Clinical manifestations of active tuberculosis patients coinfected with severe acute respiratory syndrome coronavirus-2

Gul Habib; Khalid Mahmood; Latif Ahmad; Haji Gul; Azam Hayat; Mujaddad Ur Rehman

doi:10.1016/j.jctube.2023.100359

Clinical manifestations of active tuberculosis patients coinfected with severe acute respiratory syndrome coronavirus-2

J Clin Tuberc Other Mycobact Dis. 2023 May:31:100359. doi: 10.1016/j.jctube.2023.100359. Epub 2023 Mar 5.

Authors

Gul Habib¹, Khalid Mahmood², Latif Ahmad³, Haji Gul⁴, Azam Hayat¹, Mujaddad Ur Rehman¹

Affiliations

¹ Department of Microbiology, Abbottabad University of Science and Technology, Havelian Abbottabad, Pakistan.
² National Institute of Virology, Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan.
³ Department of Biology, Women University, Swabi, Pakistan.
⁴ Faculty of Veterinary and Animal Sciences, Gomal University, Dera Ismail Khan, 29220, Pakistan.

Abstract

Summary background: The coronavirus 2019 pandemic was caused by a new single-strand RNA virus that originated from Wuhan, China, and infected more than 190 countries. The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) coinfection with tuberculosis posed a serious public health concern and complicated the prognosis and treatment of patients. Since both are respiratory diseases, the sign and symptoms may overlap and could have synergistic effects on the host that can increase mortality during coinfection. The present investigation reported the clinical characteristics of patients having coinfection of COVID-19 and tuberculosis (COVID-TB).

Methods: We performed a retrospective investigation on COVID-19 infection in tuberculosis patients between the years 2020 and 2021. The SARS-CoV-2 was confirmed by PCR and the COVID-TB epidemiological and clinical findings were recorded on the day of admission and followed up for 25 days.

Results: The mean age of the COVID-19 patients was 50 ± 15 years, 76.36% were male and 23.64% were female. Weight loss, sore throat, whooping cough, chest pain, and vomiting were common symptoms, and asthma, diabetes, arthritis, and hypertension were found as co-morbidities in COVID-TB. The D-dimer, lactate dehydrogenase, C-reactive protein, erythrocyte sedimentation rate, and creatine kinase levels increased 14-fold, 12.5-fold, 11-fold, 10-fold, and 7-fold respectively during COVID-TB. The patients suffered from hyperferritinemia and lymphocytopenia which increased the likelihood of death. The levels of D-dimer, lactate dehydrogenase, C-reactive protein, erythrocyte sedimentation rate, and creatinine kinase were positively correlated with patient age. The chest radiograph showed the infectious agents have consolidated opacity and peripheral dissemination in the lungs.

Conclusion: Tuberculosis coinfection augmented the severity of COVID-19 and the likelihood of death, and high vigilance is recommended for respiratory pathogens in COVID-19.

Keywords: Creatine kinase; D-dimer; Erythrocyte sedimentation rate; Lactate dehydrogenase; SARS-CoV-2; Tuberculosis.