First case series and literature review of coronavirus disease 2019 (COVID-19) associated pulmonary tuberculosis in Southeast Asia: Challenges and opportunities

J Infect Public Health. 2023 Jan;16(1):80-89. doi: 10.1016/j.jiph.2022.11.029. Epub 2022 Nov 29.

Abstract

Background: Subclinical tuberculosis (TB) is accidentally detected by radiologic and microbiologic findings. Transmission by those with subclinical TB could delay prevention effort. However, our study demonstrated positive aspect of COVID-19 outbreak as it could allow subclinical TB to be detected faster through a chest X-Ray (CXR).

Methods: This cross-sectional cohort study aimed to report demographics, comorbidities, and outcomes related to early detection of TB among COVID-19 patients, and to elaborate the association between SARS-CoV-2 and pulmonary TB. Data of patients with SARS-CoV-2 co-infection with Mycobacterium tuberculosis (MTB) diagnosed between March 2020 - March 2022 was collected.

Results: Out of 12,275 COVID-19 patients, 26 were definitively diagnosed with MTB infection (mean age 48.16 ± 20.17 years). All cases that had suspicious CXR that were not typical for COVID-19, were tested for MTB. On average, pulmonary TB was diagnosed after admission 5(3-10) days, the treatment initiation period was 3(1-5) days from the TB diagnosis.

Conclusions: This suggests an early detection of tuberculosis among COVID-19 patients by quicker screening CXR and sputum comparing to previous symptom guided screening. Thereby reducing the chance of TB transmission demonstrated during COVID-19 pandemic. So, clinicians should be aware of pulmonary tuberculosis in COVID-19 patients with atypical radiologic findings.

Keywords: COVID-19; Mycobacterium tuberculosis; SARS-CoV-2; Subclinical tuberculosis.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Asia, Southeastern / epidemiology
  • COVID-19* / epidemiology
  • Cross-Sectional Studies
  • Humans
  • Middle Aged
  • Mycobacterium tuberculosis*
  • Pandemics
  • SARS-CoV-2
  • Sputum / microbiology
  • Tuberculosis* / epidemiology
  • Tuberculosis, Pulmonary* / complications
  • Tuberculosis, Pulmonary* / diagnosis
  • Tuberculosis, Pulmonary* / epidemiology