Tuberculosis and COVID-19 co-infection: description of the global cohort

Abstract

Information on tuberculosis (TB) and COVID-19 is still limited. The aim of this study is to describe the features of the TB/COVID-19 co-infected individuals from a prospective, anonymised, multi-country register-based cohort with special focus on the determinants of mortality and other outcomes. We enrolled all patients of any age with either active TB or previous TB and COVID-19. 172 centres from 34 countries provided individual data on 767 TB-COVID-19 co-infected patients, (>50% population-based). Of 767 patients, 553/747 (74.0%) had TB before COVID-19 (including 234/747 with previous TB), 71/747 (9.5%) had COVID-19 first and 123/747 (16.5%) had both diseases diagnosed within the same week (35, 4.6% on the same day). 85/767 patients died (11.08%) (41/289 (14.2%) in Europe and 44/478 (9.2%) outside Europe; (p=0.03)): 42 (49.4%) from COVID-19, 31 (36.5%) from COVID-19 and TB, 1/85 (1.2%) from TB and 11 from other causes. In the univariate analysis on mortality the following variables reached statistical significance: age, being male, having >1 comorbidity; diabetes mellitus, cardiovascular disease, chronic respiratory disease, chronic renal disease, presence of key symptoms, invasive ventilation and hospitalisation due to COVID-19. The final multivariable logistic regression model included age, male gender, and invasive ventilation as independent contributors to mortality. The data suggests TB and COVID-19 are a “cursed duet” and need immediate attention. TB should be considered a risk factor for severe COVID disease and patients with TB should be prioritised for COVID-19 preventative efforts, including vaccination.

Clinical characteristics of COVID-19 in patients with tuberculosis and factors associated with the disease severity

“…The second result suggests that the clinical diagnosis of COVID-19 in TB patients should not be based on taste and smell disorders, which are rare symptoms in TB patients. Among 538 patients in the global cohort study, they occurred in only 56 (10.4%) and 48 (8.9%) of patients ( TB/COVID-19 Global Study Group, 2021 ), compared to 1.3% and 1.3% in our cohort, respectively. That is, these symptoms are significantly more important for the diagnosis of COVID-19 in the absence of tuberculosis.…”

Impact of the COVID-19 pandemic on tuberculosis services

“…Since the beginning of 2020, the coronavirus disease 2019 (COVID-19) pandemic has caused a significant disruption in all areas of healthcare worldwide. 1 , 2 , 3 The functioning and response of many health services, including tuberculosis (TB) services, were profoundly affected by the policies adopted to respond to the pandemic, such as country lockdowns, reallocation of health professionals, materials, and diagnostic tools, and reduction of outpatient care. 4 , 5 , 6 , 7 , 8…”

Global reporting on tuberculosis preventive treatment among contacts

“…WHO urges governments and other stakeholders to urgently accelerate global coverage of TPT [ 10 ]. The COVID-19 pandemic makes this plea all the more pressing [ 11 – 13 ]. In addition, findings from the analysis in this letter make the case for countries to improve monitoring and reporting of key indicators at critical junctures of the cascade of preventive care and to make good use of digital technologies for this purpose and for other programmatic functions, including adherence support [ 14 ].…”