Prior COVID‐19 infection among newly diagnosed tuberculosis patients in a tertiary care center in Tehran: A case‐control study

Abstract

Abstract Objective To assess the risk of developing pulmonary tuberculosis (TB) in accordance with prior history of COVID‐19 infection. Background Since the advent of the COVID‐19 pandemic much discussion has been had on the possible role it might play on global efforts to combat TB; most, focusing on the pandemic's impact on health care systems' capabilities to manage TB cases. Mechanisms have also been proposed by which the COVID‐19 infection may directly affect individuals' chance of developing TB infection. Cases have been reported with a history of COVID‐19 infection preceding a diagnosis of TB, evidencing its possible role as a risk factor for the disease. Methods A case‐control study was conducted enrolling patients diagnosed with pulmonary TB in the absence of major risk factors previous history of TB, (HIV) human immunodeficiency virus infection), end‐stage renal disease, organ transplants, and use of immunosuppressive agents) for developing TB. Each patient was age and sex matched with one healthy control. Data regarding prior COVID‐19 infection, diabetes, and smoking status as well as the use of corticosteroids and Tocilizumab for the treatment of COVID‐19 infection was obtained. Bivariate analysis was conducted and variables with a likely association with TB status were entered in a multivariate model. Results Bivariate analysis demonstrated a significant relationship between prior COVID‐19 infection and TB (95% confidence interval = 1.1−22.8, odds ratio [OR] = 5). Among other variables the severity of COVID‐19 infection was found to have a likely association with TB status (p = .125). In a multivariate model, prior COVID‐19 infection per se, was not found to be significantly associated with TB (p = .12, OR = 4.5). Conclusions There seems to be an association between prior history of COVID‐19 and a future diagnosis of TB partially linked to the severity of disease. The findings of the current study may serve as a basis for further studies to determine the need for and efficacy of measures to follow‐up COVID‐19 patients at an increased risk for developing TB.

Keywords

• corticosteroid
• COVID‐19
• prevention
• pulmonary
• reactivation
• risk