SARS-CoV-2 infection and pulmonary tuberculosis in children and adolescents: a case-control study
Abstract Background The Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) pandemic has had an impact on the global tuberculosis (TB) epidemic but evidence on the possible interaction between SARS-CoV-2 and TB, especially in children and adolescents, remains limited. We aimed to evaluate t...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-06-01
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| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-023-08412-8 |
| _version_ | 1797789906895896576 |
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| author | Jeremi Swanepoel Marieke M. van der Zalm Wolfgang Preiser Gert van Zyl Elizabeth Whittaker Anneke C. Hesseling David A. J. Moore James A. Seddon |
| author_facet | Jeremi Swanepoel Marieke M. van der Zalm Wolfgang Preiser Gert van Zyl Elizabeth Whittaker Anneke C. Hesseling David A. J. Moore James A. Seddon |
| author_sort | Jeremi Swanepoel |
| collection | DOAJ |
| description | Abstract Background The Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) pandemic has had an impact on the global tuberculosis (TB) epidemic but evidence on the possible interaction between SARS-CoV-2 and TB, especially in children and adolescents, remains limited. We aimed to evaluate the relationship between previous infection with SARS-CoV-2 and the risk of TB in children and adolescents. Methods An unmatched case-control study was conducted using SARS-CoV-2 unvaccinated children and adolescents recruited into two observational TB studies (Teen TB and Umoya), between November 2020 and November 2021, in Cape Town, South Africa. Sixty-four individuals with pulmonary TB (aged < 20 years) and 99 individuals without pulmonary TB (aged < 20 years) were included. Demographics and clinical data were obtained. Serum samples collected at enrolment underwent quantitative SARS-CoV-2 anti-spike immunoglobulin G (IgG) testing using the Abbott SARS-CoV-2 IgG II Quant assay. Odds ratios (ORs) for TB were estimated using unconditional logistic regression. Results There was no statistically significant difference in the odds of having pulmonary TB between those who were SARS-CoV-2 IgG seropositive and those who were seronegative (adjusted OR 0.51; 95% CI: 0.23–1.11; n = 163; p = 0.09). Of those with positive SARS-CoV-2 serology indicating prior infection, baseline IgG titres were higher in individuals with TB compared to those without TB (p = 0.04) and individuals with IgG titres in the highest tertile were more likely to have pulmonary TB compared to those with IgG levels in the lowest tertile (OR: 4.00; 95%CI: 1.13– 14.21; p = 0.03). Conclusions Our study did not find convincing evidence that SARS-CoV-2 seropositivity was associated with subsequent pulmonary TB disease; however, the association between magnitude of SARS-CoV-2 IgG response and pulmonary TB warrants further investigation. Future prospective studies, evaluating the effects of sex, age and puberty on host immune responses to M. tuberculosis and SARS-CoV-2, will also provide more clarity on the interplay between these two infections. |
| first_indexed | 2024-03-13T01:57:16Z |
| format | Article |
| id | doaj.art-3ed1bd8b44554c56ae958f0a3a5ee1b9 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-03-13T01:57:16Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-3ed1bd8b44554c56ae958f0a3a5ee1b92023-07-02T11:08:56ZengBMCBMC Infectious Diseases1471-23342023-06-0123111010.1186/s12879-023-08412-8SARS-CoV-2 infection and pulmonary tuberculosis in children and adolescents: a case-control studyJeremi Swanepoel0Marieke M. van der Zalm1Wolfgang Preiser2Gert van Zyl3Elizabeth Whittaker4Anneke C. Hesseling5David A. J. Moore6James A. Seddon7Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch UniversityDesmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch UniversityDivision of Medical Virology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and National Health Laboratory Service, Tygerberg Academic HospitalDivision of Medical Virology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and National Health Laboratory Service, Tygerberg Academic HospitalDepartment of Infectious Disease, Imperial College LondonDesmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch UniversityTB Centre, London School of Hygiene and Tropical MedicineDesmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch UniversityAbstract Background The Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) pandemic has had an impact on the global tuberculosis (TB) epidemic but evidence on the possible interaction between SARS-CoV-2 and TB, especially in children and adolescents, remains limited. We aimed to evaluate the relationship between previous infection with SARS-CoV-2 and the risk of TB in children and adolescents. Methods An unmatched case-control study was conducted using SARS-CoV-2 unvaccinated children and adolescents recruited into two observational TB studies (Teen TB and Umoya), between November 2020 and November 2021, in Cape Town, South Africa. Sixty-four individuals with pulmonary TB (aged < 20 years) and 99 individuals without pulmonary TB (aged < 20 years) were included. Demographics and clinical data were obtained. Serum samples collected at enrolment underwent quantitative SARS-CoV-2 anti-spike immunoglobulin G (IgG) testing using the Abbott SARS-CoV-2 IgG II Quant assay. Odds ratios (ORs) for TB were estimated using unconditional logistic regression. Results There was no statistically significant difference in the odds of having pulmonary TB between those who were SARS-CoV-2 IgG seropositive and those who were seronegative (adjusted OR 0.51; 95% CI: 0.23–1.11; n = 163; p = 0.09). Of those with positive SARS-CoV-2 serology indicating prior infection, baseline IgG titres were higher in individuals with TB compared to those without TB (p = 0.04) and individuals with IgG titres in the highest tertile were more likely to have pulmonary TB compared to those with IgG levels in the lowest tertile (OR: 4.00; 95%CI: 1.13– 14.21; p = 0.03). Conclusions Our study did not find convincing evidence that SARS-CoV-2 seropositivity was associated with subsequent pulmonary TB disease; however, the association between magnitude of SARS-CoV-2 IgG response and pulmonary TB warrants further investigation. Future prospective studies, evaluating the effects of sex, age and puberty on host immune responses to M. tuberculosis and SARS-CoV-2, will also provide more clarity on the interplay between these two infections.https://doi.org/10.1186/s12879-023-08412-8TuberculosisSARS-CoV-2AdolescentsImmunology |
| spellingShingle | Jeremi Swanepoel Marieke M. van der Zalm Wolfgang Preiser Gert van Zyl Elizabeth Whittaker Anneke C. Hesseling David A. J. Moore James A. Seddon SARS-CoV-2 infection and pulmonary tuberculosis in children and adolescents: a case-control study BMC Infectious Diseases Tuberculosis SARS-CoV-2 Adolescents Immunology |
| title | SARS-CoV-2 infection and pulmonary tuberculosis in children and adolescents: a case-control study |
| title_full | SARS-CoV-2 infection and pulmonary tuberculosis in children and adolescents: a case-control study |
| title_fullStr | SARS-CoV-2 infection and pulmonary tuberculosis in children and adolescents: a case-control study |
| title_full_unstemmed | SARS-CoV-2 infection and pulmonary tuberculosis in children and adolescents: a case-control study |
| title_short | SARS-CoV-2 infection and pulmonary tuberculosis in children and adolescents: a case-control study |
| title_sort | sars cov 2 infection and pulmonary tuberculosis in children and adolescents a case control study |
| topic | Tuberculosis SARS-CoV-2 Adolescents Immunology |
| url | https://doi.org/10.1186/s12879-023-08412-8 |
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