Impact of Tuberculosis on Disease Severity and Viral Shedding Duration in COVID-19 Patients

Wei Huang; Ping Liu; Bo Yan; Fang Zheng; Yang Yang; Xiuhong Xi; Lu Xia; Yinzhong Shen

doi:10.3390/v16020260

Impact of Tuberculosis on Disease Severity and Viral Shedding Duration in COVID-19 Patients

Viruses. 2024 Feb 6;16(2):260. doi: 10.3390/v16020260.

Authors

Wei Huang¹, Ping Liu¹, Bo Yan², Fang Zheng³, Yang Yang¹, Xiuhong Xi¹, Lu Xia¹, Yinzhong Shen⁴

Affiliations

¹ Department of Tuberculosis, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.
² Center for Tuberculosis Research, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.
³ Department of Medical Affairs, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.
⁴ Department of Infection and Immunity, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.

Abstract

Accumulating evidence show a potential association between tuberculosis and COVID-19 disease severity. To further clarify the impact of tuberculosis on COVID-19 disease severity and viral shedding duration, a retrospective study was conducted on 223 COVID-19 patients, including 34 with tuberculosis and 189 without tuberculosis. Clinical information and viral load shedding time were collected. A higher percentage of severe/critical COVID-19 diagnosis and deaths was observed in patients with tuberculosis than in those without tuberculosis (8.8% vs. 3.2%, p = 0.142; 2.9% vs. 1.1%, p = 0.393), and COVID-19 patients with tuberculosis had longer viral shedding than those without tuberculosis (median: 15.0 days vs. 11.0 days; p = 0.0001). Having tuberculosis (HR = 2.21, 95% CI 1.37-3.00; p = 0.000), being of elderly age (HR = 1.02, 95% CI 1.01-1.03; p = 0.001) and being diagnosed with severe or critical COVID-19 (HR = 5.63, 95% CI 2.10-15.05; p = 0.001) were independent factors associated with prolonged virus time of SARS-CoV-2. COVID-19 patients with tuberculosis receiving anti-tuberculosis therapy time (ATT) for <2 months had a significantly longer virus shedding duration than those receiving ATT for ≥ 4 months (17.5 vs. 11.5 days, p = 0.012). Our results demonstrated that COVID-19 patients with tuberculosis tend to have more severe disease and a worse prognosis, and tuberculosis prolonged viral shedding, highlighting special attention and/or care required for COVID-19 patients with tuberculosis receiving ATT for <2 months.

Keywords: COVID-19; severity; tuberculosis; viral shedding.

MeSH terms

Aged
COVID-19 Testing
COVID-19*
Humans
Patient Acuity
RNA, Viral
Retrospective Studies
SARS-CoV-2
Tuberculosis* / complications
Tuberculosis* / diagnosis
Tuberculosis* / drug therapy
Virus Shedding

Substances

RNA, Viral

Grants and funding

This study was funded by Shanghai Municipal Science and Technology Major Project, Shanghai Science and Technology Committee (ZD2021CY001), and Shanghai Shenkang Hospital Development Center Clinical Science and Technology Innovation Project (SHDC22021317). The funders had no role in study design, data collection, data analysis, data interpretation, or writing of the report.