Long-term outcomes of the global tuberculosis and COVID-19 co-infection cohort

Casco N.; Jorge A.L.; Palmero D.J.; Alffenaar J.-W.; Fox G.J.; Ezz W.; Cho J.-G.; Denholm J.; Skrahina A.; Solodovnikova V.; Arbex M.A.; Alves T.; Rabahi M.F.; Pereira G.R.; Sales R.; Silva D.R.; Saffie M.M.; Salinas N.E.; Miranda R.C.; Cisterna C.; Concha C.; Fernandez I.; Villalón C.; Vera C.G.; Tapia P.G.; Cancino V.; Carbonell M.; Cruz A.; Muñoz E.; Muñoz C.; Navarro I.; Pizarro R.; Sánchez G.P.C.; Riquelme M.S.V.; Vilca E.; Soto A.; Flores X.; Garavagno A.; Bahamondes M.H.; Merino L.M.; Pradenas A.M.; Revillot M.E.; Rodriguez P.; Salinas A.S.; Taiba C.; Valdés J.F.; Subiabre J.N.; Ortega C.; Palma S.; Castillo P.P.; Pinto M.; Bidegain F.R.; Venegas M.; Yucra E.; Li Y.; Cruz A.; Guelvez B.; Plaza R.V.; Hoyos K.Y.T.; Cardoso-Landivar J.; Van Den Boom M.; Andréjak C.; Blanc F.-X.; Dourmane S.; Froissart A.; Izadifar A.; Rivière F.; Schlemmer F.; Manika K.; Diallo B.D.; Hassane-Harouna S.; Artiles N.; Mejia L.A.; Gupta N.; Ish P.; Mishra G.; Patel J.M.; Udwadia Z.F.; Singla R.; Alladio F.; Calcagno A.; Gaviraghi A.; Angeli F.; Centis R.; Codecasa L.R.; De Lauretis A.; Esposito S.M.R.; Formenti B.; Giacomet V.; Goletti D.; Gualano G.; Matteelli A.; Migliori G.B.; Motta I.; Palmieri F.; Pontali E.; Prestileo T.; Riccardi N.; Saderi L.; Saporiti M.; Sotgiu G.; Spanevello A.; Stochino C.; Tadolini M.; Torre A.; Villa S.; Visca D.; Kurhasani X.; Furjani M.; Rasheed N.; Danila E.; Diktanas S.; López Ridaura R.; López F.L.L.; Torrico M.M.; Rendon A.; Akkerman O.W.; Chizaram O.; Al-Abri S.; Alyaquobi F.; Althohli K.; Aguirre S.; Teixeira R.C.; De Egea V.; Irala S.; Medina A.; Sequera G.; Sosa N.; Vázquez F.; Llanos-Tejada F.K.; Manga S.; Villanueva-Villegas R.; Araujo D.; Duarte R.; Marques T.S.; Grecu V.I.; Socaci A.; Barkanova O.; Bogorodskaya M.; Borisov S.; Mariandyshev A.; Kaluzhenina A.; Vukicevic T.A.; Stosic M.; Beh D.; Ng D.; Ong C.W.M.; Solovic I.; Dheda K.; Gina P.; Caminero J.A.; De Souza Galvão M.L.; Dominguez-Castellano A.; García-García J.-M.; Pinargote I.M.; Fernandez S.Q.; Sánchez-Montalvá A.; Huguet E.T.; Murguiondo M.Z.; Bart P.-A.; Mazza-Stalder J.; D Ambrosio L.; Kamolwat P.; Bakko F.; Barnacle J.; Bird S.; Brown A.; Chandran S.; Killington K.; Man K.; Papineni P.; Ritchie F.; Tiberi S.; Utjesanovic N.; Zenner D.; Hearn J.L.; Heysell S.; Young L. · European Respiratory Journal (2023) · DOI: 10.1183/13993003.00925-2023

Resumen

Background Longitudinal cohort data of patients with tuberculosis (TB) and coronavirus disease 2019 (COVID-19) are lacking. In our global study, we describe long-term outcomes of patients affected by TB and COVID-19. Methods We collected data from 174 centres in 31 countries on all patients affected by COVID-19 and TB between 1 March 2020 and 30 September 2022. Patients were followed-up until cure, death or end of cohort time. All patients had TB and COVID-19; for analysis purposes, deaths were attributed to TB, COVID-19 or both. Survival analysis was performed using Cox proportional risk-regression models, and the log-rank test was used to compare survival and mortality attributed to TB, COVID-19 or both. Results Overall, 788 patients with COVID-19 and TB (active or sequelae) were recruited from 31 countries, and 10.8% (n=85) died during the observation period. Survival was significantly lower among patients whose death was attributed to TB and COVID-19 versus those dying because of either TB or COVID-19 alone (p<0.001). Significant adjusted risk factors for TB mortality were higher age (hazard ratio (HR) 1.05, 95% CI 1.03–1.07), HIV infection (HR 2.29, 95% CI 1.02–5.16) and invasive ventilation (HR 4.28, 95% CI 2.34–7.83). For COVID-19 mortality, the adjusted risks were higher age (HR 1.03, 95% CI 1.02–1.04), male sex (HR 2.21, 95% CI 1.24–3.91), oxygen requirement (HR 7.93, 95% CI 3.44–18.26) and invasive ventilation (HR 2.19, 95% CI 1.36–3.53). Conclusions In our global cohort, death was the outcome in >10% of patients with TB and COVID-19. A range of demographic and clinical predictors are associated with adverse outcomes.