TB-COVID co-infections increasingly common, tied to worse outcomes, data show – University of Minnesota Twin Cities

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A new meta-analysis of 17 studies reveals that tuberculosis (TB) and COVID-19 co-infection are becoming increasingly prevalent around the world, with death rates gradually declining but remaining higher than COVID-19 infection alone. The study was published yesterday in PLOS Neglected Tropical Diseases.

The 17 studies were conducted in 38 countries or regions, spanning both high- and low-TB prevalence areas. Sixteen of the studies were single-country studies. The other study included TB-COVID patients from 172 centers in 34 countries as part of the TB/COVID-19 Global Study Group in 2022.

Two studies estimated TB-COVID joint infection prevalence, one conducted in Western Cape Province, South Africa, (prevalence of 0.06%) and one in California (prevalence of 0.02%). In all studies, patients were treated with known TB drugs, including rifampicin, isoniazid, ethambutol, and pyrazinamide. The authors found no studies that could provide specific guidance on the best practices for managing TB-COVID co-infections.

Patients with both infections were at an increased risk for hospitalization, intensive care unit admission, and death. The estimated fatality rate among hospitalized patients with TB-COVID co-infection was 11.4% (95% confidence interval [CI], 5.6% to 18.8%). Overall fatality rate for patients co-infected was 7.1% (95% CI, 4.0% to 10.8%).

The pooled relative risk of in-hospital fatality was 0.8 (95% CI, 0.18 to 3.68) for TB-COVID patients versus patients with COVID-19 only, the authors found.

Individuals with TB-COVID co-infection are at heightened risk of hospitalization, protracted recovery periods, and accelerated mortality compared to those with sole COVID-19 infections

"Our analysis consistently shows that individuals with TB-COVID co-infection are at heightened risk of hospitalization, protracted recovery periods, and accelerated mortality compared to those with sole COVID-19 infections," the study authors wrote. "Remarkably, we found limited information on the post-COVID-19 condition of co-infected patient."

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TB-COVID co-infections increasingly common, tied to worse outcomes, data show - University of Minnesota Twin Cities