Mycobacterium tuberculosis and SARS-CoV-2 Coinfections: A Review.

Narjess Bostanghadiri,Davood Darban-Sarokhalil,Lanfranco Fattorini,Shabnam Razavi,Faramarz Masjedian Jazi

doi:10.3389/fmicb.2021.747827

Abstract

BackgroundTuberculosis (TB) is still one of the most important causes of death worldwide. The lack of timely attention on TB diagnosis and treatment during the coronavirus disease 2019 (COVID-19) pandemic is a potential threat to health issues and may have severe consequences for patients and health systems. There is not much information on the management of TB during this period. Here, we reviewed the current literature to evaluate the rate of Mycobacterium tuberculosis and severe acute respiratory syndrome coronavirus 2 coinfections and interactions between these infectious agents.MethodsSeveral databases, including Web of Science, Scopus, and MEDLINE (via PubMed), were searched for original articles addressing TB and COVID-19 diseases published from December 2019 to April 2021.ResultsOf 3,879 articles, 57 articles were included in this study, and among 106,033 patients affected by COVID-19, 891 also had TB. Overall, investigators found a consistent increase in C-reactive protein, D-dimer (especially in patients with severe clinical manifestation), erythrocyte sedimentation rate, lactate dehydrogenase, alanine aminotransferase, and a reduction of lymphocytes. The respiratory symptoms of TB/COVID-19 patients were similar to those of TB patients, but the risk of developing pulmonary TB increased in COVID-19 patients. Also, the mortality rate in TB/COVID-19 patients was higher than that in patients affected only by COVID-19 or TB.ConclusionSome reports indicated worsening respiratory symptoms and even activation of latent TB after COVID-19 or vice versa. It seems that both active and previously treated TB constituted a risk factor for COVID-19 in terms of severity and mortality, regardless of other underlying diseases and patient status. Health systems should not neglect TB during this era of the ongoing COVID-19 pandemic by setting up appropriate diagnostic and clinical management algorithms.

Highlights

Tuberculosis (TB) is an infectious disease that seriously affects human health
Each article meeting inclusion criteria was substantially assessed for the author, country, year, cross-section, type of study, age, gender, number of COVID-19 cases, number of TB patients, TB and COVID-19 diagnostic methods, laboratory criteria, clinical features, Mycobacterium tuberculosis (MTB) types, treatment of TB and COVID-19, recovery, and mortality rate
Epidemiological history and exposure, clinical manifestations, laboratory tests, and imaging examinations should be considered as comprehensive measures for rapid diagnosis, quarantine, and treatment

Summary

Introduction

Tuberculosis (TB) is an infectious disease that seriously affects human health. Mycobacterium tuberculosis (MTB) infects the lungs primarily, it may spread to other organs and tissues, including intestines, liver, lymph nodes, skin, brain, and musculoskeletal and reproductive systems (Mbuh et al, 2019; Mathiasen et al, 2020).M. tuberculosis and SARS-CoV-2 CoinfectionsIt is estimated that one-quarter of the world’s population is latently infected with MTB, 5–15% of whom develop active TB in their lifetime; the reactivation risk varies geographically and individually (Mousquer et al, 2020). Because of similar symptoms between the two diseases, the WHO Global TB control programs faced serious challenges, impairing TB diagnosis and treatment and neglecting TB among COVID-19 patients, leading to the increase in drug-resistant MTB strains. Both TB and COVID-19 have similar risk factors including immune system defects, diabetes, poverty, overcrowding, and air pollution (Getnet et al, 2019; Mousquer et al, 2020; Togun et al, 2020). We reviewed the current literature to evaluate the rate of Mycobacterium tuberculosis and severe acute respiratory syndrome coronavirus 2 coinfections and interactions between these infectious agents

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Results

Conclusion