Tuberculosis/SARS-CoV-2 Co-infection: a Case Series

<bold>Background:</bold> SARS-CoV-2 and tuberculosis affect the lungs and may present with severe pulmonary disease and death. Based on the hypothesis that pulmonary tuberculosis (TB) is related to more severe clinical forms of COVID-19, this study aimed to identify the frequency of TB/SARS-CoV-2 co-infection, the death rates, and their associated factors in inpatients with TB. <bold>Method:</bold> This was a retrospective case series, which assessed data from electronic medical records of adults with TB admitted to a tertiary hospital, between March-July/2020. For the analysis, a significance level of 5%, and SPSS v.22 were used. <bold>Outcomes:</bold> From a total of 53 patients, eight (15%) presented with TB/COVID co-infection. The mean age was 42 ±15 years and the majority were male (79%). The most frequent symptoms were dyspnea (89%), fever (87%) and chest pain (57%). The death rate between co-infected and non-co-infected was 38% and 4%, respectively (OR=12.9; p=0.003). Initially, we compared two groups: death and non-death. In the death group, coinfection (60%), use of O₂ (100%), admission to the intensive care unit (ICU); (100%), mechanical ventilation (MV); (100%) were more frequent (p <0.05, for all). There was also a higher average length of hospital stay (p=0.001) and number of leukocytes (p=0.029), with no differences in relation to the other clinical variables or radiological (cavitations). When comparing co-infected versus non-co-infected patients, ICU admission (63%) and use of O₂ (88%) were more frequent amongst co-infected patients (p <0.05 for both). <bold>Conclusion:</bold> The findings of this preliminary study suggest that TB/SARS-CoV-2 co-infection may be related to greater severity and death rate. The screening for COVID-19 in inpatients with TB is of relevance.