The COVID-19/Tuberculosis Syndemic and Potential Antibody Therapy for TB Based on the Lessons Learnt From the Pandemic

Abstract

2020 will be marked in history for the dreadful implications of the COVID-19 pandemic that shook the world globally. The pandemic has reshaped the normality of life and affected mankind in the aspects of mental and physical health, financial, economy, growth, and development. The focus shift to COVID-19 has indirectly impacted an existing air-borne disease, Tuberculosis. In addition to the decrease in TB diagnosis, the emergence of the TB/COVID-19 syndemic and its serious implications (possible reactivation of latent TB post-COVID-19, aggravation of an existing active TB condition, or escalation of the severity of a COVID-19 during TB-COVID-19 coinfection), serve as primary reasons to equally prioritize TB. On a different note, the valuable lessons learnt for the COVID-19 pandemic provide useful knowledge for enhancing TB diagnostics and therapeutics. In this review, the crucial need to focus on TB amid the COVID-19 pandemic has been discussed. Besides, a general comparison between COVID-19 and TB in the aspects of pathogenesis, diagnostics, symptoms, and treatment options with importance given to antibody therapy were presented. Lastly, the lessons learnt from the COVID-19 pandemic and how it is applicable to enhance the antibody-based immunotherapy for TB have been presented.

COVID-19 and tuberculosis coinfection: A case–control study from a tertiary care center in South India

“…There is a lack of understanding of the immunopathological interplay of COVID-19 and TB syndemic, which leaves several unanswered questions on disease prognosis, clinical management, and determinants of mortality in TB-COVID-19 coinfection. [ 10 ] Studies have shown that TB might increase susceptibility to COVID-19 infection. [ 11 12 ] On the other hand, COVID-19 infection leads to significant reduction and functional exhaustion in total T cell counts, thereby increasing susceptibility to TB.…”

Under diagnosis of tuberculosis in times of pandemic and the use of microRNAs as biomarkers of infection

“…29,30 Overall, TB-COVID-19 syndemia has several possible implications including reactivation of TBL after SARS-CoV-2 infection, TB-COVID-19 coinfection which consequently may lead to aggravation of an existing active TB condition, may increase the risk of severity of SARS-CoV-2 infection. 11,12 Understanding the nature of the interactions between MTB and SARS-CoV-2 pathogens will be crucial for the development of therapeutic strategies against coinfection.…”

“…An important reason for refocusing on TB diagnosis during the pandemic is because of the emergence of the TB-COVID-19 syndemic. 11 It is unclear what the implications of this syndemia are; however, one possibility is that TB-COVID-19 coinfection will lead to a worsening of the existing active TB condition or an existing MTB infection may increase the risk of severity in SARS-CoV-2. 11,12 Another concerning aspect of this syndemic, is the reported cases of reactivation of latent TB in post-COVID-19 patients, 13 as one-quarter of the world's population is estimated to be affected by latent TB.…”

“…11 It is unclear what the implications of this syndemia are; however, one possibility is that TB-COVID-19 coinfection will lead to a worsening of the existing active TB condition or an existing MTB infection may increase the risk of severity in SARS-CoV-2. 11,12 Another concerning aspect of this syndemic, is the reported cases of reactivation of latent TB in post-COVID-19 patients, 13 as one-quarter of the world's population is estimated to be affected by latent TB. 14 For these reasons, simultaneous diagnostic testing for TB and COVID-19 is essential to ensure effective treatment for patients.…”

Yoga and Quality of Life in Pulmonary Tuberculosis Patients During COVID19 and Post- COVID-19: A Narrative Review

“…There is a synergistic relationship between the spread of COVID-19 and pulmonary tuberculosis, which makes it more difficult to isolate the two diseases (Dass et al, 2022). COVID-19 is a new pandemic that causes terrible respiratory and enormous mental disease, ultimately resulting to lower quality of life in patients, whereas TB has been around for millennia and is responsible for the majority of fatalities in the globe (Cramer et al, 2017).…”