis (from November 2019 to March 2021)

Clinical Outcomes of Individuals with COVID-19 and Tuberculosis during the Pre-Vaccination Period of the Pandemic: A Systematic Review

Mycobacterium tuberculosis and SARS-CoV-2 Coinfections: A Review

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