Abstract
We synthesized evidence on the influence of SARS-CoV-2 coinfection (Coinfection Review ) and its management (Clinical Management Review ) on treatment outcomes among people with tuberculosis (TB) disease. We systematically searched the literature from 1 January 2020 to 6 February 2022. Primary outcomes included: unfavorable TB treatment outcomes (Coinfection and Clinical Management Review ) and/or severe or critical COVID-19 or death (Clinical Management Review ). Study quality was assessed with Newcastle Ottawa Scale. We included 11 studies and 7305 participants. Evidence was low quality, and no study was designed to answer our research questions. Eight studies of 5749 people (286 [5%] with SARS-CoV-2) treated for TB were included in the Coinfection Review , and five addressed the primary outcome. There was no significant association between SARS-CoV-2 coinfection and unfavorable TB outcomes. Four studies of 1572 people treated for TB (291 [19%] received corticosteroids) were included in the Clinical Management Review , and two addressed a primary outcome. Studies were likely confounded by indication and discordant findings existed among studies with vs. without statistical adjustment. It remains unclear whether SARS-CoV-2 and its management are associated with unfavorable outcomes among people with TB. High-quality research is required to address the key knowledge gap.
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