tetano
Editor, Senior Moderator
Cureus
. 2021 Nov 25;13(11):e19882.
doi: 10.7759/cureus.19882. eCollection 2021 Nov.
Impact of Latent Tuberculosis on Severity and Outcomes in Admitted COVID-19 Patients
Manu Madan[SUP] 1 [/SUP], Bhvya Baldwa[SUP] 1 [/SUP], Arun Raja[SUP] 1 [/SUP], Rahul Tyagi[SUP] 1 [/SUP], Tanima Dwivedi[SUP] 2 [/SUP], Anant Mohan[SUP] 1 [/SUP], Saurabh Mittal[SUP] 1 [/SUP], Karan Madan[SUP] 1 [/SUP], Vijay Hadda[SUP] 1 [/SUP], Pawan Tiwari[SUP] 1 [/SUP], Randeep Guleria[SUP] 1 [/SUP]
Affiliations
Abstract
Background There is limited data on coronavirus disease 2019 (COVID-19) and latent tuberculosis infection (LTBI). Methodology We analyzed data of admitted COVID-19 patients evaluated for LTBI to examine the impact of LTBI on severity, laboratory parameters, and COVID-19 outcome. Prospectively collected data were analyzed for 60 patients who were administered the Mantoux tuberculosis skin test (TST) using five tuberculin units of purified protein derivative. All patients were administered TST irrespective of Bacille Calmette-Guérin (BCG) vaccination status. Comorbidities, clinical features, radiologic involvement, laboratory parameters, and clinical course were analyzed concerning LTBI. Results The mean age was 45.9 (±15.2) years, and 35 (58.3%) patients had non-severe disease. The vast majority (n = 56/60; 93.3%) had been vaccinated with single-dose BCG in infancy or early childhood, as per national immunization guidelines. LTBI was diagnosed in 15 (25%) patients. LTBI prevalence was lower in severe (n = 1/25; 4%) than non-severe (n = 14/35; 40%) COVID-19 (p = 0.01) patients. LTBI patients had lower percentage neutrophil count, higher lymphocyte percentage, higher monocyte count, lower neutrophil-lymphocyte (NL) ratio, lower alanine aminotransferase, lower C-reactive protein, and lesser radiologic involvement compared to those without LTBI (p < 0.05). Similarly, among the mild COVID-19 subgroup, those with LTBI had higher lymphocyte and monocyte counts and lesser radiologic involvement than those without LTBI (p < 0.05). Conclusions LTBI patients appear to have milder disease, higher lymphocyte and monocyte count, higher NL ratio, and lesser radiographic involvement. This observation needs to be studied in larger studies using interferon release assays.
Keywords: covid-19; covid-19 severity; latent tuberculosis; ltbi; mantoux test.
. 2021 Nov 25;13(11):e19882.
doi: 10.7759/cureus.19882. eCollection 2021 Nov.
Impact of Latent Tuberculosis on Severity and Outcomes in Admitted COVID-19 Patients
Manu Madan[SUP] 1 [/SUP], Bhvya Baldwa[SUP] 1 [/SUP], Arun Raja[SUP] 1 [/SUP], Rahul Tyagi[SUP] 1 [/SUP], Tanima Dwivedi[SUP] 2 [/SUP], Anant Mohan[SUP] 1 [/SUP], Saurabh Mittal[SUP] 1 [/SUP], Karan Madan[SUP] 1 [/SUP], Vijay Hadda[SUP] 1 [/SUP], Pawan Tiwari[SUP] 1 [/SUP], Randeep Guleria[SUP] 1 [/SUP]
Affiliations
- PMID: 34966601
- PMCID: PMC8709920
- DOI: 10.7759/cureus.19882
Abstract
Background There is limited data on coronavirus disease 2019 (COVID-19) and latent tuberculosis infection (LTBI). Methodology We analyzed data of admitted COVID-19 patients evaluated for LTBI to examine the impact of LTBI on severity, laboratory parameters, and COVID-19 outcome. Prospectively collected data were analyzed for 60 patients who were administered the Mantoux tuberculosis skin test (TST) using five tuberculin units of purified protein derivative. All patients were administered TST irrespective of Bacille Calmette-Guérin (BCG) vaccination status. Comorbidities, clinical features, radiologic involvement, laboratory parameters, and clinical course were analyzed concerning LTBI. Results The mean age was 45.9 (±15.2) years, and 35 (58.3%) patients had non-severe disease. The vast majority (n = 56/60; 93.3%) had been vaccinated with single-dose BCG in infancy or early childhood, as per national immunization guidelines. LTBI was diagnosed in 15 (25%) patients. LTBI prevalence was lower in severe (n = 1/25; 4%) than non-severe (n = 14/35; 40%) COVID-19 (p = 0.01) patients. LTBI patients had lower percentage neutrophil count, higher lymphocyte percentage, higher monocyte count, lower neutrophil-lymphocyte (NL) ratio, lower alanine aminotransferase, lower C-reactive protein, and lesser radiologic involvement compared to those without LTBI (p < 0.05). Similarly, among the mild COVID-19 subgroup, those with LTBI had higher lymphocyte and monocyte counts and lesser radiologic involvement than those without LTBI (p < 0.05). Conclusions LTBI patients appear to have milder disease, higher lymphocyte and monocyte count, higher NL ratio, and lesser radiographic involvement. This observation needs to be studied in larger studies using interferon release assays.
Keywords: covid-19; covid-19 severity; latent tuberculosis; ltbi; mantoux test.