患有新冠肺炎且有结核病病史的住院患者的特征与结局：来自巴西新冠肺炎登记处的一项配对病例对照研究
Characteristics and outcomes of in-hospital patients with Covid-19 and history of tuberculosis: a matched case-control from the Brazilian Covid-19 Registry.
作者信息
de Carvalho Rafael Lima Rodrigues, Pereira Daniella Nunes, Chagas Victor Schulthais, Augusto Valéria Maria, Costa Felício Roberto, Nascimento Guilherme Fagundes, Ruschel Karen Brasil, Moreira Leila Beltrami, Carneiro Marcelo, Guimarães Júnior Milton Henriques, Costa Mônica Aparecida, Bonardi Naiara Patrícia Fagundes, de Oliveira Neimy Ramos, Aguiar Rubia Laura Oliveira, Costa Raíssa de Melo, Pires Magda Carvalho, Marcolino Milena Soriano
机构信息
School of Nursing, Universidade Federal da Bahia, Basílio da Gama, 241, Salvador, Bahia, Brazil.
Institute for Health Technology Assessment (IATS/CNPq), R. Ramiro Barcelos, 2350, Porto Alegre, Rio Grande do Sul, Brazil.
出版信息
BMC Infect Dis. 2024 Dec 19;24(1):1448. doi: 10.1186/s12879-024-10305-3.
BACKGROUND
The Covid-19 pandemic caused a negative impact on other infectious diseases control, prevention, and treatment. Consequently, low and middle-income countries suffer from other endemic diseases, such as tuberculosis. This study was designed to compare Covid-19 manifestations and outcomes between patients with previously treated tuberculosis and controls without this condition.
METHODS
We performed a matched case-control study drawn from the Brazilian Covid-19 Registry data, including in-hospital patients aged 18 and over with laboratory-confirmed Covid-19 from March 1, 2020, to March 31, 2022. Cases were patients with a past history of tuberculosis. Controls were Covid-19 patients without a tuberculosis history. Patients were matched by hospital, sex, presence of HIV, and number of comorbidities, with a 1:4 ratio.
RESULTS
Of 13,636 patients with laboratory-confirmed diagnoses of Covid-19 enrolled in this study, 80 had a history of tuberculosis. Statistical differences in history of chronic pulmonary obstructive disease (15% vs. 3.2%), psychiatric disease (10% vs. 3.5%,), chronic kidney disease (11.2% vs. 2.8%), and solid-organ transplantation; (5% vs. 0.9%, p < 0.05 for all) were higher in patients with a past history of tuberculosis. Prior use of inhalatory medications (5% vs. 0.6%,), oral corticoids (8.8% vs. 1.9%), immunosuppressants (8.8% vs. 1.9%,) and the use of illicit drugs were more common in the case group (6.2% vs. 0.3% p < 0.05for all). There were no significant differences in in-hospital mortality, mechanical ventilation, need for dialysis, and ICU admission.
CONCLUSIONS
Patients with a history of tuberculosis infection presented a higher frequency of use of illicit drugs, chronic pulmonary obstructive disease, psychiatric disease, chronic kidney disease, solid-organ transplantation, prior use of inhalatory medications, oral corticoids, and immunosuppressants. The outcomes were similar between cases and controls.
背景
新冠疫情对其他传染病的控制、预防和治疗产生了负面影响。因此，低收入和中等收入国家饱受其他地方病之苦，如结核病。本研究旨在比较既往接受过结核病治疗的患者与未患此病的对照组之间的新冠表现和结局。
方法
我们进行了一项匹配病例对照研究，数据来自巴西新冠登记处，研究对象为2020年3月1日至2022年3月31日期间年龄在18岁及以上、实验室确诊为新冠的住院患者。病例为有结核病病史的患者。对照为无结核病病史的新冠患者。患者按医院、性别、是否感染艾滋病毒和合并症数量进行匹配，比例为1:4。
结果
在本研究纳入的13636例实验室确诊为新冠的患者中，80例有结核病病史。既往有结核病病史的患者中，慢性阻塞性肺疾病史（15%对3.2%）、精神疾病史（10%对3.5%）、慢性肾脏病（11.2%对2.8%）和实体器官移植史（5%对0.9%，所有p<0.05）的统计差异更高。病例组既往使用吸入药物（5%对0.6%）、口服皮质类固醇（8.8%对1.9%）、免疫抑制剂（8.8%对1.9%）以及使用非法药物的情况更为常见（6.2%对0.3%，所有p<0.05）。住院死亡率、机械通气、透析需求和入住重症监护病房方面无显著差异。
结论
有结核感染病史的患者使用非法药物、患慢性阻塞性肺疾病、精神疾病、慢性肾脏病、实体器官移植、既往使用吸入药物、口服皮质类固醇和免疫抑制剂的频率更高。病例组和对照组的结局相似。
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