Tuberculosis in individuals who recovered from COVID-19: a systematic review of case reports

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dc.contributor.authorAlemu, Ayinalemen_ZA
dc.contributor.authorBitew, Zebenay Worknehen_Za
dc.contributor.authorSeid, Getachewen_ZA
dc.contributor.authorDiriba, Getuen_ZA
dc.contributor.authorGashu, Emebeten_ZA
dc.contributor.authorBerhe, Negaen_ZA
dc.contributor.authorMariam, Solomon H.en_ZA
dc.contributor.authorGumi, Balakoen_ZA
dc.date.accessioned2023-04-28T09:33:31Zen_ZA
dc.date.available2023-04-28T09:33:31Zen_ZA
dc.date.issued2021-11en_ZA
dc.descriptionCITATION: Alemu, A. et al. (2021) Tuberculosis in individuals who recovered from COVID-19: A systematic review of case reports. PLoS ONE17(11): e0277807. doi.10.1371/journal.pone.0277807en_ZA
dc.descriptionThe original publication is available at: journals.plos.orgen_ZA
dc.description.abstractBackground The emergence of COVID-19 overwhelmed tuberculosis (TB) prevention and control, resulting in a decrease in TB detection rate and an increase in TB deaths. Furthermore, the temporary immunosuppressive effects, lung inflammation, and the corticosteroids used to treat COVID-19, may play a direct role in immunosuppression, leading to reactivation of either previous infection or latent TB or the development of new TB. Thus, the aim of this study was to review TB incidence in individuals who recovered from COVID-19. Methods We conducted a systematic search of available databases for previously published studies that reported TB in COVID-19 survivors. The PRISMA checklist was used to guide the review, and the JBI checklist was used to evaluate the study’s quality. The descriptive data were summarized. Results Data were extracted from 21 studies conducted in 13 countries having 33 cases. The median age was 44 years (range; 13.5–80), and more than half (18, 54.5%) were males. Twelve patients immigrated from TB endemic settings. All 17 patients assessed for HIV were seronegative, and all 11 patients assessed for BCG vaccination status were vaccinated. The majority (20, 69%) of patients had some type of comorbidity with diabetes (12/29) and hypertension (9/29) being the most common. Four patients (30.77%) had a history of TB. Corticosteroids were used to treat COVID-19 in 62.5% (10) of individuals. Dexamethasone, remdesivir, azithromycin, hydroxychloroquine, and enoxaparin were the most commonly used drugs to treat COVID-19. The most common TB symptoms were fever, cough, weight loss, dyspnea, and fatigue. Twenty, eleven, and two patients developed pulmonary, extrapulmonary, and disseminated/miliary TB respectively. It may take up to seven months after COVID-19 recovery to develop tuberculosis. Data on the final treatment outcome was found for 24 patients, and five patients died during the anti-TB treatment period. Conclusion Tuberculosis after recovering from COVID-19 is becoming more common, potentially leading to a TB outbreak in the post-COVID-19 era. The immunosuppressive nature of the disease and its treatment modalities may contribute to post COVID-19 TB. Thus, we recommend a further study with a large sample size. Furthermore, we recommend feasibility studies to assess and treat latent TB in COVID-19 patients residing in TB endemic counties since treatment of latent TB is done only in TB non-endemic countries.en_ZA
dc.description.versionPublisher’s versionen_ZA
dc.format.extent17 pagesen_ZA
dc.identifier.citationAlemu, A. et al. (2021) Tuberculosis in individuals who recovered from COVID-19: A systematic review of case reports. PLoS ONE17(11): e0277807. doi.10.1371/journal.pone.0277807en_ZA
dc.identifier.issn1932-6203 (online)en_ZA
dc.identifier.otherdoi.10.1371/journal.pone.0277807en_ZA
dc.identifier.urihttp://hdl.handle.net/10019.1/126849en_ZA
dc.language.isoen_ZAen_ZA
dc.publisherPLOSen_ZA
dc.rights.holderAuthors retain copyrighten_ZA
dc.subjectTuberculosis -- Preventionen_ZA
dc.subjectCOVID-19 (Disease) -- Complicationsen_ZA
dc.subjectImmunosuppressive agentsen_ZA
dc.subjectPublic healthen_ZA
dc.subjectTuberculosis -- Patientsen_ZA
dc.titleTuberculosis in individuals who recovered from COVID-19: a systematic review of case reportsen_ZA
dc.typeArticleen_ZA
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