We read with great interest the research letter by TADOLINI et al. [1], in which they have published the first cohort of 49 cases of tuberculosis (TB) and coronavirus disease 20019 (COVID-19) co-infection. However, a few issues regarding the letter need to be addressed. The authors categorised the patients with TB and COVID-19 co-infection into 3 groups based on timing of their diagnosis. However, in view of the difference in the natural history of TB (chronic course) and COVID-19 (acute), categorising 14 patients as having COVID-19 prior to TB (median time interval of 4 days between the two diagnosis) and nine as diagnosed simultaneously (within the same week) seems inappropriate. Since TB has an insidious onset, it is obvious that TB was present before COVID-19 infection in both the subgroups, although the diagnosis was made at different times. In fact, it may be right to say that all the three subgroups actually constitute a single group of old/active TB patients who developed COVID-19 infection. COVID-19 has probably just unmasked some of the subtle active TB cases that were responsible for hidden transmission in the general population [2]. Superimposed COVID-19 has brought them to the hospital to get a timely diagnosis.

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Introduction OSA has been postulated to be associated with mortality in COVID-19, but studies are lacking thereof. This study was done to estimate the prevalence of OSA in patients with COVID-19 using various screening questionnaires and to assess effect of OSA on outcome of disease. Methodology In this prospective observational study, consecutive patients with RT-PCR confirmed COVID-19 were screened for OSA by different questionnaires (STOPBANG, Berlin Questionnaire, NoSAS, and Epworth Scale). Association between OSA, outcome (mortality) and requirement for respiratory support was assessed. Results In study of 213 patients; screening questionnaires for OSA [STOPBANG, Berlin Questionnaire (BQ), NoSAS] were more likely to be positive in patients who died compared to patients who survived. On binary logistic regression analysis, age ≥ 55 and STOPBANG score ≥ 5 were found to have small positive but independent effect on mortality even after adjusting for other variables. Proportion of patients who were classified as high risk for OSA by various OSA screening tools significantly increased with increasing respiratory support ( p < 0.001 for STOPBANG, BQ, ESS and p = 0.004 for NoSAS). Conclusion This is one of the first prospective studies of sequentially hospitalized patients with confirmed COVID-19 status who were screened for possible OSA could be an independent risk factor for poor outcome in patients with COVID-19.