Long-term outcomes of the global tuberculosis and COVID-19 co-infection cohort
Global Tuberculosis Network and TB/COVID-19 Global Study Group, Nicolás Casco, Alberto Levi Jorge, Domingo Palmero, Jan‐Willem C. Alffenaar, Greg J. Fox, Wafaa Ezz, Jin‐Gun Cho, Justin T. Denholm, Alena Skrahina, Varvara Solodovnikova, Marcos Abdo Arbex, Tatiana Alves, Marcelo Fouad Rabahi, Giovana Rodrigues Pereira, Roberta Sales, Denise Rossato Silva, Muntasir Saffie, Nadia Escobar Salinas, Ruth Caamaño Miranda, Catalina Cisterna, Clorinda Concha, Israel Fernandez, Claudia Villalón, Carolina Guajardo Vera, Patricia Gallegos Tapia, Viviana Cancino, Monica Carbonell, Arturo Jiménez Cruz, Eduardo Muñóz, Camila Muñoz, Indira Navarro, Rolando Pizarro, Gloria Pereira Cristina Sánchez, Maria Soledad Vergara Riquelme, Evelyn Vilca, Aline Soto, Ximena Figueroa Flores, Ana Garavagno, Martina Hartwig Bahamondes, L. Merino, Ana María Pradenas, Macarena Espinoza Revillot, Patricia Rodríguez, Angeles Serrano Salinas, Carolina Taiba, Joaquín Farías Valdés, Jorge Navarro Subiabre, Carlos Ortega, Sofia Palma, Patricia Perez Castillo, Mónica Pinto, Francisco Rivas Bidegain, Margarita Venegas, Edith Yucra, Yang Li, Andres Cruz, Beatriz Guelvez, Regina Victoria Plaza, Kelly Yoana Tello Hoyos, José Landivar, Martin van den Boom, Claire Andréjak, F.–X. Blanc, Samir Dourmane, Antoine Froissart, A. Izadifar, F. Rivière, F. Schlemmer, Κaterina Manika, Boubacar Diallo, Souleymane Hassane-Harouna, Norma Artiles, Licenciada Andrea Mejia, Nitesh Gupta, Pranav Ish, Gyanshankar Mishra, Jigneshkumar M. Patel, Rupak Singla, Zarir Udwadia, Francesca Alladio, Fabio Angeli, Andrea Calcagno, Rosella Centis, Luigi Ruffo Codecasa, Angelo De Lauretis, Susanna Esposito, Beatrice Formenti, Alberto Gaviraghi, Vania Giacomet, Delia Goletti, Gina Gualano, Alberto Matteelli, Giovanni Battista Migliori, Ilaria Motta, Fabrizio Palmieri, Emanuele Pontali, Tullio Prestileo, Niccolò Riccardi, Laura Saderi
Abstract
BACKGROUND: Longitudinal cohort data of patients with tuberculosis (TB) and coronavirus disease 2019 (COVID-19) are lacking. In our global study, we describe long-term outcomes of patients affected by TB and COVID-19. METHODS: We collected data from 174 centres in 31 countries on all patients affected by COVID-19 and TB between 1 March 2020 and 30 September 2022. Patients were followed-up until cure, death or end of cohort time. All patients had TB and COVID-19; for analysis purposes, deaths were attributed to TB, COVID-19 or both. Survival analysis was performed using Cox proportional risk-regression models, and the log-rank test was used to compare survival and mortality attributed to TB, COVID-19 or both. RESULTS: those dying because of either TB or COVID-19 alone (p<0.001). Significant adjusted risk factors for TB mortality were higher age (hazard ratio (HR) 1.05, 95% CI 1.03-1.07), HIV infection (HR 2.29, 95% CI 1.02-5.16) and invasive ventilation (HR 4.28, 95% CI 2.34-7.83). For COVID-19 mortality, the adjusted risks were higher age (HR 1.03, 95% CI 1.02-1.04), male sex (HR 2.21, 95% CI 1.24-3.91), oxygen requirement (HR 7.93, 95% CI 3.44-18.26) and invasive ventilation (HR 2.19, 95% CI 1.36-3.53). CONCLUSIONS: In our global cohort, death was the outcome in >10% of patients with TB and COVID-19. A range of demographic and clinical predictors are associated with adverse outcomes.