Clinical outcomes of patients with coronavirus disease 2019 and active tuberculosis co-infection in Beijing China: A retrospective single-center descriptive study

北京地区新型冠状病毒肺炎合并活动性结核病患者的临床结局:一项回顾性单中心描述性研究

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Abstract

BACKGROUND: Coronavirus disease 2019 (COVID-19) and tuberculosis (TB) co-infection (COVID-19-TB) has the potential to exacerbate lung damage; however, information about the clinical features of COVID-19-TB is limited. This study aims to clarify the clinical characteristics and outcomes of patients with COVID-19-TB. METHODS: In this single-center retrospective study, the clinical features and outcomes of patients with COVID-19 with active TB who were admitted to Beijing Chest Hospital, Beijing, China, from 1 December 2022 to 18 January 2023 were collected. The severity of COVID-19 and TB was graded according to guidelines from the World Health Organization. The relationships of demographic and clinical variables with intensive care unit (ICU) admission were evaluated using univariable and multivariable logistic regression models. RESULTS: Overall, 102 patients with COVID-19-TB were enrolled. The mean age was 54.5 years (range 36.5-70 years). The most common clinical manifestations were cough (68.63%), sputum production (53.92%), fever (51.96%), and ground-glass opacities (35.29%). Complications included acute respiratory distress syndrome (11.76%), sepsis (9.8%), and respiratory failure (7.84%). Patients with COVID-19-TB had high concentrations of various proinflammatory cytokines, including interferon-γ, interleukin-1β, interferon-γ-inducible protein 10 kD, and monocyte chemoattractant protein-1. Sixteen of the 102 patients with COVID-19-TB (15.69%) were admitted to the ICU, and 10 (9.80%) died during hospitalization. The significant risk factors for ICU admission were respiratory failure, pulmonary fungal infection, and ventilation and oxygen therapy. CONCLUSIONS: The mortality rate of COVID-19-TB was 9.80%. Several demographic and clinical characteristics were associated with adverse outcomes, indicating the importance of early recognition and treatment.

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