Mycobacterium tuberculosis and SARS-CoV-2 co-infections: The knowns and unknowns

Area of Science:

• Immunology
• Infectious Diseases
• Pulmonology

Background:

• Co-infection with Mycobacterium tuberculosis (Mtb) and SARS-CoV-2 presents significant health challenges.
• Both pathogens induce immunopathology and lung damage, but their combined effects remain poorly understood.
• A substantial portion of the global population harbors latent TB, raising concerns about SARS-CoV-2 triggering active disease.

Purpose of the Study:

• To explore the relationship between SARS-CoV-2 infection and the transition of latent Mtb to active TB.
• To investigate the impact of active Mtb infection on the establishment and severity of COVID-19.
• To elucidate the dysregulated immune responses and potential interplay between SARS-CoV-2 and Mtb co-infections.

Main Methods:

• Review of existing literature on Mtb and SARS-CoV-2 immunopathogenesis.
• Analysis of immune-related pathways affected by each pathogen.
• Discussion of potential converging and diverging immune mechanisms in co-infection.

Main Results:

• Both SARS-CoV-2 and Mtb modulate host immune responses, leading to extensive lung damage.
• The transition of latent TB to active TB due to SARS-CoV-2 infection requires further investigation.
• The effect of active TB on COVID-19 severity and establishment is currently unknown.

Conclusions:

• Mechanistic studies and co-infection models are essential for understanding SARS-CoV-2 and Mtb co-infections.
• Identifying shared and distinct immune pathways is critical for developing effective interventions.
• Addressing co-infections is paramount for reducing the global health burden of both diseases.