Tuberculosis and COVID-19: An overlapping situation during pandemic

Area of Science:

• Infectious Diseases
• Pulmonology
• Public Health

Background:

• The COVID-19 pandemic, caused by SARS-CoV-2, significantly impacted global health, with Turkey reporting over 148,000 cases by May 2020.
• Tuberculosis (TB) remains a significant public health issue, with an incidence of 14.1 per 100,000 people in Turkey in 2018.
• The overlapping respiratory symptoms of COVID-19 and TB can lead to diagnostic delays.

Purpose of the Study:

• To highlight the importance of considering tuberculosis in the differential diagnosis of patients presenting with symptoms suggestive of COVID-19.
• To emphasize the potential for delayed diagnosis and treatment when overlapping respiratory diseases occur during a pandemic.

Main Methods:

• Respiratory samples from 4605 patients were tested for SARS-CoV-2 using RT-PCR.
• 185 samples were analyzed for Mycobacterium tuberculosis using the Xpert Ultra assay.
• Clinical and radiological findings prompted co-testing for SARS-CoV-2 and M. tuberculosis in 30 patients.

Main Results:

• Two patients were diagnosed with both COVID-19 and active tuberculosis.
• One patient diagnosed with TB became coinfected with SARS-CoV-2 during hospitalization.
• Another patient initially suspected and treated for COVID-19 was ultimately diagnosed with pulmonary TB and HIV.

Conclusions:

• Tuberculosis, known as a "great imitator," should not be overlooked in the differential diagnosis during the COVID-19 pandemic.
• Prompt and accurate diagnosis of co-existing respiratory conditions like TB and COVID-19 is essential for effective patient management.
• Healthcare providers must maintain a broad differential diagnosis, even amidst a dominant pandemic.