Di Bari Virginia, Cerva Carlotta, Libertone Raffaella, Carli Serena Maria, Musso Maria, Goletti Delia, Aiello Alessandra, Mazzarelli Antonio, Cannas Angela, Matusali Giulia, Palmieri Fabrizio, Gualano Gina
Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases "Lazzaro Spallanzani", IRCCS, 00149 Rome, Italy.
Translational Research Unit, National Institute for Infectious Diseases (INMI) "Lazzaro Spallanzani", IRCCS, 00149 Rome, Italy.
Infect Dis Rep. 2025 Feb 5;17(1):11. doi: 10.3390/idr17010011.
BACKGROUND/OBJECTIVES: Tuberculosis (TB) remains a major global health issue, further complicated by the COVID-19 pandemic. This study assesses the clinical outcomes of TB-COVID-19-coinfected patients compared to those with TB disease alone at an Italian infectious disease hospital during the pandemic's first two years.
Retrospective data analysis was conducted on TB patients hospitalized from March 2020 to June 2022. Data included demographics, comorbidities, clinical characteristics, and outcomes. Coinfection was defined as concurrent TB disease and SARS-CoV-2 infection. Statistical methods included Fisher's exact test and Mann-Whitney statistics.
Of 267 TB patients, 25 (9.4%) had concurrent COVID-19 infection. The TB-COVID-19 group showed higher rates of diabetes and cough. Acute respiratory failure was more prevalent in coinfected patients (odds ratio, 5.99), and coinfection was associated with worse outcomes compared to TB alone (odds ratio, 0.15). Despite similar socio-demographic factors, the coexistence of TB and COVID-19 led to exacerbated respiratory failure and increased mortality.
Coinfection with TB and COVID-19 significantly increases the risk of acute respiratory failure and poor outcomes. Clinicians should be aware of this risk, especially in patients with pulmonary involvement. Although specific protocols are unavailable, prompt diagnosis and management may enhance outcomes. Additional research is necessary to understand the long-term effects of TB-COVID-19 coinfection, particularly as COVID-19 becomes endemic.
背景/目的：结核病（TB）仍然是一个重大的全球健康问题，新冠疫情使其进一步复杂化。本研究评估了在疫情的头两年里，意大利一家传染病医院中同时感染结核病和新冠病毒（TB-COVID-19）的患者与仅患有结核病患者的临床结局。
对2020年3月至2022年6月期间住院的结核病患者进行回顾性数据分析。数据包括人口统计学、合并症、临床特征和结局。合并感染定义为同时患有结核病和新冠病毒感染。统计方法包括Fisher精确检验和Mann-Whitney统计。
在267例结核病患者中，25例（9.4%）同时感染了新冠病毒。TB-COVID-19组的糖尿病和咳嗽发生率更高。急性呼吸衰竭在合并感染患者中更为普遍（优势比，5.99），与仅患结核病相比，合并感染与更差的结局相关（优势比，0.15）。尽管社会人口统计学因素相似，但结核病和新冠病毒的共存导致呼吸衰竭加剧和死亡率增加。
结核病和新冠病毒合并感染显著增加了急性呼吸衰竭和不良结局的风险。临床医生应意识到这种风险，尤其是在肺部受累的患者中。尽管没有具体的方案，但及时诊断和管理可能会改善结局。有必要进行更多研究以了解TB-COVID-19合并感染的长期影响，特别是随着新冠病毒成为地方病。
