A Novel Viral Epidemic Collides with an Ancient Scourge: COVID-19 Associated with Tuberculosis

Cutler, Todd; Scales, David; Levine, William; Schluger, Neil W.; O’Donnell, Max R

doi:10.1164/rccm.202003-0828im

Cited by 14 publications

(24 citation statements)

References 3 publications

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“…This needs careful interpretation due to a wide overall 95% CI as well as due to studies with different designs. This evidence is supported by two large cohort studies conducted in Spain and South Africa, showing that the risks for PCR-con rmed COVID-19 diagnosis, hospitalization, Intensive Care Unit (ICU) admission, and death among HIVpositive persons receiving ART were greater in men compared to old age [42][43][44][45][46][47][48]. However, the risk for hospitalization varied by the nucleoside transcriptase inhibitor (NRTI) regimen and was lower in patients receiving TDF/FTC versus those receiving other regimens [42][43][44][45][46][47][48].…”

Section: Discussionmentioning

confidence: 87%

“…Each article that met selection criteria was fundamentally assessed for Author/Country, Population/Study design, Exposures, Comparators, Treatments, TB occurrence and SARS/MERS/COVID-19 severity, recovery and mortality rate. [28][29][30][31], one case control study [32] and four case series [33][34][35][36] were conducted in China, two case series [37][38] were done in Singapore, one case series [39] and one case control study [40] were undertaken in Saudi Arabia, a case series [41] was conducted in Italy, one cohort study was done in South Africa [42] and another in the Philippines [43], one case study was conducted in the United State of America [44], other three case studies were found in Turkey [45], Hong Kong [46] and India [47] respectively.…”

Section: Search Resultsmentioning

confidence: 99%

“…SARS-CoV and HIV may decrease conjunctly CD4 count and lymphocytes, adding high corticosteroids [33] as a treatment for SARS-CoV may be TB precipitant factors [33]. Following this, SARS-CoV or COVID-19 patients may-be more susceptible to active and latent TB as proven by different studies [27,33,[44][45][46][47]. It is important to realize that lung lesions due to SARS and/or TB may increase signi cantly the likelihood of SARS-CoV and TB.…”

Section: Discussionmentioning

confidence: 99%

“…Eight out of fourteen had severe/critical disease course among which one case of SARS-CoV, one of MERS-CoV and six cases of COVID-19 and had a long recovery process. SARS-CoV or COVID-19 cases with PTB co-infection: Seven studies (an observational study, two case series and four case studies) [27,33,35,[44][45][46][47] diagnosed PTB (positive acid-fast bacilli smear on sputum samples or IGRA), while cases were admitted for SARS-CoV (two cases) and COVID-19 (twelve cases). SARS-CoV and COVID-19 were con rmed by RT-PCR, and microscopy as well as medical imaging diagnosed TB.…”

Section: Descriptive Analysismentioning

confidence: 99%

“…In fact, TB is the leading immune-suppressing infection and the most common cause of death among HIV-infected patients [8]. Worldwide, there were 37.9 million [32.7 million- 44.0 million] people living with HIV and 1.7 million [1.4 million-2.3 million] people became newly infected with HIV at the end of 2018 [9]. WHO reports that people living with HIV are 20 times more likely to develop TB than their counterparts [10].…”

Section: Introductionmentioning

confidence: 99%

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Implications of COVID-19 in high burden countries for HIV/TB: A systematic review of evidence

Tamuzi

Birhanu

Shumba³

et al. 2020

Preprint

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Background: The triple burden of COVID-19, tuberculosis and human immunodeficiency virus is one of the major global health challenges of the 21st century. In high burden HIV/TB countries, the spread of COVID-19 among people living with HIV is a well-founded concern. A thorough understanding of HIV/TB and COVID-19 pandemics is important as the three diseases interact. This may clarify HIV/TB/COVID-19 as a newly related field. However, several gaps remain in the knowledge of the burden of COVID-19 on patients with TB and HIV. This study was conducted to review different studies on SARS-CoV, MERS-CoV or COVID-19 associated with HIV/TB co-infection or only TB, to understand the interactions between HIV, TB and COVID-19 and its implications on the burden of the COVID-19 among HIV/TB co-infected or TB patients, screening algorithm and clinical management.Methods: We conducted an electronic search of potentially eligible studies published in English in the Cochrane Controlled Register of Trials, PubMed, Medrxiv, Google scholar and Clinical Trials Registry databases. We included case studies, case series and observational studies published between January, 2002 and July, 2020 in which SARS-CoV, MERS-CoV and COVID-19 co-infected to HIV/TB or TB in adults. We screened titles, abstracts and full articles for eligibility. Descriptive and meta-analysis were done and results have been presented in graphs and tables.Results: After removing 95 duplicates, 58 out of 437 articles were assessed for eligibility, of which 14 studies were included for descriptive analysis and seven studies were included in the meta-analysis. Compared to the descriptive analysis, the meta-analysis showed strong evidence that current TB exposure was high-risk COVID-19 group (OR 1.67, 95% CI 1.06-2.65, P= 0.03). The pooled of COVID-19/TB severity rate increased from OR 4.50 (95% CI 1.12-18.10, P=0.03), the recovery rate was high among COVID-19 compared to COVID-19/TB irrespective of HIV status (OR 2.23, 95% CI 1.83-2.74, P < 0.001) and the mortality was reduced among non-TB group (P<0.001).Conclusion: In summary, TB was a risk factor for COVID-19 both in terms of severity and mortality irrespective of HIV status. Structured diagnostic algorithms and clinical management are suggested to improve COVID-19/HIV/TB or COVID-19/TB co-infections outcomes.

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