Outcome of COVID-19 and tuberculosis coinfection

ABSTRACT

Background: Covid 19 and Tuberculosis are the infectious diseases primarily affecting the lung. Both of them present with cough, fever and difficulty in breathing but Tuberculosis has a longer incubation period and onset of disease is slower. The patients of Tuberculosis are more likely to have comorbidities (malnutrition, diabetes mellitus, Human Immunodeficiency Virus) that increases their vulnerability to covid-19. Aim: To study the clinical profile, course, management and outcome in patient presented with covid-19 and tuberculosis in covid pandemic in Mumbai. Methods: We studied the 323-patient admitted in covid Intensive Care Unit and ward who were proven covid 19 positives by Reverse Transcriptase Polymerase Chain Reaction, Cartridge Based Nucleic Acid Amplification Test or rapid antigen test. All patients were given standard medical care, ventilatory support if required as per covid19 protocol. The chest x-ray, blood investigation and sputum investigation were studied till the time of discharge or death. Results: Out of 323 patients studied 14 had Tuberculosis. Out of those 14 patients 10 patient had pulmonary tuberculosis, 3 had Tuberculous pleural effusion and one had abdominal tuberculosis. All of them had pneumonia on chest x-ray which can be attributed to covid-19 or Tuberculosis. Conclusion: In our study all 14 patients were survived and discharged. As there is high burden of tuberculosis the covid-19 only helped in exposing the tip of the iceberg of the grave problem of undiagnosed tuberculosis in community. It seems that there is just coincidental occurrence of tuberculosis and covid19 coinfection than a causal association.