Login Register Cart 0
Generic placeholder image

Current Respiratory Medicine Reviews

Editor-in-Chief

ISSN (Print): 1573-398X
ISSN (Online): 1875-6387

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

Pulmonary Tuberculosis in Post COVID-19 Patients: Occurrence and Clinical Profile

Author(s): S. Vijayalakshmi, J.S. Akshata*, Anushree Chakraborthy, Swathi Karanth, Swapna Ramaswamy and Nagaraja Chikkavenkatappa

Volume 19, Issue 3, 2023

Published on: 19 July, 2023

Page: [239 - 243] Pages: 5

DOI: 10.2174/1573398X19666230706121915

Price: $65

Abstract

Background: Tuberculosis continues to be a major public health disease to date. The mortality of this disease, which was reducing till 2019, was reversed in 2020 and 2021, as per the global tuberculosis report 2022. The novel coronavirus disease 2019(COVID-19) pandemic has affected tuberculosis management in various aspects. The transient immunosuppression associated with the disease and the treatment modality has been speculated to activate latent tuberculosis infection as well as increase the infection risk with Mycobacterium Tuberculosis.

Objective: The aim of this study was to analyze the clinical characteristics of post-COVID-19 pulmonary tuberculosis patients.

Methods: We conducted a retrospective descriptive analysis of post-COVID-19 patients admitted from January 2021 to May 2022 with persistent or new-onset respiratory symptoms. The occurrence of pulmonary tuberculosis in these patients and their clinico- demographic details are summarized.

Results: About 31(19.4%) of 160 post-COVID-19 patients with respiratory symptoms were diagnosed to have pulmonary tuberculosis. About 21(67.7%) had comorbidities, of which the predominant was diabetes mellitus in 14(45%) patients, and the majority (85%) had poorly controlled blood sugar levels. None of the patients had a history of contact with a pulmonary tuberculosis patient in the previous 2 years, but 4(13%) patients had a previous history of tuberculosis. Moreover,.66% of cases had a history of moderate and severe COVID-19 disease, and 70% had received systemic corticosteroids and other immunosuppressive drugs like tocilizumab during the COVID-19 illness treatment. More than 50% of the patients had negative smears for acid-fast bacilli and were diagnosed using rapid molecular methods like CBNAAT and LPA. Drug-resistant tuberculosis was seen in 6(19%) patients. 4(13%) patients died during the hospitalized course of treatment, and the remaining 27(87%) were discharged with antituberculous treatment, but their final outcome is unknown.

Conclusion: A high index of suspicion and use of rapid molecular diagnostic methods is indicated in post-COVID-19 patients with respiratory symptoms for early diagnosis of tuberculosis and prevention of community transmission. Identification of post-COVID-19 patients with latent tuberculosis infection and the feasibility of advocation of tuberculosis preventive therapy in such patients, especially those with other risk factors like diabetes mellitus, need to be considered.

« Previous
Graphical Abstract

[1]
Long COVID or Post-COVID Conditions by Centre for Disease Control and prevention. 2022.2022. Available from: https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html#:~:text=Some%20people%20who%20have%20been,after%20initial%20COVID%2D19%20infection
[2]
Lopez-Leon S, Wegman-Ostrosky T, Perelman C, et al. More than 50 long-term effects of COVID-19: A systematic review and meta-analysis. Sci Rep 2021; 11(1): 16144.
[http://dx.doi.org/10.1038/s41598-021-95565-8] [PMID: 34373540]
[3]
World Health Organization. Global tuberculosis report 2022 2021. Available from: https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2022
[4]
Behera D. TB control in India in the COVID era. Indian J Tuberc 2021; 68(1): 128-33.
[http://dx.doi.org/10.1016/j.ijtb.2020.08.019] [PMID: 33641833]
[5]
Visca D, Ong CWM, Tiberi S, et al. Tuberculosis and COVID-19 interaction: A review of biological, clinical and public health effects. Pulmonology 2021; 27(2): 151-65.
[http://dx.doi.org/10.1016/j.pulmoe.2020.12.012] [PMID: 33547029]
[6]
Radu C, Cristina G, et al. Tuberculosis and COVID-19: Lessons from the Past Viral Outbreaks and Possible Future Outcomes. Can Respir J 2020; 2020: 1401053.
[7]
Walaza S, Cohen C, Tempia S, et al. Influenza and tuberculosis co‐infection: A systematic review. Influenza Other Respir Viruses 2020; 14(1): 77-91.
[http://dx.doi.org/10.1111/irv.12670] [PMID: 31568678]
[8]
Small CL, Shaler CR, McCormick S, et al. Influenza infection leads to increased susceptibility to subsequent bacterial superinfection by impairing NK cell responses in the lung. J Immunol 2010; 184(4): 2048-56.
[http://dx.doi.org/10.4049/jimmunol.0902772] [PMID: 20083661]
[9]
Diao B, Wang C, et al. Reduction and Functional Exhaustion of T Cells in Patients with Coronavirus Disease 2019 (COVID-19). Front Immunol 2019; 11: 827.
[http://dx.doi.org/10.3389/fimmu.2020.00827] [PMID: 32425950]
[10]
Zheng M, Gao Y, Wang G, et al. Functional exhaustion of antiviral lymphocytes in COVID-19 patients. Cell Mol Immunol 2020; 17(5): 533-5.
[http://dx.doi.org/10.1038/s41423-020-0402-2] [PMID: 32203188]
[11]
National Tuberculosis Association of the USA. Diagnostic Standards and Classification of Tuberculosis. New York: National Tuberculosis Association 1961.
[12]
Aqusa Z, Nousheen I, et al. Post COVID-19 tuberculosis: An emerging threat of pandemic. Monaldi Arch Chest Dis 2021; 91(3)
[13]
Tadolini M, Codecasa LR, García-García JM, et al. Active tuberculosis, sequelae and COVID-19 co-infection: First cohort of 49 cases. Eur Respir J 2020; 56(1): 2001398.
[http://dx.doi.org/10.1183/13993003.01398-2020] [PMID: 32457198]
[14]
Alemu A, Bitew ZW, Seid G, et al. Tuberculosis in individuals who recovered from COVID-19: A systematic review of case reports. PLoS One 2022; 17(11): e0277807.
[http://dx.doi.org/10.1371/journal.pone.0277807] [PMID: 36441785]
[15]
Anitha S, Raj SP. A battle against Covid -19 and tuberculosis – a case series of six post Covid tuberculosis. Int J Med Sci Clinic Res Rev 2022; 5(5): 890-5.
[16]
Aguillón-Durán GP, Prieto-Martínez E, Ayala D, et al. COVID-19 and chronic diabetes: The perfect storm for reactivation tuberculosis?: A case series. J Med Case Reports 2021; 15(1): 621.
[http://dx.doi.org/10.1186/s13256-021-03193-7] [PMID: 34915933]
[17]
Baker MA, Harries AD, Jeon CY, et al. The impact of diabetes on tuberculosis treatment outcomes: A systematic review. BMC Med 2011; 9(1): 81.
[http://dx.doi.org/10.1186/1741-7015-9-81] [PMID: 21722362]
[18]
Gopalaswamy R, Subbian S. Corticosteroids for COVID-19 Therapy: Potential Implications on Tuberculosis. Int J Mol Sci 2021; 22(7): 3773.
[http://dx.doi.org/10.3390/ijms22073773] [PMID: 33917321]
[19]
Reisinger AC, Hermann J, Vagena FR, Hackl G, Eller P. Tuberculosis sepsis after tocilizumab treatment. Clin Microbiol Infect 2020; 26(11): 1493-4.
[http://dx.doi.org/10.1016/j.cmi.2020.05.030] [PMID: 32512231]
[20]
Friedman A, DeGeorge KC. Reactivation of latent tuberculosis in a COVID-19 patient on corticosteroid treatment. BMJ Case Rep 2022; 15(5): e247562.
[http://dx.doi.org/10.1136/bcr-2021-247562] [PMID: 35545310]
[21]
Khayat M, Fan H, Vali Y. COVID-19 promoting the development of active tuberculosis in a patient with latent tuberculosis infection: A case report. Respir Med Case Rep 2021; 32: 101344.
[http://dx.doi.org/10.1016/j.rmcr.2021.101344] [PMID: 33495728]
[22]
Guidelines for programmatic management of tuberculosis preventive treatment in India 2021.

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy