Tuberculosis and COVID-19 Co-infection: An Updated Review Tuberculosis and COVID -19 Co-infection

Main Article Content

Ajay Mishra
Anu Anna George
Kamal Kant Sahu
Amos Lal
George Abraham


Tuberculosis, COVID -19, Diagnosis, Outcome, Mortality, Evidence


Coronavirus disease (COVID 19) has involved millions of people all over the world. Tuberculosis (TB) continues to affect millions of people every year with high mortality. There is limited literature on the occurrence of COVID 19 in patients with TB. We reviewed the available data on various clinical details, management, and outcome among patients with COVID-19 and TB. 8 studies reported a total of 80 patients with this coinfection. These patients were reported from ten different countries, with Italy reporting the largest number of cases. Migrant, males constituted a major proportion of cases. Most reported patients were symptomatic. Fever, dry cough, and dyspnea were the most commonly reported symptoms. Bilateral ground glass opacities were more common in COVID 19 infection and cavitary lesions were more common in patients with TB. Most reported TB patients had been found to have mycobacterium tuberculosis from sputum culture in the background of pulmonary TB. Most patients of TB were treated with multidrug regimen antitubercular therapy. In all 8 studies, COVID 19 was treated as per the local protocol. Mortality was reported in more than 10% of patients. Mortality was higher in elderly patients (> 70 years) and amongst patient with multiple medical comorbidities


Download data is not yet available.


Metrics Loading ...
Abstract 2391 | PDF Downloads 1700


1. Sahu KK, Mishra AK, Lal A. Trajectory of the COVID-19 pandemic: chasing a moving target. Ann Transl Med. 2020;8(11):694. doi:10.21037/atm-20-2793
2. Goyal P, Choi JJ, Pinheiro LC, et al. Clinical Characteristics of Covid-19 in New York City. N Engl J Med. 2020;382(24):2372-2374. doi:10.1056/NEJMc2010419
3. Sahu KK, Mishra AK, Martin K, Chastain I. COVID-19 and restrictive lung disease: A deadly combo to trip off the fine balance. Monaldi Arch Chest Dis. 2020;90(2):10.4081/monaldi.2020.1346. Published 2020 Jun 29. doi:10.4081/monaldi.2020.1346
4. Mishra AK, Lal A, Sahu KK, Sargent J. Cardiovascular factors predicting poor outcome in COVID-19 patients [published online ahead of print, 2020 May 28]. Cardiovasc Pathol. 2020;49:107246. doi:10.1016/j.carpath.2020.107246
5. WHO Global tuberculosis report 2019. WHO/CDS/TB/2019.15.
6. Lal A, Mishra AK, Sahu KK, Abraham GM. The return of Koch's: Ineffective treatment or re-infection. Enferm Infecc Microbiol Clin. 2020;38(3):144-145. doi:10.1016/j.eimc.2019.06.001
7. Dv K, Gunasekaran K, Mishra AK, Iyyadurai R. Disseminated tuberculosis presenting as cold abscess of the thyroid gland-a case report. Oxf Med Case Reports. 2017;2017(9):omx049. Published 2017 Sep 11. doi:10.1093/omcr/omx049
8. Sahu KK, Mishra AK, Lal A, Abraham GM. Mycobacterium Avium Complex: A Rare Cause of Pancytopenia in HIV Infection. J Microsc Ultrastruct. 2019;8(1):27-30. Published 2019 Nov 29. doi:10.4103/JMAU.JMAU_18_19
9. John SM, Sagar S, Aparna JK, Joy S, Mishra AK. Risk factors for hypercalcemia in patients with tuberculosis. Int J Mycobacteriol. 2020;9(1):7-11. doi:10.4103/ijmy.ijmy_211_19
10. He, G., Wu, J., Shi, J., Dai, J., Gamber, M., Jiang, X., Sun, W., Cai, J., 2020. COVID‐19 in Tuberculosis patients: a report of three cases. Journal of Medical Virology.. doi:10.1002/jmv.25943
11. Motta I, Centis R, D'Ambrosio L, et al. Tuberculosis, COVID-19 and migrants: preliminary analysis of deaths occurring in 69 patients from two cohorts [published online ahead of print, 2020 May 14]. Pulmonology. 2020;10.1016/j.pulmoe.2020.05.002. doi:10.1016/j.pulmoe.2020.05.002
12. Rajendra A, Mishra AK, Francis NR, Carey RA. Severe hypercalcemia in a patient with pulmonary tuberculosis. J Family Med Prim Care. 2016;5(2):509-511. doi:10.4103/2249-4863.192327
13. Stochino C, Villa S, Zucchi P, Parravicini P, Gori A, Raviglione MC. Clinical characteristics of COVID-19 and active tuberculosis co-infection in an Italian reference hospital [published online ahead of print, 2020 Jun 1]. Eur Respir J. 2020;2001708. doi:10.1183/13993003.01708-2020
14. Lal A, Mishra AK, Sahu KK. CT chest findings in coronavirus disease-19 (COVID-19). J Formos Med Assoc. 2020;119(5):1000-1001. doi:10.1016/j.jfma.2020.03.010
15. Khurana AK, Aggarwal D. The (in)significance of TB and COVID-19 co-infection [published online ahead of print, 2020 Jun 18]. Eur Respir J. 2020;2002105. doi:10.1183/13993003.02105-2020
16. Ninan F, Mishra AK, John AO, Iyadurai R. Splenic granuloma: Melioidosis or Tuberculosis?. J Family Med Prim Care. 2018;7(1):271-273. doi:10.4103/jfmpc.jfmpc_171_17
17. Tadolini M, Codecasa LR, García-García JM, et al. Active tuberculosis, sequelae and COVID-19 co-infection: first cohort of 49 cases. Eur Respir J. 2020;56(1):2001398. Published 2020 Jul 9. doi:10.1183/13993003.01398-2020
18. Lal A, Mishra AK, Sahu KK, Davaro R. Tuberculous cold abscess eroding iliac bone. Rev Esp Patol. 2020;53(1):71-72. doi:10.1016/j.patol.2019.08.002
19. Prompetchara E., Ketloy C., Palaga T. Immune responses in COVID-19 and potential vaccines: lessons learned from SARS and MERS epidemic. Asian Pac J Allergy Immunol. 2020;38:1–9. doi: 10.12932/AP-200220-0772.
20. Mishra AK, Sahu KK, George AA, Lal A. A review of cardiac manifestations and predictors of outcome in patients with COVID - 19 [published online ahead of print, 2020 May 3]. Heart Lung. 2020;S0147-9563(20)30157-6. doi:10.1016/j.hrtlng.2020.04.019
21. Sahu KK, Mishra AK, Martin K, Chastain I. COVID-19 and clinical mimics. Correct diagnosis is the key to appropriate therapy. Monaldi Arch Chest Dis. 2020;90(2):10.4081/monaldi.2020.1327. Published 2020 May 6. doi:10.4081/monaldi.2020.1327
22. Mishra AK, Sahu KK, Lal A, Sargent J. Mechanisms of stroke and the role of anticoagulants in COVID-19 [published online ahead of print, 2020 Jun 26]. J Formos Med Assoc. 2020;S0929-6646(20)30286-2. doi:10.1016/j.jfma.2020.06.026
23. Sadanshiv M, George AA, Mishra AK, Kuriakose CK. Rifampicin-induced immune allergic reaction. Trop Doct. 2018;48(2):156-159. doi:10.1177/0049475517724689
24. Mishra AK, Sahu KK, Sargent J. Cardiac drugs and outcome in COVID-19. QJM. 2020;113(7):523-524. doi:10.1093/qjmed/hcaa127
25. Chopra KK, Arora VK, Singh S. COVID 19 and tuberculosis. Indian J Tuberc. 2020;67(2):149-151. doi:10.1016/j.ijtb.2020.06.001
26. Mishra AK, Lal A, Sahu KK, George AA, Sargent J. Letter to the Editor Regarding "Neurological Impact of Coronavirus Disease (COVID-19): Practical Considerations for the Neuroscience Community" [published online ahead of print, 2020 May 17]. World Neurosurg. 2020;S1878-8750(20)31060-3. doi:10.1016/j.wneu.2020.05.089
27. Togun T, Kampmann B, Stoker NG, Lipman M. Anticipating the impact of the COVID-19 pandemic on TB patients and TB control programmes. Ann Clin Microbiol Antimicrob. 2020;19(1):21. Published 2020 May 23. doi:10.1186/s12941-020-00363-1
28. Mishra AK, Sahu KK, George AA, Sargent J, Lal A. Cerebrovascular events in COVID-19 patients. Monaldi Arch Chest Dis. 2020;90(2):10.4081/monaldi.2020.1341. Published 2020 Jun 10. doi:10.4081/monaldi.2020.1341
29. Mishra AK, George AA, Sargent J. Letter to the Editor Regarding "Acute Stroke Management During the Coronavirus Disease 2019 (COVID-19) Pandemic: From Trough of Disillusionment to Slope of Enlightenment" [published online ahead of print, 2020 Jun 24]. World Neurosurg. 2020;S1878-8750(20)31369-3. doi:10.1016/j.wneu.2020.06.111
30. Kumar DR, Bhattacharya DB, Meena DV, Soneja DM, Wig DN. COVID-19 and TB co-infection - 'Finishing touch'' in perfect recipe to 'severity' or 'death'. J Infect. 2020 Sep;81(3):e39-e40. doi: 10.1016/j.jinf.2020.06.062. Epub 2020 Jun 29. PMID: 32610112; PMCID: PMC7322446.
31. Tham SM, Lim WY, Lee CK, Loh J, Premkumar A, Yan B, Kee A, Chai L, Tambyah PA, Yan G. Four Patients with COVID-19 and Tuberculosis, Singapore, April-May 2020. Emerg Infect Dis. 2020 Jul 15;26(11). doi: 10.3201/eid2611.202752. Epub ahead of print. PMID: 32667283.
32. Faqihi F, Alharthy A, Noor A, Balshi A, Balhamar A, Karakitsos D. COVID-19 in a patient with active tuberculosis: A rare case-report. Respir Med Case Rep. 2020 Jul 4;31:101146. doi: 10.1016/j.rmcr.2020.101146. PMID: 32665887; PMCID: PMC7334644.
33. Vilbrun SC, Mathurin L, Pape JW, Fitzgerald D, Walsh KF. Case Report: Multidrug-Resistant Tuberculosis and COVID-19 Coinfection in Port-au-Prince, Haiti. Am J Trop Med Hyg. 2020 Sep 25. doi: 10.4269/ajtmh.20-0851. Epub ahead of print. PMID: 32978934.
34. Ata F, Yousaf Q, Veliyankodan Parambil J, Parengal J, Mohamedali MG, Yousaf Z. A 28-Year-Old Man from India with SARS-Cov-2 and Pulmonary Tuberculosis Co-Infection with Central Nervous System Involvement. Am J Case Rep. 2020 Aug 19;21:e926034. doi: 10.12659/AJCR.926034. PMID: 32813683; PMCID: PMC7458692.
35. Selvaraj JU, Sujalini BB, Rohitson MS, George AA, Arvind VH, Mishra AK. Identification of predictors of cerebrovascular infarcts in patients with tuberculous meningitis. Int J Mycobacteriol. 2020 Jul-Sep;9(3):303-308. doi: 10.4103/ijmy.ijmy_107_20. PMID: 32862165.

Most read articles by the same author(s)

Similar Articles

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 > >> 

You may also start an advanced similarity search for this article.