A systematic review of reactivation of tuberculosis due to use of corticosteroids for COVID-19 treatment between January 2020 to January 2022

Coronavirus-19 disease became a matter of concern for the whole world and WHO declared it as pandemic on 11 March 2020. Soon a number of clinical trials started to check for the treatment modalities, to compare their efficacy and safety. Out of which corticosteroids in trials showed decrease in mortality in severe COVID-19 patients. However existing diseases such as tuberculosis still remains a leading killer and matter of concern. One out of four individuals are said to be having tuberculosis (mostly in inactive form or latent form) but there remains a threat of reactivation of tuberculosis in presence of risk factors such as corticosteroid administration as it causes immunosuppression. This is a retrospective observational study on reactivation of tuberculosis due to corticosteroids used in COVID-19 treatment. Most commonly given corticosteroid was found to be dexamethasone and the duration of corticosteroid therapy ranged between 5 to 12 days. Majority of patients (5 out of 6) showed reactivation of tuberculosis within 30 days of starting of corticosteroid therapy and most common co-morbidity associated was found to be diabetes mellitus followed by hypertension in such patients. Symptoms of 4 out of 6 patients resolved after starting of anti-tubercular therapy.