Latent Mycobacterium Tb Reactivation in Two Patients With Covid-19 Pneumonia

Younes, Islam; Noori, Muhammad Atif Masood; Elkattawy, Sherif; Viechweg, John; Nwachukwu, Onyeka

doi:10.1016/j.chest.2021.07.459

Cited by 4 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Then, the remaining 2337 studies were screened by title and abstract. Full-text screening was conducted for 23 studies, and finally, data were extracted from 21 studies comprising [11][12][13][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] 33 individual cases (Fig 1). The studies were reported from 13 countries with the highest frequency from the United States of America (10 patients), and Tu ¨rkiye (eight patients) followed by Bangladesh (three patients), and Mexico (three patients).…”

Section: Resultsmentioning

confidence: 99%

Tuberculosis in individuals who recovered from COVID-19: A systematic review of case reports

et al. 2022

View full text Add to dashboard Cite

Background The emergence of COVID-19 overwhelmed tuberculosis (TB) prevention and control, resulting in a decrease in TB detection rate and an increase in TB deaths. Furthermore, the temporary immunosuppressive effects, lung inflammation, and the corticosteroids used to treat COVID-19, may play a direct role in immunosuppression, leading to reactivation of either previous infection or latent TB or the development of new TB. Thus, the aim of this study was to review TB incidence in individuals who recovered from COVID-19. Methods We conducted a systematic search of available databases for previously published studies that reported TB in COVID-19 survivors. The PRISMA checklist was used to guide the review, and the JBI checklist was used to evaluate the study’s quality. The descriptive data were summarized. Results Data were extracted from 21 studies conducted in 13 countries having 33 cases. The median age was 44 years (range; 13.5–80), and more than half (18, 54.5%) were males. Twelve patients immigrated from TB endemic settings. All 17 patients assessed for HIV were seronegative, and all 11 patients assessed for BCG vaccination status were vaccinated. The majority (20, 69%) of patients had some type of comorbidity with diabetes (12/29) and hypertension (9/29) being the most common. Four patients (30.77%) had a history of TB. Corticosteroids were used to treat COVID-19 in 62.5% (10) of individuals. Dexamethasone, remdesivir, azithromycin, hydroxychloroquine, and enoxaparin were the most commonly used drugs to treat COVID-19. The most common TB symptoms were fever, cough, weight loss, dyspnea, and fatigue. Twenty, eleven, and two patients developed pulmonary, extrapulmonary, and disseminated/miliary TB respectively. It may take up to seven months after COVID-19 recovery to develop tuberculosis. Data on the final treatment outcome was found for 24 patients, and five patients died during the anti-TB treatment period. Conclusion Tuberculosis after recovering from COVID-19 is becoming more common, potentially leading to a TB outbreak in the post-COVID-19 era. The immunosuppressive nature of the disease and its treatment modalities may contribute to post COVID-19 TB. Thus, we recommend a further study with a large sample size. Furthermore, we recommend feasibility studies to assess and treat latent TB in COVID-19 patients residing in TB endemic counties since treatment of latent TB is done only in TB non-endemic countries.

show abstract

Section: Resultsmentioning

confidence: 99%

Tuberculosis in individuals who recovered from COVID-19: A systematic review of case reports

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Bronchial washing PCR came out to be positive for Mycobacterium TB. 12 Gandotra et al reported a case of 47-year-old male presented with fever and dry cough for two weeks. The patient tested positive for COVID-19.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of reactivation of tuberculosis due to use of corticosteroids for COVID-19 treatment between January 2020 to January 2022

Tewari

Yadav²

2022

Int J Basic Clin Pharmacol

View full text Add to dashboard Cite

Coronavirus-19 disease became a matter of concern for the whole world and WHO declared it as pandemic on 11 March 2020. Soon a number of clinical trials started to check for the treatment modalities, to compare their efficacy and safety. Out of which corticosteroids in trials showed decrease in mortality in severe COVID-19 patients. However existing diseases such as tuberculosis still remains a leading killer and matter of concern. One out of four individuals are said to be having tuberculosis (mostly in inactive form or latent form) but there remains a threat of reactivation of tuberculosis in presence of risk factors such as corticosteroid administration as it causes immunosuppression. This is a retrospective observational study on reactivation of tuberculosis due to corticosteroids used in COVID-19 treatment. Most commonly given corticosteroid was found to be dexamethasone and the duration of corticosteroid therapy ranged between 5 to 12 days. Majority of patients (5 out of 6) showed reactivation of tuberculosis within 30 days of starting of corticosteroid therapy and most common co-morbidity associated was found to be diabetes mellitus followed by hypertension in such patients. Symptoms of 4 out of 6 patients resolved after starting of anti-tubercular therapy.

show abstract

“…Another case of 71year-old male with diabetes mellitus developed tuberculosis after being treated with dexamethasone for COVID-19 infection. 12 Noh et al reported a case of 80-year-old female who was a known case of hypertension and coronary artery disease presenting with pulmonary tuberculosis 3 months after being treated with tocilizumab and corticosteroids for COVID-19 infection. 13 Pozdnyakov et al reported a case of 64-year-old male who developed pulmonary tuberculosis after treatment of COVID-19 infection with methylprednisolone.…”

Section: Methodsmentioning

confidence: 99%

COVID-19 and tuberculosis reactivation: a systematic review assessing most common risk factors

Tewari

Yadav²

2022

Int J Basic Clin Pharmacol

View full text Add to dashboard Cite

COVID-19 as a pandemic not only shifted the focus of the healthcare system from other diseases but also affected the disease progression of infections like tuberculosis which remained a leading killer in the past worldwide. COVID-19 itself is said to reactivate latent tuberculosis as shown in animal experiments. Immunomodulators such as corticosteroids and tocilizumab which are being used for covid treatment even further predisposes patients to tuberculosis reactivation and increased progression of the disease. Diabetes is already known to be a risk factor for tuberculosis reactivation and impact tuberculosis progression and worsen the situation. The exact mechanism of interaction of covid-19 and tuberculosis and their effect on each other remains unknown. Considering high prevalence of tuberculosis and the current scenario of covid-19 in world, there is need to study the impact of covid-19 infection on tuberculosis progression or reactivation and commonly associated risk factors. We conducted a systematic search of the online databases to collect data of patients who had tuberculosis reactivation or increased progression of disease after covid-19 infection. Data of a total of 18 patients was retrieved and used for the syntheses of the study. Diabetes was present in 50% of the patients. 55.5% patients were administered corticosteroids for covid-19 treatment later presenting with tuberculosis. Tocilizumab however was administered to 22.2% patients who also received corticosteroids. 27.7% patients suffered tuberculosis reactivation after covid-19 infection without history of diabetes and corticosteroid or tocilizumab administration. None of the patients were reported to have HIV infection. Major risk factors present in patients included corticosteroid administration and diabetes. However, tuberculosis reactivation was seen even in absence of these factors indicating that covid-19 infection may itself be responsible for tuberculosis reactivation. The exact mechanism however remains unknown and further clinical studies are needed to know the same.

show abstract

Latent Mycobacterium Tb Reactivation in Two Patients With Covid-19 Pneumonia

Cited by 4 publications

References 0 publications

Tuberculosis in individuals who recovered from COVID-19: A systematic review of case reports

Tuberculosis in individuals who recovered from COVID-19: A systematic review of case reports

A systematic review of reactivation of tuberculosis due to use of corticosteroids for COVID-19 treatment between January 2020 to January 2022

COVID-19 and tuberculosis reactivation: a systematic review assessing most common risk factors

Contact Info

Product

Resources

About