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BMJ Open Respir Res . Previously treated latent tuberculosis infection is associated with less severe acute COVID-19: a cohort study

tetano

Editor, Senior Moderator
BMJ Open Respir Res


. 2025 Oct 13;12(1):e003003.
doi: 10.1136/bmjresp-2024-003003. Previously treated latent tuberculosis infection is associated with less severe acute COVID-19: a cohort study

Katie Scandrett[SUP] 1 2 [/SUP], Scott Pallett[SUP] 3 4 [/SUP], Yemisi Takwoingi[SUP] 1 2 [/SUP], Adam F Cunningham[SUP] 5 [/SUP], Martin Dedicoat[SUP] 6 [/SUP], Matthew K O'Shea[SUP] 7 5 6 [/SUP]



Affiliations
Abstract

Introduction: There is significant potential for respiratory infections, such as tuberculosis (TB) and COVID-19, to overlap but little is known about such co-infection. We aimed to study the impact of active TB and latent TB on the incidence of severe COVID-19 in a large cohort of individuals in a setting of low TB endemicity.
Methods: Clinical data of patients admitted to hospital with acute SARS-CoV-2 were merged with a database of patients with a history of previous or current active TB, latent TB or healthy controls. We assessed the incidence of COVID-19 in these groups, length of hospital stay, admission to the intensive care unit (ICU) and in-hospital mortality.
Results: COVID-19 incidence among individuals with current active TB was 6.2% (12/194) and previous active TB 0.67% (30/4496). In contrast, the incidence in previously treated latent TB was 0.09% (4/4542) and among TB contacts 0.24% (34/13 391). There were similar rates of ICU admission and mortality among individuals with COVID-19 and current active TB, TB contacts and other patients. No individuals with previously treated latent TB and COVID-19 were admitted to the ICU or died.
Conclusions: Individuals with a history of latent TB seem to be at reduced risk of severe COVID-19 and have better outcomes than those with active TB and even uninfected controls. Further studies are required to understand the mechanistic basis of this observation.

Keywords: Tuberculosis; Viral infection.

 
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