The National Medical Research Center of Phthisiopulmonology and Infectious Diseases under the Ministry of Health of the Russian Federation, Moscow, Russia.
Federal Budget Institution of Science "Central Research Institute of Epidemiology" of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, Moscow, Russia.
Int J Infect Dis. 2022 Nov;124 Suppl 1:S82-S89. doi: 10.1016/j.ijid.2022.04.041. Epub 2022 Apr 26.
Data on patients with COVID-19 who have pulmonary tuberculosis (TB) are limited. In this study, we compared the clinical characteristics of patients with COVID-19/TB and patients with COVID-19 only. In addition, we analyzed the links between the severity of COVID-19 disease and the clinical characteristics of patients with COVID-19/TB.
We conducted a retrospective, anonymized, cross-sectional study of 111 patients who met inclusion criteria for analysis (75 patients with COVID-19/TB and 36 patients with COVID-19).
Patients in both groups (COVID-19/TB vs COVID-19) mainly suffered from fever (72.0% vs 100%, p < 0.001), fatigue (76.0% vs 94.4%, p = 0.018), chest pain (72.0% vs 36.1%, p < 0.001), followed by cough (60.0% vs 97.2%, p < 0.001) and dyspnea (44.0% vs 63.9%, p = 0.05). In group COVID-19/TB the most frequently reported co-morbidities were chronic liver disease (17 [22.7%]), cardiovascular diseases (25 [33.3%]), and diseases of the nervous system (13 [17.3%]). Female gender, fever, dyspnea, pulmonary bilateral TB lesion, and three or more co-morbidities have a statistically significant positive effect on the severity of the disease among patients with COVID-19/TB.
It is important to perform rapid molecular testing and computed tomography to correctly distinguish COVID-19 and TB because of the similar clinical characteristics of both diseases. Bilateral pulmonary TB lesion and co-morbidity should be considered risk factors for severe COVID-19.
关于合并 COVID-19 的肺结核（TB）患者的数据有限。本研究比较了 COVID-19/TB 患者和单纯 COVID-19 患者的临床特征。此外，我们分析了 COVID-19 疾病严重程度与 COVID-19/TB 患者临床特征之间的关系。
我们对符合分析纳入标准的 111 例患者进行了回顾性、匿名、横断面研究（COVID-19/TB 组 75 例，COVID-19 组 36 例）。
两组患者（COVID-19/TB 与 COVID-19）主要表现为发热（72.0%与 100%，p<0.001）、乏力（76.0%与 94.4%，p=0.018）、胸痛（72.0%与 36.1%，p<0.001），其次为咳嗽（60.0%与 97.2%，p<0.001）和呼吸困难（44.0%与 63.9%，p=0.05）。在 COVID-19/TB 组，最常报告的合并症为慢性肝病（17 [22.7%]）、心血管疾病（25 [33.3%]）和神经系统疾病（13 [17.3%]）。女性、发热、呼吸困难、肺部双侧 TB 病变和三种或更多合并症对 COVID-19/TB 患者疾病严重程度有统计学显著的正向影响。
由于两种疾病的临床特征相似，因此快速进行分子检测和计算机断层扫描以正确区分 COVID-19 和 TB 非常重要。双侧肺部 TB 病变和合并症应被视为 COVID-19 重症的危险因素。
