Calles-Cabanillas Liz E, Aguillón-Durán Genesis P, Ayala Doris, Caso José A, Garza Miguel, Joya-Ayala Mateo, Cruz-Gonzalez America M, Loera-Salazar Raul, Prieto-Martinez Ericka, Rodríguez-Herrera Javier E, Garcia-Oropesa Esperanza M, Thomas John M, Lee Miryoung, Torrelles Jordi B, Restrepo Blanca I
School of Public Health, University of Texas Health Science Center at Houston, One West University Blvd, SPH Bldg, Brownsville, TX, 78520, USA.
Department of Health and Biomedical Sciences, University of Texas Rio Grande Valley, Edinburg, TX, 78541, USA.
BMC Infect Dis. 2024 Dec 4;24(1):1383. doi: 10.1186/s12879-024-10244-z.
The global setback in tuberculosis (TB) prevalence and mortality in the post-COVID-19 era has been partially attributed to pandemic-related disruptions in healthcare systems. The additional biological contribution of COVID-19 to TB is less clear. The goal of this study was to determine if there is an association between COVID-19 in the past 18 months and a new TB episode, and the role played by type 2 diabetes mellitus (DM) comorbidity in this relationship.
A cross-sectional study was conducted among 112 new active TB patients and 373 non-TB controls, identified between June 2020 and November 2021 in communities along the Mexican border with Texas. Past COVID-19 was based on self-report or positive serology. Bivariable/multivariable analysis were used to evaluate the odds of new TB in hosts with past COVID-19 and/or DM status.
The odds of new TB were higher among past COVID-19 cases vs. controls, but only significant among DM patients (aOR 2.3). The odds of TB in people with DM was 2.7-fold higher among participants without past COVID-19 and increased to 7.9-fold among those with past COVID-19.
DM interacts with past COVID-19 synergistically to magnify the risk of TB. Latent TB screening and prophylactic treatment, if positive, is recommended in past COVID-19 persons with DM. Future studies are warranted with a longitudinal design and larger sample size to confirm our findings.
在新冠疫情后时代，全球结核病（TB）患病率和死亡率的回落部分归因于医疗系统中与大流行相关的干扰。新冠病毒对结核病的额外生物学影响尚不清楚。本研究的目的是确定过去18个月内的新冠病毒感染与新发结核病之间是否存在关联，以及2型糖尿病（DM）合并症在这种关系中所起的作用。
在2020年6月至2021年11月期间，对墨西哥与得克萨斯州边境沿线社区确定的112例新的活动性结核病患者和373例非结核病对照进行了一项横断面研究。过去的新冠病毒感染基于自我报告或血清学阳性。采用双变量/多变量分析来评估既往感染新冠病毒和/或患有糖尿病的宿主发生新发结核病的几率。
既往感染新冠病毒的病例中，新发结核病的几率高于对照组，但仅在糖尿病患者中具有统计学意义（调整后比值比为2.3）。在没有既往感染新冠病毒的参与者中，糖尿病患者患结核病的几率高2.7倍，而在有既往感染新冠病毒的参与者中则增至7.9倍。
糖尿病与既往感染新冠病毒具有协同作用，会增加结核病风险。建议对既往感染新冠病毒的糖尿病患者进行潜伏性结核病筛查，若结果呈阳性则进行预防性治疗。未来有必要开展纵向设计、更大样本量的研究以证实我们的发现。
