中国北京2019冠状病毒病与活动性肺结核合并感染患者的临床结局：一项回顾性单中心描述性研究
Clinical outcomes of patients with coronavirus disease 2019 and active tuberculosis co-infection in Beijing China: A retrospective single-center descriptive study.
作者信息
Yang Xinting, Wang Chaohong, Xue Yu, Zhang Yun, Zheng Maike, Sun Qing, Long Sibo, Wang Da, Yan Jun, Liao Xinlei, Zhang Tiantian, Cao Lei, Chen Yan, Ju Wenfu, Zhang Jing, Gao Mengqiu, Zhao Yan, Luu Laurence Don Wai, Pan Junhua, Wang Yi, Wang Guirong
机构信息
Tuberculosis Department, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China.
Department of Clinical Laboratory, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
出版信息
Infect Med (Beijing). 2025 Feb 18;4(1):100169. doi: 10.1016/j.imj.2025.100169. eCollection 2025 Mar.
BACKGROUND
Coronavirus disease 2019 (COVID-19) and tuberculosis (TB) co-infection (COVID-19-TB) has the potential to exacerbate lung damage; however, information about the clinical features of COVID-19-TB is limited. This study aims to clarify the clinical characteristics and outcomes of patients with COVID-19-TB.
METHODS
In this single-center retrospective study, the clinical features and outcomes of patients with COVID-19 with active TB who were admitted to Beijing Chest Hospital, Beijing, China, from 1 December 2022 to 18 January 2023 were collected. The severity of COVID-19 and TB was graded according to guidelines from the World Health Organization. The relationships of demographic and clinical variables with intensive care unit (ICU) admission were evaluated using univariable and multivariable logistic regression models.
RESULTS
Overall, 102 patients with COVID-19-TB were enrolled. The mean age was 54.5 years (range 36.5-70 years). The most common clinical manifestations were cough (68.63%), sputum production (53.92%), fever (51.96%), and ground-glass opacities (35.29%). Complications included acute respiratory distress syndrome (11.76%), sepsis (9.8%), and respiratory failure (7.84%). Patients with COVID-19-TB had high concentrations of various proinflammatory cytokines, including interferon-γ, interleukin-1β, interferon-γ-inducible protein 10 kD, and monocyte chemoattractant protein-1. Sixteen of the 102 patients with COVID-19-TB (15.69%) were admitted to the ICU, and 10 (9.80%) died during hospitalization. The significant risk factors for ICU admission were respiratory failure, pulmonary fungal infection, and ventilation and oxygen therapy.
CONCLUSIONS
The mortality rate of COVID-19-TB was 9.80%. Several demographic and clinical characteristics were associated with adverse outcomes, indicating the importance of early recognition and treatment.
背景
2019冠状病毒病（COVID-19）与结核病（TB）合并感染（COVID-19-TB）有可能加剧肺部损伤；然而，关于COVID-19-TB临床特征的信息有限。本研究旨在阐明COVID-19-TB患者的临床特征和预后。
方法
在这项单中心回顾性研究中，收集了2022年12月1日至2023年1月18日期间在中国北京胸科医院住院的活动性结核病合并COVID-19患者的临床特征和预后。根据世界卫生组织的指南对COVID-19和结核病的严重程度进行分级。使用单变量和多变量逻辑回归模型评估人口统计学和临床变量与重症监护病房（ICU）入院的关系。
结果
总共纳入了102例COVID-19-TB患者。平均年龄为54.5岁（范围36.5 - 70岁）。最常见的临床表现为咳嗽（68.63%）、咳痰（53.92%）、发热（51.96%）和磨玻璃影（35.29%）。并发症包括急性呼吸窘迫综合征（11.76%）、脓毒症（9.8%）和呼吸衰竭（7.84%）。COVID-19-TB患者体内多种促炎细胞因子浓度较高，包括干扰素-γ、白细胞介素-1β、干扰素-γ诱导蛋白10 kD和单核细胞趋化蛋白-1。102例COVID-19-TB患者中有16例（15.69%）入住ICU，10例（9.80%）在住院期间死亡。入住ICU的显著危险因素为呼吸衰竭、肺部真菌感染以及通气和氧疗。
结论
COVID-19-TB的死亡率为9.80%。一些人口统计学和临床特征与不良预后相关，表明早期识别和治疗的重要性。
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