Teng P K, Han X D, Liu Y Z, Zhao W Y, Liu D S, Liu X D
Department of Respiratory and Critical Care Medicine, Qingdao Municipal Hospital, Qingdao 266011, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2022 May 12;45(5):510-514. doi: 10.3760/cma.j.cn112147-20220122-00416.
Coronavirus disease (COVID-19) and tuberculosis (TB) are two respiratory infectious diseases with a high incidence of transmission, mainly via respiratory droplets and both can weaken the immune system and lower the number of CD4T cells in patients. COVID-19 can occur before, at the same time or after the diagnosis of TB. Patients with pulmonary TB are more likely to have co-infection when they have a history of epidemiological exposure to COVID-19. At present, many cases of nosocomial infection of COVID-19 caused by ineffective prevention and control measures in tuberculosis hospitals have been reported successively at domestic and overseas. Therefore, it is urgent to strengthen the prevention and control of nosocomial infections in tuberculosis hospitals. The superposition of the two diseases can lead to a worsening prognosis, aggravating the patient's condition and making treatment more difficult. In addition, in the context of the new coronavirus epidemic, early recognition of co-infection with new coronavirus should be made when TB patients in chest hospitals present with symptoms such as aggregated fever or progressive disease. At the same time, we should focus on identifying the clinical and imaging manifestations of TB and COVID-19 co-infection. At present, research on COVID-19 complicated with pulmonary TB is scarce, and there are disputes on many aspects. As a country with a high prevalence of tuberculosis, it is of great practical significance to identify the clinical characteristics, outcomes, and treatment of the two infectious diseases in China.
冠状病毒病（COVID-19）和结核病（TB）是两种传播率很高的呼吸道传染病，主要通过呼吸道飞沫传播，且二者均可削弱免疫系统并降低患者体内CD4T细胞数量。COVID-19可在结核病诊断之前、同时或之后发生。肺结核患者若有COVID-19的流行病学暴露史，则更易发生合并感染。目前，国内外相继报道了多家结核病医院因防控措施不力导致COVID-19医院感染的多起病例。因此，加强结核病医院医院感染的防控工作迫在眉睫。两种疾病叠加可导致预后恶化，加重患者病情并使治疗更加困难。此外，在新型冠状病毒疫情背景下，胸科医院的结核病患者出现高热聚集或病情进展等症状时，应尽早识别是否合并新型冠状病毒感染。同时，应重点识别结核病与COVID-19合并感染的临床及影像学表现。目前，关于COVID-19合并肺结核的研究较少，在很多方面存在争议。作为结核病高流行国家，明确我国这两种传染病的临床特征、转归及治疗具有重要的现实意义。
