Abstract
Background Information on tuberculosis (TB) and coronavirus disease 2019 (COVID-19) is still limited. The aim of this study was to describe the features of the TB/COVID-19 co-infected individuals from a prospective, anonymised, multicountry register-based cohort with special focus on the determinants of mortality and other outcomes.
Methods 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).
Results Of 767 patients, 553 (74.0%) out of 747 had TB before COVID-19 (including 234 out of 747 with previous TB), 71 (9.5%) out of 747 had COVID-19 first and 123 (16.5%) out of 747 had both diseases diagnosed within the same week (n=35 (4.6%) on the same day). 85 (11.08%) out of 767 patients died (41 (14.2%) out of 289 in Europe and 44 (9.2%) out of 478 outside Europe; p=0.03): 42 (49.4%) from COVID-19, 31 (36.5%) from COVID-19 and TB, one (1.2%) from TB and 11 from other causes. In the univariate analysis on mortality the following variables reached statistical significance: age, male gender, having more than one 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.
Conclusion The data suggest that 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.
Abstract
High mortality (11%) was observed with COVID-19/TB co-infection associated with older age, male gender and invasive ventilation. Efforts to avoid SARS-CoV-2 infection in TB patients are recommended to prevent excess morbidity and mortality. https://bit.ly/3mSylCK
Footnotes
The contributors of the TB/COVID-19 Global Study Group are: Nicolas Casco, Alberto Levi Jorge, Domingo Juan Palmero (Argentina); Jan-Willem Alffenaar, Justin Denholm, Greg J. Fox, Wafaa Ezz, Jin-Gun Cho (Australia); Alena Skrahina, Varvara Solodovnikova (Belarus); Pierre Bachez, Alberto Piubello (Belgium); Marcos Abdo Arbex, Tatiana Alves, Marcelo Fouad Rabahi, Giovana Rodrigues Pereira, Roberta Sales, Denise Rossato Silva (Brazil); Muntasir M. Saffie (Canada); Ruth Caamaño Miranda, Viviana Cancino, Monica Carbonell, Catalina Cisterna, Clorinda Concha, Arturo Cruz, Nadia Escobar Salinas, Macarena Espinoza Revillot, Joaquín Farías Valdés, Israel Fernandez, Ximena Flores, Patricia Gallegos Tapia, Ana Garavagno, Carolina Guajardo Vera, Martina Hartwig Bahamondes, Luis Moyano Merino, Eduardo Muñoz, Camila Muñoz, Indira Navarro, Jorge Navarro Subiabre, Carlos Ortega, Sofia Palma, Ana María Pradenas, Gloria Pereira, Patricia Perez Castillo, Mónica Pinto, Rolando Pizarro, Francisco Rivas Bidegain, Patricia Rodriguez, Cristina Sánchez, Angeles Serrano Salinas, Aline Soto, Carolina Taiba, Margarita Venegas, Maria Soledad Vergara Riquelme, Evelyn Vilca, Claudia Villalón, Edith Yucra (Chile); Yang Li (China); Andres Cruz, Beatriz Guelvez, Regina Victoria Plaza, Kelly Yoana Tello Hoyos (Colombia); Claire Andréjak, François-Xavier Blanc, Samir Dourmane, Antoine Froissart, Armine Izadifar, Frédéric Rivière, Frédéric Schlemmer (France); Katerina Manika (Greece); Boubacar Djelo Diallo, Souleymane Hassane-Harouna (Republic of Guinea); Norma Artiles, Licenciada Andrea Mejia (Honduras); Nitesh Gupta, Pranav Ish, Gyanshankar Mishra, Samridhi Sharma, Rupak Singla, Zarir F. Udwadia (India); Francesca Alladio, Fabio Angeli, Andrea Calcagno, Rosella Centis, Luigi Ruffo Codecasa, Lia D'Ambrosio, Angelo De Lauretis, Susanna Esposito, Beatrice Formenti, Alberto Gaviraghi, Vania Giacomet, Delia Goletti, Gina Gualano, Alberto Matteelli, Giovanni Battista Migliori, Ilaria Motta, Fabrizio Palmieri, Emanuele Pontali, Tullio Prestileo, Niccolò Riccardi, Laura Saderi, Matteo Saporiti, Giovanni Sotgiu, Claudia Stochino, Marina Tadolini, Alessandro Torre, Simone Villa, Dina Visca (Italy); Edvardas Danila, Saulius Diktanas (Lithuania); Ruy López Ridaura, Fátima Leticia Luna López, Marcela Muñoz Torrico, Adrian Rendon (Mexico); Onno W. Akkerman (the Netherlands); Mahamadou Bassirou Souleymane (Niger); Seif Al-Abri, Fatma Alyaquobi, Khalsa Althohli (Oman); Edwin Aizpurua, Rolando Gonzales, Julio Jurado, Alejandra Loban (Panama); Sarita Aguirre, Rosarito Coronel Teixeira, Viviana De Egea, Sandra Irala, Angélica Medina, Guillermo Sequera, Natalia Sosa, Fátima Vázquez (Paraguay); Félix K. Llanos-Tejada, Selene Manga, Renzo Villanueva-Villegas (Peru); David Araujo, Raquel Duarte, Tânia Sales Marques (Portugal); Victor Ionel Grecu, Adriana Socaci (Romania); Olga Barkanova, Maria Bogorodskaya, Sergey Borisov, Andrei Mariandyshev, Anna Kaluzhenina (Russian Federation); Tatjana Adzic Vukicevic, Maja Stosic (Serbia); Darius Beh, Deborah Ng, Catherine W.M. Ong (Singapore); Ivan Solovic (Slovakia); Keertan Dheda, Phindile Gina (South Africa); José A Caminero, José Cardoso-Landivar, Maria Luiza De Souza Galvão, Angel Dominguez-Castellano, José-María García-García, Israel Molina Pinargote, Sarai Quirós Fernandez, Adrián Sánchez-Montalvá, Eva Tabernero Huguet, Miguel Zabaleta Murguiondo (Spain); Pierre-Alexandre Bart, Jesica Mazza-Stalder (Switzerland); Freya Bakko, James Barnacle, Annabel Brown, Shruthi Chandran, Kieran Killington, Kathy Man, Padmasayee Papineni, Simon Tiberi, Natasa Utjesanovic, Dominik Zenner (UK); Jasie L. Hearn, Scott Heysell, Laura Young (Virginia, USA).
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This article has an editorial commentary: https://doi.org/10.1183/13993003.00149-2022
Conflict of interest: None declared.
- Received September 21, 2021.
- Accepted November 1, 2021.
- Copyright ©The authors 2022.
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