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ORIGINAL RESEARCH article
Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 11 - 2024 |
doi: 10.3389/fmed.2024.1416197
The impact of pulmonary tuberculosis on SARS-CoV-2 infection: A nationwide cohort study
Provisionally accepted
Sang Hwan Lee
1
Yun Jin Kim
1,2
Jaehoon Oh
1
Hyunggoo Kang
1
Kyung Hun Yoo
1
Byuk Sung Ko
1
TAE HO LIM
1
Bo-Guen Kim
3
Hyun Lee
1,3
Sang-Heon Kim
3
Jang Won Sohn
3
Ho Joo Yoon
3
Hayoung Choi
3
Yongil Cho
1*
Dong Won Park
3*- 1 College of Medicine, Hanyang University, Seoul, Seoul, Republic of Korea
- 2 Hanyang University, Seoul, Republic of Korea
- 3 Division of Pulmonary Medicine and Allergy, Dept of Internal Medicine, Hanyang University College of Medicine., Seoul, Republic of Korea
Background: The interaction between COVID-19 and tuberculosis (TB) is not yet fully understood, and large-scale research on the mortality outcome of such dual infection has been limited. This study aimed to investigate the impact of PTB on mortality among patients with COVID-19 within a Korean population by conducting an extensive analysis of a nationwide large dataset. Method: We investigated the mortality and disease severity among COVID-19 patients who had PTB in South Korea. This study analyzed 462,444 out of 566,494 COVID-19 patients identified between January 2020 and December 2021. Result: A total of 203 COVID-19 with PTB patients and 812 matched COVID-19 without PTB were analyzed using 1:4 propensity score matching. COVID-19 patients with PTB exhibited higher in-hospital mortality (odds ratio (OR) 3.02, 95% confidence interval (CI) 1.45-6.27, p-value = 0.003) and were at increased risk of requiring conventional oxygen therapy (OR 1.57, 95% CI 1.10-2.25, p-value=0.013) as well as high flow nasal cannula (HFNC) or noninvasive ventilation (NIV) oxygen therapy (OR 1.91, 95 CI 1.10-3.32, p-value =0.022) compared to those without PTB. Compared to matched COVID-19 without PTB, co-infected patients showed increased mortality rates across various timeframes, including during hospitalization, and at 30-day and 90-day intervals. In-hospital mortality rates were particularly elevated among women, individuals with malignancy, and those with lower incomes. Furthermore, the increased in-hospital mortality among PTB patients persisted irrespective of the timing of TB diagnosis or vaccination status against COVID-19. Conclusion: We suggest that physicians be aware of the risk of mortality and severity among COVID-19 patients with PTB; coinfection with COVID-19 is a critical situation that remains to be further explored and needs more attention in countries with an intermediate to high PTB burden.
Keywords: COVID-19, pulmonary tuberculosis, Tuberculosis, Mortality, Coinfection
Received: 12 Apr 2024; Accepted: 23 Aug 2024.
Copyright: © 2024 Lee, Kim, Oh, Kang, Yoo, Ko, LIM, Kim, Lee, Kim, Sohn, Yoon, Choi, Cho and Park. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yongil Cho, College of Medicine, Hanyang University, Seoul, 04763, Seoul, Republic of Korea
Dong Won Park, Division of Pulmonary Medicine and Allergy, Dept of Internal Medicine, Hanyang University College of Medicine., Seoul, Republic of Korea
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