Department of Tuberculosis, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.
Center for Tuberculosis Research, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.
Viruses. 2024 Feb 6;16(2):260. doi: 10.3390/v16020260.
Accumulating evidence show a potential association between tuberculosis and COVID-19 disease severity. To further clarify the impact of tuberculosis on COVID-19 disease severity and viral shedding duration, a retrospective study was conducted on 223 COVID-19 patients, including 34 with tuberculosis and 189 without tuberculosis. Clinical information and viral load shedding time were collected. A higher percentage of severe/critical COVID-19 diagnosis and deaths was observed in patients with tuberculosis than in those without tuberculosis (8.8% vs. 3.2%, = 0.142; 2.9% vs. 1.1%, = 0.393), and COVID-19 patients with tuberculosis had longer viral shedding than those without tuberculosis (median: 15.0 days vs. 11.0 days; = 0.0001). Having tuberculosis (HR = 2.21, 95% CI 1.37-3.00; = 0.000), being of elderly age (HR = 1.02, 95% CI 1.01-1.03; = 0.001) and being diagnosed with severe or critical COVID-19 (HR = 5.63, 95% CI 2.10-15.05; = 0.001) were independent factors associated with prolonged virus time of SARS-CoV-2. COVID-19 patients with tuberculosis receiving anti-tuberculosis therapy time (ATT) for <2 months had a significantly longer virus shedding duration than those receiving ATT for ≥ 4 months (17.5 vs. 11.5 days, = 0.012). Our results demonstrated that COVID-19 patients with tuberculosis tend to have more severe disease and a worse prognosis, and tuberculosis prolonged viral shedding, highlighting special attention and/or care required for COVID-19 patients with tuberculosis receiving ATT for <2 months.
越来越多的证据表明，结核病与 COVID-19 疾病严重程度之间存在潜在关联。为了进一步阐明结核病对 COVID-19 疾病严重程度和病毒脱落持续时间的影响，对 223 例 COVID-19 患者进行了回顾性研究，其中 34 例合并结核病，189 例无结核病。收集了临床信息和病毒载量脱落时间。与无结核病的患者相比，结核病患者更易出现严重/危重症 COVID-19 诊断和死亡（8.8%比 3.2%， = 0.142；2.9%比 1.1%， = 0.393），且 COVID-19 合并结核病患者的病毒脱落时间长于无结核病的患者（中位数：15.0 天比 11.0 天； = 0.0001）。患有结核病（HR = 2.21，95%CI 1.37-3.00； = 0.000）、年龄较大（HR = 1.02，95%CI 1.01-1.03； = 0.001）和被诊断为严重或危重症 COVID-19（HR = 5.63，95%CI 2.10-15.05； = 0.001）是与 SARS-CoV-2 病毒时间延长相关的独立因素。接受抗结核治疗时间（ATT）＜2 个月的 COVID-19 合并结核病患者的病毒脱落持续时间明显长于 ATT≥4 个月的患者（17.5 天比 11.5 天， = 0.012）。本研究结果表明，COVID-19 合并结核病患者的疾病往往更严重，预后更差，且结核病延长了病毒脱落时间，这突出表明需要对接受 ATT＜2 个月的 COVID-19 合并结核病患者给予特别关注和/或护理。
