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

Migliori, G. B.; Casco, N.; Jorge, A. L.; Palmero, D. J.; Alffenaar, J. -W.; Denholm, J.; Fox, G. J.; Ezz, W.; Cho, J. -G.; Skrahina, A.; Solodovnikova, V.; Bachez, P.; Piubello, A.; Arbex, M. A.; Alves, T.; Rabahi, M. F.; Pereira, G. R.; Sales, R.; Silva, D. R.; Saffie, M. M.; Miranda, R. C.; Cancino, V.; Carbonell, M.; Cisterna, C.; Concha, C.; Cruz, A.; Salinas, N. E.; Revillot, M. E.; Valdes, J. F.; Fernandez, I.; Flores, X.; Tapia, P. G.; Garavagno, A.; Vera, C. G.; Bahamondes, M. H.; Merino, L. M.; Munoz, E.; Munoz, C.; Navarro, I.; Subiabre, J. N.; Ortega, C.; Palma, S.; Pradenas, A. M.; Pereira, G.; Castillo, P. P.; Pinto, M.; Pizarro, R.; Bidegain, F. R.; Rodriguez, P.; Sanchez, C.; Salinas, A. S.; Soto, A.; Taiba, C.; Venegas, M.; Riquelme, M. S. V.; Vilca, E.; Villalon, C.; Yucra, E.; Li, Y.; Cruz, A.; Guelvez, B.; Plaza, R. V.; Hoyos, K. Y. T.; Andrejak, C.; Blanc, F. -X.; Dourmane, S.; Froissart, A.; Izadifar, A.; Riviere, F.; Schlemmer, F.; Manika, K.; Diallo, B. D.; Hassane-Harouna, S.; Artiles, N.; Mejia, L. A.; Gupta, N.; Ish, P.; Mishra, G.; Sharma, S.; Singla, R.; Udwadia, Z. F.; Alladio, F.; Angeli, F.; Calcagno, A.; Centis, R.; Codecasa, L. R.; D'Ambrosio, L.; De Lauretis, A.; Esposito, S.; Formenti, B.; Gaviraghi, A.; Giacomet, V.; Goletti, D.; Gualano, G.; Matteelli, A.; Migliori, G. B.; Motta, I.; Palmieri, F.; Pontali, E.; Prestileo, T.; Riccardi, N.; Saderi, L.; Saporiti, M.; Sotgiu, G.; Stochino, C.; Tadolini, M.; Torre, A.; Villa, S.; Visca, D.; Danila, E.; Diktanas, S.; Ridaura, R. L.; Lopez, F. L. L.; Torrico, M. M.; Rendon, A.; Akkerman, O. W.; Souleymane, M. B.; Al-Abri, S.; Alyaquobi, F.; Althohli, K.; Aizpurua, E.; Gonzales, R.; Jurado, J.; Loban, A.; Aguirre, S.; Teixeira, R. C.; De Egea, V.; Irala, S.; Medina, A.; Sequera, G.; Sosa, N.; Vazquez, F.; Llanos-Tejada, F. K.; Manga, S.; Villanueva-Villegas, R.; Araujo, D.; Duarte, R.; Marques, T. S.; Grecu, V. I.; Socaci, A.; Barkanova, O.; Bogorodskaya, M.; Borisov, S.; Mariandyshev, A.; Kaluzhenina, A.; Vukicevic, T. A.; Stosic, M.; Beh, D.; Ng, D.; Ong, C. W. M.; Solovic, I.; Dheda, K.; Gina, P.; Caminero, J. A.; Cardoso-Landivar, J.; De Souza Galvao, M. L.; Dominguez-Castellano, A.; Garcia-Garcia, J. -M.; Pinargote, I. M.; Fernandez, S. Q.; Sanchez-Montalva, A.; Huguet, E. T.; Murguiondo, M. Z.; Bart, P. -A.; Mazza-Stalder, J.; Bakko, F.; Barnacle, J.; Brown, A.; Chandran, S.; Killington, K.; Man, K.; Papineni, P.; Tiberi, S.; Utjesanovic, N.; Zenner, D.; Hearn, J. L.; Heysell, S.; Young, L.

doi:10.1183/13993003.02538-2021

Background Information on tuberculosis (TB) and coronavirus disease 2019 (COVID-19) is still limited. The aim of this study was to describe the features of the TB/COVID-19 co-infected individuals from a prospective, anonymised, multicountry register-based cohort with special focus on the determinants of mortality and other outcomes. Methods 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). Results Of 767 patients, 553 (74.0%) out of 747 had TB before COVID-19 (including 234 out of 747 with previous TB), 71 (9.5%) out of 747 had COVID-19 first and 123 (16.5%) out of 747 had both diseases diagnosed within the same week (n=35 (4.6%) on the same day). 85 (11.08%) out of 767 patients died (41 (14.2%) out of 289 in Europe and 44 (9.2%) out of 478 outside Europe; p=0.03): 42 (49.4%) from COVID-19, 31 (36.5%) from COVID-19 and TB, one (1.2%) from TB and 11 from other causes. In the univariate analysis on mortality the following variables reached statistical significance: age, male gender, having more than one 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. Conclusion The data suggest that 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.