Bostanghadiri Narjess, Jazi Faramarz Masjedian, Razavi Shabnam, Fattorini Lanfranco, Darban-Sarokhalil Davood
Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Microbial Biotechnology Research Center, Iran University of Medical Sciences, Tehran, Iran.
Front Microbiol. 2022 Feb 3;12:747827. doi: 10.3389/fmicb.2021.747827. eCollection 2021.
Tuberculosis (TB) is still one of the most important causes of death worldwide. The lack of timely attention on TB diagnosis and treatment during the coronavirus disease 2019 (COVID-19) pandemic is a potential threat to health issues and may have severe consequences for patients and health systems. There is not much information on the management of TB during this period. Here, we reviewed the current literature to evaluate the rate of and severe acute respiratory syndrome coronavirus 2 coinfections and interactions between these infectious agents.
Several databases, including Web of Science, Scopus, and MEDLINE (via PubMed), were searched for original articles addressing TB and COVID-19 diseases published from December 2019 to April 2021.
Of 3,879 articles, 57 articles were included in this study, and among 106,033 patients affected by COVID-19, 891 also had TB. Overall, investigators found a consistent increase in C-reactive protein, D-dimer (especially in patients with severe clinical manifestation), erythrocyte sedimentation rate, lactate dehydrogenase, alanine aminotransferase, and a reduction of lymphocytes. The respiratory symptoms of TB/COVID-19 patients were similar to those of TB patients, but the risk of developing pulmonary TB increased in COVID-19 patients. Also, the mortality rate in TB/COVID-19 patients was higher than that in patients affected only by COVID-19 or TB.
Some reports indicated worsening respiratory symptoms and even activation of latent TB after COVID-19 or vice versa. It seems that both active and previously treated TB constituted a risk factor for COVID-19 in terms of severity and mortality, regardless of other underlying diseases and patient status. Health systems should not neglect TB during this era of the ongoing COVID-19 pandemic by setting up appropriate diagnostic and clinical management algorithms.
结核病（TB）仍是全球最重要的死因之一。在2019冠状病毒病（COVID-19）大流行期间，对结核病诊断和治疗缺乏及时关注，这对健康问题构成潜在威胁，可能给患者和卫生系统带来严重后果。关于这一时期结核病管理的信息不多。在此，我们回顾了当前文献，以评估严重急性呼吸综合征冠状病毒2合并感染率以及这些感染因子之间的相互作用。
检索了多个数据库，包括科学网、Scopus和MEDLINE（通过PubMed），以查找2019年12月至2021年4月发表的关于结核病和COVID-19疾病的原创文章。
在3879篇文章中，本研究纳入了57篇文章，在106033例受COVID-19影响的患者中，891例同时患有结核病。总体而言，研究人员发现C反应蛋白、D-二聚体（尤其是临床表现严重的患者）、红细胞沉降率、乳酸脱氢酶、丙氨酸转氨酶持续升高，淋巴细胞减少。结核病/COVID-19患者的呼吸道症状与结核病患者相似，但COVID-19患者发生肺结核的风险增加。此外，结核病/COVID-19患者的死亡率高于仅受COVID-19或结核病影响的患者。
一些报告表明，COVID-19后呼吸道症状恶化，甚至潜伏性结核病激活，反之亦然。似乎无论其他基础疾病和患者状况如何，活动性结核病和既往治疗过的结核病在严重程度和死亡率方面都是COVID-19的危险因素。在当前COVID-19大流行时代，卫生系统不应通过建立适当的诊断和临床管理算法而忽视结核病。
