Clinical characteristics of COVID-19 in patients with tuberculosis and factors associated with the disease severity

BACKGROUND: Data on patients with COVID-19 who have pulmonary tuberculosis (TB) are limited. In this study, we compared the clinical characteristics of patients with COVID-19/TB and patients with COVID-19 only. In addition, we analyzed the links between the severity of COVID-19 disease and the clinical characteristics of patients with COVID-19/TB. METHODS: We conducted a retrospective, anonymized, cross-sectional study of 111 patients who met inclusion criteria for analysis (75 patients with COVID-19/TB and 36 patients with COVID-19). RESULTS: Patients in both groups (COVID-19/TB vs COVID-19) mainly suffered from fever (72.0% vs 100%, p < 0.001), fatigue (76.0% vs 94.4%, p = 0.018), chest pain (72.0% vs 36.1%, p < 0.001), followed by cough (60.0% vs 97.2%, p < 0.001) and dyspnea (44.0% vs 63.9%, p = 0.05). In group COVID-19/TB the most frequently reported co-morbidities were chronic liver disease (17 [22.7%]), cardiovascular diseases (25 [33.3%]), and diseases of the nervous system (13 [17.3%]). Female gender, fever, dyspnea, pulmonary bilateral TB lesion, and three or more co-morbidities have a statistically significant positive effect on the severity of the disease among patients with COVID-19/TB. CONCLUSION: It is important to perform rapid molecular testing and computed tomography to correctly distinguish COVID-19 and TB because of the similar clinical characteristics of both diseases. Bilateral pulmonary TB lesion and co-morbidity should be considered risk factors for severe COVID-19.