Tuberculosis and COVID-19: An overlapping situation during pandemic

Abstract

Introduction: The novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the coronavirus disease 2019 (COVID-19). First COVID-19 case was detected in March, 10, 2020 in Turkey and as of May, 18, 2020 148,067 cases have been identified and 4096 citizens have died. Tuberculosis (TB) is a worldwide public health concern, incidence of tuberculosis (per 100,000 people) in Turkey was reported at 14, 1 in 2018. During pandemic COVID-19 was the main concern in every clinic and as we discuss here overlapping respiratory diseases may result in delaying of the diagnosis and treatment.
 Methodology: There were 4605 respiratory samples examined between March 23 and May 18 for COVID-19 and 185 samples for Mycobacterium tuberculosis in our laboratory. The Xpert Ultra assay was performed for the diagnosis of pulmonary tuberculosis; SARS-CoV-2 RNA was determined by real-time PCR (RT-PCR) analysis in combined nasopharyngeal and deep oropharyngeal swabs of suspected cases of COVID-19.
 Results: Both of SARS-CoV-2 and M. tuberculosis tests were requested on the clinical and radiological grounds in 30 patients. Here we discussed 2 patients who were both COVID-19 and TB positive. One patient already diagnosed with tuberculosis become COVID-19 positive during hospitalization and another patient suspected and treated for COVID-19 received the final diagnosis of pulmonary TB and Human Immunodeficiency Virus infection.
 Conclusions: We want to emphasize that while considering COVID-19 primarily during these pandemic days, we should not forget one of the “great imitators”, tuberculosis within differential diagnoses.

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“…[22] Some studies suggested that PLWH with tuberculosis infection are more susceptible to SARS-CoV-2 infection. [23,24] However, reports about PLWH with OIs and SARS-CoV-2 infection are limited. [25] On the other hand, the common OIs in PLWH are tuberculosis, pneumocystis pneumonia, and bacterial pneumonia, all of which can cause lung damage, [26] and injure the local pulmonary immunity.…”

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“…It is known that the emergence of MDR-TB and the pandemic of novel coronavirus in recent years have posed a major threat to global TB prevention and control (60,61). Immune dysfunction in TB patients and the emergence of Mtb resistant strains lead to unsatisfactory therapeutic effects, so it is critical to find a new therapeutic regimen.…”