Tuberculosis in individuals who recovered from COVID-19: A systematic review of case reports.
<h4>Background</h4>The emergence of COVID-19 overwhelmed tuberculosis (TB) prevention and control, resulting in a decrease in TB detection rate and an increase in TB deaths. Furthermore, the temporary immunosuppressive effects, lung inflammation, and the corticosteroids used to treat COV...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0277807 |
| _version_ | 1797959160039473152 |
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| author | Ayinalem Alemu Zebenay Workneh Bitew Getachew Seid Getu Diriba Emebet Gashu Nega Berhe Solomon H Mariam Balako Gumi |
| author_facet | Ayinalem Alemu Zebenay Workneh Bitew Getachew Seid Getu Diriba Emebet Gashu Nega Berhe Solomon H Mariam Balako Gumi |
| author_sort | Ayinalem Alemu |
| collection | DOAJ |
| description | <h4>Background</h4>The emergence of COVID-19 overwhelmed tuberculosis (TB) prevention and control, resulting in a decrease in TB detection rate and an increase in TB deaths. Furthermore, the temporary immunosuppressive effects, lung inflammation, and the corticosteroids used to treat COVID-19, may play a direct role in immunosuppression, leading to reactivation of either previous infection or latent TB or the development of new TB. Thus, the aim of this study was to review TB incidence in individuals who recovered from COVID-19.<h4>Methods</h4>We conducted a systematic search of available databases for previously published studies that reported TB in COVID-19 survivors. The PRISMA checklist was used to guide the review, and the JBI checklist was used to evaluate the study's quality. The descriptive data were summarized.<h4>Results</h4>Data were extracted from 21 studies conducted in 13 countries having 33 cases. The median age was 44 years (range; 13.5-80), and more than half (18, 54.5%) were males. Twelve patients immigrated from TB endemic settings. All 17 patients assessed for HIV were seronegative, and all 11 patients assessed for BCG vaccination status were vaccinated. The majority (20, 69%) of patients had some type of comorbidity with diabetes (12/29) and hypertension (9/29) being the most common. Four patients (30.77%) had a history of TB. Corticosteroids were used to treat COVID-19 in 62.5% (10) of individuals. Dexamethasone, remdesivir, azithromycin, hydroxychloroquine, and enoxaparin were the most commonly used drugs to treat COVID-19. The most common TB symptoms were fever, cough, weight loss, dyspnea, and fatigue. Twenty, eleven, and two patients developed pulmonary, extrapulmonary, and disseminated/miliary TB respectively. It may take up to seven months after COVID-19 recovery to develop tuberculosis. Data on the final treatment outcome was found for 24 patients, and five patients died during the anti-TB treatment period.<h4>Conclusion</h4>Tuberculosis after recovering from COVID-19 is becoming more common, potentially leading to a TB outbreak in the post-COVID-19 era. The immunosuppressive nature of the disease and its treatment modalities may contribute to post COVID-19 TB. Thus, we recommend a further study with a large sample size. Furthermore, we recommend feasibility studies to assess and treat latent TB in COVID-19 patients residing in TB endemic counties since treatment of latent TB is done only in TB non-endemic countries. |
| first_indexed | 2024-04-11T00:28:27Z |
| format | Article |
| id | doaj.art-77457337f91b4aa8b973bfd5aaa051ca |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-11T00:28:27Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-77457337f91b4aa8b973bfd5aaa051ca2023-01-08T05:31:21ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-011711e027780710.1371/journal.pone.0277807Tuberculosis in individuals who recovered from COVID-19: A systematic review of case reports.Ayinalem AlemuZebenay Workneh BitewGetachew SeidGetu DiribaEmebet GashuNega BerheSolomon H MariamBalako Gumi<h4>Background</h4>The emergence of COVID-19 overwhelmed tuberculosis (TB) prevention and control, resulting in a decrease in TB detection rate and an increase in TB deaths. Furthermore, the temporary immunosuppressive effects, lung inflammation, and the corticosteroids used to treat COVID-19, may play a direct role in immunosuppression, leading to reactivation of either previous infection or latent TB or the development of new TB. Thus, the aim of this study was to review TB incidence in individuals who recovered from COVID-19.<h4>Methods</h4>We conducted a systematic search of available databases for previously published studies that reported TB in COVID-19 survivors. The PRISMA checklist was used to guide the review, and the JBI checklist was used to evaluate the study's quality. The descriptive data were summarized.<h4>Results</h4>Data were extracted from 21 studies conducted in 13 countries having 33 cases. The median age was 44 years (range; 13.5-80), and more than half (18, 54.5%) were males. Twelve patients immigrated from TB endemic settings. All 17 patients assessed for HIV were seronegative, and all 11 patients assessed for BCG vaccination status were vaccinated. The majority (20, 69%) of patients had some type of comorbidity with diabetes (12/29) and hypertension (9/29) being the most common. Four patients (30.77%) had a history of TB. Corticosteroids were used to treat COVID-19 in 62.5% (10) of individuals. Dexamethasone, remdesivir, azithromycin, hydroxychloroquine, and enoxaparin were the most commonly used drugs to treat COVID-19. The most common TB symptoms were fever, cough, weight loss, dyspnea, and fatigue. Twenty, eleven, and two patients developed pulmonary, extrapulmonary, and disseminated/miliary TB respectively. It may take up to seven months after COVID-19 recovery to develop tuberculosis. Data on the final treatment outcome was found for 24 patients, and five patients died during the anti-TB treatment period.<h4>Conclusion</h4>Tuberculosis after recovering from COVID-19 is becoming more common, potentially leading to a TB outbreak in the post-COVID-19 era. The immunosuppressive nature of the disease and its treatment modalities may contribute to post COVID-19 TB. Thus, we recommend a further study with a large sample size. Furthermore, we recommend feasibility studies to assess and treat latent TB in COVID-19 patients residing in TB endemic counties since treatment of latent TB is done only in TB non-endemic countries.https://doi.org/10.1371/journal.pone.0277807 |
| spellingShingle | Ayinalem Alemu Zebenay Workneh Bitew Getachew Seid Getu Diriba Emebet Gashu Nega Berhe Solomon H Mariam Balako Gumi Tuberculosis in individuals who recovered from COVID-19: A systematic review of case reports. PLoS ONE |
| title | Tuberculosis in individuals who recovered from COVID-19: A systematic review of case reports. |
| title_full | Tuberculosis in individuals who recovered from COVID-19: A systematic review of case reports. |
| title_fullStr | Tuberculosis in individuals who recovered from COVID-19: A systematic review of case reports. |
| title_full_unstemmed | Tuberculosis in individuals who recovered from COVID-19: A systematic review of case reports. |
| title_short | Tuberculosis in individuals who recovered from COVID-19: A systematic review of case reports. |
| title_sort | tuberculosis in individuals who recovered from covid 19 a systematic review of case reports |
| url | https://doi.org/10.1371/journal.pone.0277807 |
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