Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
Department of Global Health, Boston University School of Public Health, Boston, MA, USA.
Infect Dis (Lond). 2020 Nov-Dec;52(12):902-907. doi: 10.1080/23744235.2020.1806353. Epub 2020 Aug 18.
There is a growing literature on the association of SARS-CoV-2 and other chronic conditions, such as noncommunicable diseases. However, little is known about the impact of coinfection with tuberculosis. We aimed to compare the risk of death and recovery, as well as time-to-death and time-to-recovery, in COVID-19 patients with and without tuberculosis.
We created a 4:1 propensity score matched sample of COVID-19 patients without and with tuberculosis, using COVID-19 surveillance data in the Philippines. We conducted a longitudinal cohort analysis of matched COVID-19 patients as of May 17, 2020, following them until June 15, 2020. The primary analysis estimated the risk ratios of death and recovery in patients with and without tuberculosis. Kaplan-Meier curves described time-to-death and time-to-recovery stratified by tuberculosis status, and differences in survival were assessed using the Wilcoxon test.
The risk of death in COVID-19 patients with tuberculosis was 2.17 times higher than in those without (95% CI: 1.40-3.37). The risk of recovery in COVID-19 patients with tuberculosis was 25% lower than in those without (RR = 0.75,05% CI 0.63-0.91). Similarly, time-to-death was significantly shorter ( = .0031) and time-to-recovery significantly longer in patients with tuberculosis ( = .0046).
Our findings show that coinfection with tuberculosis increased morbidity and mortality in COVID-19 patients. Our findings highlight the need to prioritize routine and testing services for tuberculosis, although health systems are disrupted by the heavy burden of the SARS-CoV-2 pandemic.
关于 SARS-CoV-2 与非传染性疾病等其他慢性疾病之间关联的文献越来越多。然而，对于结核分枝杆菌合并感染的影响知之甚少。我们旨在比较 COVID-19 患者合并和不合并结核分枝杆菌感染的死亡和恢复风险，以及死亡时间和恢复时间。
我们使用菲律宾 COVID-19 监测数据，创建了一个 COVID-19 患者无结核和有结核的 4:1 倾向评分匹配样本。我们对截至 2020 年 5 月 17 日的匹配 COVID-19 患者进行了纵向队列分析，随访至 2020 年 6 月 15 日。主要分析估计了无结核和有结核 COVID-19 患者的死亡和恢复风险比。根据结核分枝杆菌状态描述了死亡和恢复的 Kaplan-Meier 曲线，使用 Wilcoxon 检验评估了生存差异。
与无结核患者相比，COVID-19 合并结核患者的死亡风险高 2.17 倍（95%CI：1.40-3.37）。COVID-19 合并结核患者的恢复风险低 25%（RR=0.75，95%CI 0.63-0.91）。同样，结核患者的死亡时间明显缩短（ = .0031），恢复时间明显延长（ = .0046）。
我们的研究结果表明，结核分枝杆菌合并感染增加了 COVID-19 患者的发病率和死亡率。我们的研究结果强调，尽管 SARS-CoV-2 大流行给卫生系统带来了沉重负担，但仍需要优先考虑结核分枝杆菌的常规和检测服务。
