Colliding Challenges: An Analysis of SARS-CoV-2 Infection in Patients with Pulmonary Tuberculosis versus SARS-CoV-2 Infection Alone

Medicina (Kaunas). 2024 May 16;60(5):823. doi: 10.3390/medicina60050823.

Abstract

Background and Objectives: The concurrent occurrence of tuberculosis and COVID-19 coinfection poses significant clinical complexities, warranting a nuanced approach to diagnosis, management, and patient care. Materials and Methods: A retrospective, cross-sectional study was conducted on two groups: one comprising 32 patients with pulmonary TB (PTB) and COVID-19 co-infection, and one including 100 patients with COVID-19 alone. Data was collected from medical records, including patient history, clinical parameters, laboratory, imaging results, and patient outcome. Results: A lower BMI emerges as a significant marker suggesting underlying PTB in patients with SARS-CoV-2 co-infection. Type 2 diabetes mellitus increases the risk of death in PTB-SARS-CoV-2 co-infection. Co-infected patients show lymphocytopenia and higher neutrophil levels, CRP, transaminases, and D-dimer levels. Elevated CRP and ALT levels are linked to increased co-infection likelihood. Certain parameters like SpO2, CRP, ALT, AST, and D-dimer effectively differentiate between co-infected and COVID-19 patients. Platelet-to-lymphocyte ratio is notably higher in co-infected individuals. Lesion severity on imaging is significantly associated with co-infection, highlighting imaging's diagnostic importance. Longer hospital stays are linked to co-infection but not significantly to death risk. Conclusions: Certain clinical and biological factors may serve as potential indicators of PTB co-infection in patients with SARS-CoV-2.

Keywords: COVID19 outcomes; SARS-CoV-2 and tuberculosis co-infection; immunocompromised in SARS-CoV-2 infection; pulmonary tuberculosis.

MeSH terms

  • Adult
  • Aged
  • Body Mass Index
  • COVID-19* / complications
  • Coinfection* / epidemiology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • SARS-CoV-2
  • Tuberculosis, Pulmonary* / blood
  • Tuberculosis, Pulmonary* / complications

Grants and funding

We would like to acknowledge VICTOR BABES UNIVERSITY OF MEDICINE AND PHARMACY TIMISOARA for their support in covering the costs of publication for this research paper, according to the UMFVBT Senate Decision No. 24/7135/24.06.2020.