Corticosteroids for COVID-19 Therapy: Potential Implications on Tuberculosis.

Area of Science:

• Infectious Diseases
• Pulmonology
• Pharmacology

Background:

• COVID-19, caused by SARS-CoV-2, is a global pandemic affecting the respiratory system.
• Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), also primarily affects the lungs and shares similar symptoms with COVID-19.
• Latent TB infection (LTBI) can reactivate to active TB under immunosuppressive conditions.

Purpose of the Study:

• To review corticosteroid (CST) therapy recommendations for COVID-19.
• To highlight the risks of LTBI reactivation during CST treatment for COVID-19.
• To emphasize the importance of screening for LTBI in COVID-19 patients undergoing CST therapy.

Main Methods:

• Review of current literature on COVID-19, TB, and corticosteroid therapy.
• Analysis of the mechanisms of action of CSTs and their impact on host immunity.
• Discussion of diagnostic and treatment challenges at the intersection of COVID-19 and TB.

Main Results:

• Corticosteroids (CSTs) are recommended for hospitalized COVID-19 patients but can cause immunosuppression.
• Altered immunity during COVID-19 combined with CST therapy increases the risk of secondary infections and LTBI reactivation.
• Co-infection with COVID-19 and TB presents a significant global health burden.

Conclusions:

• Corticosteroid therapy for COVID-19 poses a risk for tuberculosis reactivation.
• Screening for latent TB infection is essential before initiating corticosteroid treatment in COVID-19 patients.
• Integrated management strategies are needed to address the dual burden of COVID-19 and TB.