tetano
Editor, Senior Moderator
BMC Infect Dis
. 2023 Jun 29;23(1):442.
doi: 10.1186/s12879-023-08412-8. SARS-CoV-2 infection and pulmonary tuberculosis in children and adolescents: a case-control study
Jeremi Swanepoel[SUP] 1 2 [/SUP], Marieke M van der Zalm[SUP] 3 [/SUP], Wolfgang Preiser[SUP] 4 [/SUP], Gert van Zyl[SUP] 4 [/SUP], Elizabeth Whittaker[SUP] 5 [/SUP], Anneke C Hesseling[SUP] 3 [/SUP], David A J Moore[SUP] 6 [/SUP], James A Seddon[SUP] 3 5 [/SUP]
Affiliations
Background: The Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) pandemic has had an impact on the global tuberculosis (TB) epidemic but evidence on the possible interaction between SARS-CoV-2 and TB, especially in children and adolescents, remains limited. We aimed to evaluate the relationship between previous infection with SARS-CoV-2 and the risk of TB in children and adolescents.
Methods: An unmatched case-control study was conducted using SARS-CoV-2 unvaccinated children and adolescents recruited into two observational TB studies (Teen TB and Umoya), between November 2020 and November 2021, in Cape Town, South Africa. Sixty-four individuals with pulmonary TB (aged < 20 years) and 99 individuals without pulmonary TB (aged < 20 years) were included. Demographics and clinical data were obtained. Serum samples collected at enrolment underwent quantitative SARS-CoV-2 anti-spike immunoglobulin G (IgG) testing using the Abbott SARS-CoV-2 IgG II Quant assay. Odds ratios (ORs) for TB were estimated using unconditional logistic regression.
Results: There was no statistically significant difference in the odds of having pulmonary TB between those who were SARS-CoV-2 IgG seropositive and those who were seronegative (adjusted OR 0.51; 95% CI: 0.23-1.11; n = 163; p = 0.09). Of those with positive SARS-CoV-2 serology indicating prior infection, baseline IgG titres were higher in individuals with TB compared to those without TB (p = 0.04) and individuals with IgG titres in the highest tertile were more likely to have pulmonary TB compared to those with IgG levels in the lowest tertile (OR: 4.00; 95%CI: 1.13- 14.21; p = 0.03).
Conclusions: Our study did not find convincing evidence that SARS-CoV-2 seropositivity was associated with subsequent pulmonary TB disease; however, the association between magnitude of SARS-CoV-2 IgG response and pulmonary TB warrants further investigation. Future prospective studies, evaluating the effects of sex, age and puberty on host immune responses to M. tuberculosis and SARS-CoV-2, will also provide more clarity on the interplay between these two infections.
Keywords: Adolescents; Immunology; SARS-CoV-2; Tuberculosis.
. 2023 Jun 29;23(1):442.
doi: 10.1186/s12879-023-08412-8. SARS-CoV-2 infection and pulmonary tuberculosis in children and adolescents: a case-control study
Jeremi Swanepoel[SUP] 1 2 [/SUP], Marieke M van der Zalm[SUP] 3 [/SUP], Wolfgang Preiser[SUP] 4 [/SUP], Gert van Zyl[SUP] 4 [/SUP], Elizabeth Whittaker[SUP] 5 [/SUP], Anneke C Hesseling[SUP] 3 [/SUP], David A J Moore[SUP] 6 [/SUP], James A Seddon[SUP] 3 5 [/SUP]
Affiliations
- PMID: 37386354
- DOI: 10.1186/s12879-023-08412-8
Background: The Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) pandemic has had an impact on the global tuberculosis (TB) epidemic but evidence on the possible interaction between SARS-CoV-2 and TB, especially in children and adolescents, remains limited. We aimed to evaluate the relationship between previous infection with SARS-CoV-2 and the risk of TB in children and adolescents.
Methods: An unmatched case-control study was conducted using SARS-CoV-2 unvaccinated children and adolescents recruited into two observational TB studies (Teen TB and Umoya), between November 2020 and November 2021, in Cape Town, South Africa. Sixty-four individuals with pulmonary TB (aged < 20 years) and 99 individuals without pulmonary TB (aged < 20 years) were included. Demographics and clinical data were obtained. Serum samples collected at enrolment underwent quantitative SARS-CoV-2 anti-spike immunoglobulin G (IgG) testing using the Abbott SARS-CoV-2 IgG II Quant assay. Odds ratios (ORs) for TB were estimated using unconditional logistic regression.
Results: There was no statistically significant difference in the odds of having pulmonary TB between those who were SARS-CoV-2 IgG seropositive and those who were seronegative (adjusted OR 0.51; 95% CI: 0.23-1.11; n = 163; p = 0.09). Of those with positive SARS-CoV-2 serology indicating prior infection, baseline IgG titres were higher in individuals with TB compared to those without TB (p = 0.04) and individuals with IgG titres in the highest tertile were more likely to have pulmonary TB compared to those with IgG levels in the lowest tertile (OR: 4.00; 95%CI: 1.13- 14.21; p = 0.03).
Conclusions: Our study did not find convincing evidence that SARS-CoV-2 seropositivity was associated with subsequent pulmonary TB disease; however, the association between magnitude of SARS-CoV-2 IgG response and pulmonary TB warrants further investigation. Future prospective studies, evaluating the effects of sex, age and puberty on host immune responses to M. tuberculosis and SARS-CoV-2, will also provide more clarity on the interplay between these two infections.
Keywords: Adolescents; Immunology; SARS-CoV-2; Tuberculosis.