Tolossa Tadesse, Tsegaye Reta, Shiferaw Siraj, Wakuma Bizuneh, Ayala Diriba, Bekele Belay, Shibiru Tesfaye
Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.
Department of Nursing, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.
Int Med Case Rep J. 2021 Sep 2;14:611-615. doi: 10.2147/IMCRJ.S326383. eCollection 2021.
The triple burden of COVID-19, human immune virus (HIV), and TB co-infection is one of the contemporary challenges to this globe. People living with chronic medical diseases such as HIV and TB are more likely to experience poor outcomes from COVID-19. This study aimed to report survival from triple co-infection with PTB, HIV, and COVID-19 in Wollega University referral hospital (WURH), western Ethiopia.
A 55-year-old male known HIV patient on HAART for the last 3 years presented to WURH on May 26, 2021, with chief complaints of shortness of breath of 5 days' duration associated with productive cough, history of high-grade fever, and severe headache. He had produced a lot of bloody sputum one month prior to the current complaints. On 1st day of his presentation, a Gene Expert test was done from sputum, and he was positive for pulmonary TB. On the same day, a nasopharyngeal sample for COVID-19 using polymerase chain reaction (PCR) was positive. On his 2nd day of admission, he was transferred to the COVID-19 treatment center with the diagnosis of severe COVID-19, PTB, and WHO stage-3 RVI. During his stay in the hospital, he was provided with oxygen via a nasal cannula. Intensive phase anti-TB treatment was initiated on the 3rd day of admission. HAART was continued with the same regimen he was taking prior to his presentation. On June 6, 2021, the patient was recovered and discharged from the hospital after 10 days of hospital stay.
This case report suggests, after 10 days of admission with triple infections, there is a good clinical prognosis and survival from COVID-19. On admission, further diagnosis and investigations of TB co-infection should be performed for all patients admitted with COVID-19 due to their similar and non-specific clinical manifestations.
2019冠状病毒病（COVID-19）、人类免疫病毒（HIV）和结核病合并感染的三重负担是当今全球面临的挑战之一。患有HIV和结核病等慢性疾病的人感染COVID-19后更有可能出现不良后果。本研究旨在报告埃塞俄比亚西部沃莱加大学转诊医院（WURH）中肺结核（PTB）、HIV和COVID-19三重合并感染患者的生存情况。
一名55岁男性，已知为HIV患者，过去3年一直在接受高效抗逆转录病毒治疗（HAART），于2021年5月26日就诊于WURH，主要症状为持续5天的呼吸急促，伴有咳痰、高热病史和严重头痛。在此次就诊前一个月，他咳出了大量血痰。就诊当天，对痰液进行了基因专家检测，结果显示他患有肺结核。同一天，采用聚合酶链反应（PCR）检测的鼻咽部COVID-19样本呈阳性。入院第二天，他被转至COVID-19治疗中心，诊断为重症COVID-19、PTB和世界卫生组织3期逆转录病毒感染（RVI）。住院期间，通过鼻导管给他吸氧。入院第三天开始强化期抗结核治疗。继续按照他就诊前的相同方案进行HAART治疗。2021年6月6日，患者康复，住院10天后出院。
本病例报告表明，三重感染入院10天后，COVID-19患者有良好的临床预后和生存情况。由于COVID-19患者的临床表现相似且无特异性，入院时应对所有COVID-19患者进行结核病合并感染的进一步诊断和检查。
