Tuberculosis, COVID-19 and hospital admission: Consensus on pros and cons based on a review of the evidence

Migliori, Giovanni Battista; Visca, Dina; Boom, Martin van den; Tiberi, Simon; Silva, Denise Rossato; Centis, Rosella; D’Ambrosio, Lia; Thomas, Tania A; Pontali, Emanuele; Saderi, Laura; Schaaf, H. Simon; Sotgiu, Giovanni

doi:10.1016/j.pulmoe.2020.12.016

Cited by 26 publications

(28 citation statements)

References 42 publications

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“…Another important question arising from previous studies [ 10 , 14 , 18 , 27 ] relates to the resources required for managing patients with TB and COVID-19. The study results indicate that an important proportion of patients needed ventilation (18%.…”

Section: Discussionmentioning

confidence: 99%

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

Ong¹

2021

Eur Respir J

110

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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.

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Section: Discussionmentioning

confidence: 99%

“…Last but not least, the experience gained during the COVID-19 pandemic will allow us to make better use of telemedicine interventions, thus reducing the burden of physical access to health services and transmission. Unnecessary hospitalisation should be actively discouraged [ 7 , 9 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

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

Ong¹

2021

Eur Respir J

110

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“…The following paragraphs educationally describe the stages so far included in the TB spectrum of disease. New insights into TB pathogenesis are also considered [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

The definition of tuberculosis infection based on the spectrum of tuberculosis disease

Migliori

Ong

Petrone

et al. 2021

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Latent tuberculosis infection was the term traditionally used to indicate tuberculosis (TB) infection. This term was used to define “a state of persistent immune response to stimulation by Mycobacterium tuberculosis antigens through tests such as the tuberculin skin test (TST) or an interferon-γ release assay (IGRA) without clinically active TB”. Recent evidence indicates that the spectrum from TB infection to TB disease is much more complex, including a “continuum” of situations didactically reported as uninfected individual, TB infection, incipient TB, subclinical TB without signs/symptoms, subclinical TB with unrecognised signs/symptoms, and TB disease with signs/symptoms. Recent evidence suggests that subclinical TB is responsible for important M. tuberculosis transmission. This review describes the different stages described above and their relationships. It also summarises the new developments in prevention, diagnosis and treatment of TB infection as well as their public health and policy implications.Educational aimsTo describe the evolution of the definition of “tuberculosis infection” and didactically describe the continuum of stages existing between TB infection and disease.To discuss the recommended approaches to prevent, diagnose and treat TB infection.

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“…As sucessivas ondas de COVID-19 têm sobrecarregado de forma distinta as UTIs dos países afetados, e os quadros tradicionalmente envolvidos no manejo clínico da tuberculose (pneumologistas e especialistas em doenças infecciosas) parecem desempenhar um papel central na resposta de primeira linha à pandemia de COVID-19. (6,16,17)…”

Section: Manejo Clínicounclassified

“…The subsequent waves of COVID-19 have differently burdened the ICUs in the affected countries, and the cadres traditionally involved in the clinical management of tuberculosis (pulmonologists and specialists in infectious diseases) seem to play a central role in the first-line response to the COVID-19 pandemic. 6 , 16 , 17 …”

Section: Clinical Managementmentioning

confidence: 99%

Tuberculosis and COVID-19, the new cursed duet: what differs between Brazil and Europe?

et al. 2021

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Em 1º de abril de 2020, a COVID-19 ultrapassou a tuberculose em número de óbitos por dia no mundo. A associação da tuberculose com a COVID-19 apresenta grande potencial de morbidade e mortalidade. Além disso, a pandemia de COVID-19 tem tido um impacto significativo no diagnóstico e tratamento da tuberculose. Neste artigo de revisão, abordamos tuberculose e COVID-19 concomitantes, com particular atenção às diferenças entre Brasil e Europa. Além disso, discutimos as prioridades em atendimento clínico, saúde pública e pesquisa. Descritores: Tuberculose; Infecções por coronavirus; Betacoronavirus; Coronavirus.

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Tuberculosis, COVID-19 and hospital admission: Consensus on pros and cons based on a review of the evidence

Cited by 26 publications

References 42 publications

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

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

The definition of tuberculosis infection based on the spectrum of tuberculosis disease

Tuberculosis and COVID-19, the new cursed duet: what differs between Brazil and Europe?

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