: Information on tuberculosis (TB) and COVID-19 is still limited. The aim of this study is to describe the features of the TB/COVID-19 co-infected individuals from a prospective, anonymised, multi-country register-based cohort with special focus on the determinants of mortality and other outcomes. We enrolled all patients of any age with either active TB or previous TB and COVID-19. 172 centres from 34 countries provided individual data on 767 TB-COVID-19 co-infected patients, (>50% population-based). Of 767 patients, 553/747 (74.0%) had TB before COVID-19 (including 234/747 with previous TB), 71/747 (9.5%) had COVID-19 first and 123/747 (16.5%) had both diseases diagnosed within the same week (35, 4.6% on the same day). 85/767 patients died (11.08%) (41/289 (14.2%) in Europe and 44/478 (9.2%) outside Europe; (p=0.03)): 42 (49.4%) from COVID-19, 31 (36.5%) from COVID-19 and TB, 1/85 (1.2%) from TB and 11 from other causes. In the univariate analysis on mortality the following variables reached statistical significance: age, being male, having >1 comorbidity; diabetes mellitus, cardiovascular disease, chronic respiratory disease, chronic renal disease, presence of key symptoms, invasive ventilation and hospitalisation due to COVID-19. The final multivariable logistic regression model included age, male gender, and invasive ventilation as independent contributors to mortality. The data suggests TB and COVID-19 are a "cursed duet" and need immediate attention. TB should be considered a risk factor for severe COVID disease and patients with TB should be prioritised for COVID-19 preventative efforts, including vaccination.

Tuberculosis and COVID-19 co-infection: description of the global cohort

Francesca Alladio;Andrea Calcagno;Alberto Gaviraghi;
2021

Abstract

: Information on tuberculosis (TB) and COVID-19 is still limited. The aim of this study is to describe the features of the TB/COVID-19 co-infected individuals from a prospective, anonymised, multi-country register-based cohort with special focus on the determinants of mortality and other outcomes. We enrolled all patients of any age with either active TB or previous TB and COVID-19. 172 centres from 34 countries provided individual data on 767 TB-COVID-19 co-infected patients, (>50% population-based). Of 767 patients, 553/747 (74.0%) had TB before COVID-19 (including 234/747 with previous TB), 71/747 (9.5%) had COVID-19 first and 123/747 (16.5%) had both diseases diagnosed within the same week (35, 4.6% on the same day). 85/767 patients died (11.08%) (41/289 (14.2%) in Europe and 44/478 (9.2%) outside Europe; (p=0.03)): 42 (49.4%) from COVID-19, 31 (36.5%) from COVID-19 and TB, 1/85 (1.2%) from TB and 11 from other causes. In the univariate analysis on mortality the following variables reached statistical significance: age, being male, having >1 comorbidity; diabetes mellitus, cardiovascular disease, chronic respiratory disease, chronic renal disease, presence of key symptoms, invasive ventilation and hospitalisation due to COVID-19. The final multivariable logistic regression model included age, male gender, and invasive ventilation as independent contributors to mortality. The data suggests TB and COVID-19 are a "cursed duet" and need immediate attention. TB should be considered a risk factor for severe COVID disease and patients with TB should be prioritised for COVID-19 preventative efforts, including vaccination.
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Nicolas Casco, Alberto Levi Jorge, Domingo Juan Palmero, Jan-Willem Alffenaar, Justin Denholm, Greg J Fox, Wafaa Ezz, Jin-Gun Cho, Alena Skrahina, Varvara Solodovnikova, Pierre Bachez, Alberto Piubello, Marcos Abdo Arbex, Tatiana Alves, Marcelo Fouad Rabahi, Giovana Rodrigues Pereira, Roberta Sales, Denise Rossato Silva, Muntasir M Saffie, Ruth Caamaño Miranda, Viviana Cancino, Monica Carbonell, Catalina Cisterna, Clorinda Concha, Arturo Cruz, Nadia Escobar Salinas, Macarena Espinoza Revillot, Joaquín Farías Valdés, Israel Fernandez, Ximena Flores, Patricia Gallegos Tapia, Ana Garavagno, Carolina Guajardo Vera, Martina Hartwig Bahamondes, Luis Moyano Merino, Eduardo Muñoz, Camila Muñoz, Indira Navarro, Jorge Navarro Subiabre, Carlos Ortega, Sofia Palma, Ana María Pradenas, Gloria Pereira, Patricia Perez Castillo, Mónica Pinto, Rolando Pizarro, Francisco Rivas Bidegain, Patricia Rodriguez, Cristina Sánchez, Angeles Serrano Salinas, Aline Soto, Carolina Taiba, Margarita Venegas, Maria Soledad Vergara Riquelme, Evelyn Vilca, Claudia Villalón, Edith Yucra, Yang Li, Andres Cruz, Beatriz Guelvez, Regina Victoria Plaza, Kelly Yoana Tello Hoyos, Claire Andréjak, François-Xavier Blanc, Samir Dourmane, Antoine Froissart, Armine Izadifar, Frédéric Rivière, Frédéric Schlemmer, Katerina Manika, Nitesh Gupta, Pranav Ish, Gyanshankar Mishra, Samridhi Sharma, Rupak Singla, Zarir F Udwadia, Boubacar Djelo Diallo, Souleymane Hassane-Harouna, Norma Artiles, Licenciada Andrea Mejia, Francesca Alladio, Fabio Angeli, Andrea Calcagno, Rosella Centis, Luigi Ruffo Codecasa, Lia D'Ambrosio, Angelo De Lauretis, Susanna Esposito, Beatrice Formenti, Alberto Gaviraghi, Vania Giacomet, Delia Goletti, Gina Gualano, Alberto Matteelli, Giovanni Battista Migliori, Ilaria Motta, Fabrizio Palmieri, Emanuele Pontali, Tullio Prestileo, Niccolò Riccardi, Laura Saderi, Matteo Saporiti, Giovanni Sotgiu, Claudia Stochino, Marina Tadolini, Alessandro Torre, Simone Villa, Dina Visca, Edvardas Danila, Saulius Diktanas, Ruy López Ridaura, Fátima Leticia Luna López, Marcela Muñoz Torrico, Adrian Rendon, Onno W Akkerman, Mahamadou Bassirou Souleymane, Seif Al-Abri, Fatma Alyaquobi, Khalsa Althohli, Edwin Aizpurua, Rolando Gonzales, Julio Jurado, Alejandra Loban, Sarita Aguirre, Rosarito Coronel Teixeira, Viviana De Egea, Sandra Irala, Angélica Medina, Guillermo Sequera, Natalia Sosa, Fátima Vázquez, Félix K Llanos-Tejada, Selene Manga, Renzo Villanueva -Villegas, David Araujo, Raquel Duarte, Tânia Sales Marques, Victor Ionel Grecu, Adriana Socaci, Olga Barkanova, Maria Bogorodskaya, Sergey Borisov, Andrei Mariandyshev, Anna Kaluzhenina, Tatjana Adzic Vukicevic, Maja Stosic, Darius Beh, Deborah Ng, Catherine W M Ong, Ivan Solovic, Keertan Dheda, Phindile Gina, José A Caminero, José Cardoso-Landivar, Maria Luiza De Souza Galvão, Angel Dominguez-Castellano, José-María García-García, Israel Molina Pinargote, Sarai Quirós Fernandez, Adrián Sánchez-Montalvá, Eva Tabernero Huguet, Miguel Zabaleta Murguiondo, Pierre-Alexandre Bart, Jesica Mazza-Stalder, Freya Bakko, James Barnacle, Annabel Brown, Shruthi Chandran, Kieran Killington, Kathy Man, Padmasayee Papineni, Simon Tiberi, Natasa Utjesanovic, Dominik Zenner, Jasie L Hearn, Scott Heysell, Laura Young
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