Clinical Features and Treatment Outcome of Coronavirus and Tuberculosis Co-Infected Patients: A Systematic Review of Case Reports

Abstract

Background: Coronavirus disease 19 (COVID-19) and Mycobacterium tuberculosis (MTB) are among the top ongoing health crises globally. Both cause respiratory diseases, and the clinical presentations are similar. There is no summarized information about cases of COVID-19 patients with concomitant TB infection from different settings. Therefore this review aimed to summerize the clinical features and treatment outcomes of coronavirus and tuberculosis co-infected patients. Methods: An electronic search of case reports published between 2020 and 2021 was conducted using Google Scholar, PubMed, Scopus, and ScienceDirect. From eligible reports, data were collected for the selected variables. We analyzed the collected information using SPSS version 27 software. Descriptive statistics were computed for the selected variables. Results: A total of 83 patient histories were collected from 47 case reports. The majority (80%) of the cases were reported for male patients. The mean age was 42.6 years (3 months to 84 years, SD=17.3). Fever was reported in 80% of cases, followed by cough (73.3%) and hypotension (37.1%). Blood cell parameters revealed lymphopenia (52%), lower hemoglobin (30%), elevated CRP (70%), elevated ferritin (28%), and increased D-dimer (23.4%). Treatment outcome is significantly associated with blood cell count results (p-0.044) and a rise in blood inflammatory cytokines(p-0.041). The mean days for viral clearance or negative PCR was 23 days (Range 5–82 days) and the overall mean duration of hospitalization was 27 days. The total death rate was 22.4%. Recovery was reported for 76.6% of cases. Survival status (p-0.613) and disease severity (p-0.68) are not significantly associated with the gender of the participants. Conclusion: An alteration in blood cell parameters is associated with an unfavorable treatment outcome. There is a higher death rate in COVID-19/TB co-infection. The death is associated with older age, smoking or smoking history, drug abuse, and co-morbidity of non-communicable diseases. Conversely, there is a lower death rate in HIV patients.