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

Tulip A Jhaveri; Celia Fung; Allison N LaHood; Andrew Lindeborg; Chengbo Zeng; Rifat Rahman; Paul A Bain; Gustavo E Velásquez; Carole D Mitnick

doi:10.3390/jcm11195656

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

J Clin Med. 2022 Sep 26;11(19):5656. doi: 10.3390/jcm11195656.

Authors

Tulip A Jhaveri^{1

2}, Celia Fung³, Allison N LaHood⁴, Andrew Lindeborg⁴, Chengbo Zeng⁴, Rifat Rahman⁴, Paul A Bain⁵, Gustavo E Velásquez^{6

7

8}, Carole D Mitnick^{4

8}

Affiliations

¹ Division of Infectious Diseases, Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA.
² Division of Medical Microbiology, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
³ Department of Neurology, Yale New Haven Hospital, New Haven, CT 06510, USA.
⁴ Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA.
⁵ Francis A. Countway Library of Medicine, Harvard Medical School, Boston, MA 02115, USA.
⁶ UCSF Center for Tuberculosis, University of California San Francisco, San Francisco, CA 94110, USA.
⁷ Division of HIV, Infectious Diseases, and Global Medicine, University of California San Francisco, San Francisco, CA 94110, USA.
⁸ Division of Global Health Equity, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.

Abstract

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.

Keywords: COVID-19; SARS-CoV-2; comorbidity; mortality; pre-vaccination; systematic review; tuberculosis.

Publication types

Review

Abstract

Publication types

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