Clinical characteristics and outcomes of patients with COVID-19 and tuberculosis coinfection

Infect Dis (Lond). 2023 Dec;55(12):839-846. doi: 10.1080/23744235.2023.2245885. Epub 2023 Aug 25.

Abstract

Background: Data on the coincidence of Tuberculosis (TB) and Coronavirus disease 2019 (COVID-19) are limited. We sought to investigate the clinical characteristics and outcomes of coinfected patients in Henan and identify whether TB disease is associated with an increased risk of intensive care unit (ICU) admission and mortality.

Method: We conducted a retrospective matched cohort study of COVID-19 inpatients involving 41 TB-positive patients with 82 patients without TB. Leveraging data was collected from electronic medical records.

Results: There were no significant differences in clinical manifestations, the need for mechanical ventilation and vasopressors, ICU admission, or in-hospital mortality between 2 groups. TB-positive patients had a lower lymphocyte counts (1.24 ± 0.54 vs. 1.59 ± 0.58, p = 0.01), B cells (99/µl vs. 201/µl, p < 0.01), CD4+ T cells (382/µl vs. 667/µl, p < 0.01), CD8+ T cells (243/µl vs. 423/µl, p < 0.01), NK cells (145/µl vs. 216/µl, p = 0.01), IL-2 (14.18 ± 11.23 vs. 31.86 ± 34.55, p < 0.01) and TNF-α (3.42 ± 2.93 vs. 5.62 ± 3.69, p < 0.01). Notably, the TB-positive group had a longer duration of SARS-CoV-2 shedding (67 days vs. 22 days, p < 0.01).

Conclusions: Concomitant TB does not significantly impact clinical outcomes of hospitalised patients with acute COVID-19. However, TB-positive patients had longer duration of SARS-COV-2-RNA positivity.

Keywords: Coronavirus disease 2019; SARS-CoV-2; in-patients; tuberculosis; viral shedding.

MeSH terms

  • COVID-19* / complications
  • COVID-19* / therapy
  • Cohort Studies
  • Coinfection* / epidemiology
  • Humans
  • Retrospective Studies
  • SARS-CoV-2
  • Tuberculosis* / complications