Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, #1 Jianshe East Road, 450052, Zhengzhou, China.
State Key Laboratory of Antiviral Drugs, The First Affiliated Hospital of Zhengzhou University, 450052, Zhengzhou, China.
BMC Public Health. 2024 Feb 22;24(1):556. doi: 10.1186/s12889-024-17905-3.
SARS-CoV-2 infections usually cause immune dysregulation in the human body. Studies of immunological changes resulting from coinfections with Mycobacterium tuberculosis (Mtb) or HIV are limited.
We conducted a retrospective study focusing on patients with COVID-19. A total of 550 patients infected with SARS-CoV-2 were enrolled in our study and categorized into four groups based on the presence of coinfections; 166 Delta-infected patients, among whom 103 patients had no coinfections, 52 who were coinfected with Mtb, 11 who were coinfected with HIV, and 384 Omicron-infected patients. By collecting data on epidemiologic information, laboratory findings, treatments, and clinical outcomes, we analyzed and compared clinical and immunological characteristics.
Compared with those in the Delta group, the median white blood cell, CD4 + T-cell and B-cell counts were lower in the Mtb group and the HIV group. Except for those in the Omicron group, more than half of the patients in the three groups had abnormal chest CT findings. Among the three groups, there were no significant differences in any of the cytokines. Compared with those in the Delta group, the disease duration and LOS were longer in the Mtb group and the HIV group. For unvaccinated Delta-infected patients, in the Mtb and HIV groups, the number of B cells and CD4 + T cells was lower than that in the Delta group, with no significant difference in the LOS or disease duration. In the Mtb group, three (6%) patients presented with a disease duration greater than four months and had decreased lymphocyte and IL17A counts, possibly due to double infections in the lungs caused by SARS-CoV-2 and M. tuberculosis.
We found that SARS-CoV-2 patients coinfected with Mtb or HIV exhibited a longer disease duration and longer LOS, with a decrease in B cells and CD4 + T cells, suggesting that these cells are related to immune function. Changes in cytokine levels suggest that coinfection with Mtb or HIV does not result in dysregulation of the immune response. Importantly, we discovered a chronic course of coinfection involving more than four months of Mtb and SARS-CoV-2 infection.
SARS-CoV-2 感染通常会导致人体免疫失调。关于结核分枝杆菌（Mtb）或 HIV 合并感染引起的免疫变化的研究有限。
我们进行了一项回顾性研究，重点关注 COVID-19 患者。共纳入 550 例 SARS-CoV-2 感染患者，根据是否合并感染分为 4 组；166 例 Delta 感染患者，其中 103 例无合并感染，52 例合并 Mtb 感染，11 例合并 HIV 感染，384 例 Omicron 感染患者。通过收集流行病学信息、实验室检查、治疗和临床结局数据，我们分析并比较了临床和免疫特征。
与 Delta 组相比，Mtb 组和 HIV 组的白细胞、CD4+T 细胞和 B 细胞计数中位数较低。除 Omicron 组外，三组患者中超过一半的患者胸部 CT 检查异常。三组中细胞因子均无显著差异。与 Delta 组相比，Mtb 组和 HIV 组的疾病持续时间和 LOS 较长。对于未接种疫苗的 Delta 感染患者，在 Mtb 和 HIV 组中，B 细胞和 CD4+T 细胞数量低于 Delta 组，LOS 或疾病持续时间无显著差异。在 Mtb 组中，有 3 例（6%）患者的疾病持续时间大于 4 个月，淋巴细胞和 IL17A 计数减少，可能是由于 SARS-CoV-2 和 M. tuberculosis 双重感染导致肺部病变。
我们发现，SARS-CoV-2 合并 Mtb 或 HIV 感染的患者疾病持续时间和 LOS 较长，B 细胞和 CD4+T 细胞减少，提示这些细胞与免疫功能有关。细胞因子水平的变化表明，Mtb 或 HIV 合并感染不会导致免疫反应失调。重要的是，我们发现了一种超过 4 个月的 Mtb 和 SARS-CoV-2 感染的慢性合并感染过程。
