Interaction between type 2 diabetes and past COVID-19 on active tuberculosis.

Area of Science:

• Infectious Disease Epidemiology
• Public Health
• Endocrinology

Background:

• Global tuberculosis (TB) control efforts have faced setbacks post-COVID-19, partly due to healthcare disruptions.
• The direct biological impact of COVID-19 on TB incidence remains unclear.
• Investigating the interplay between past COVID-19 infection and TB risk is crucial.

Purpose of the Study:

• To determine the association between recent COVID-19 infection and new TB episodes.
• To assess the modifying role of type 2 diabetes mellitus (DM) comorbidity in this association.

Main Methods:

• A cross-sectional study involving 112 new active TB patients and 373 non-TB controls.
• Data collected between June 2020 and November 2021 in communities along the US-Mexico border.
• Past COVID-19 status determined by self-report or serology; statistical analyses included bivariable and multivariable models.

Main Results:

• Past COVID-19 was associated with increased odds of new TB, particularly significant in patients with DM (adjusted odds ratio [aOR] 2.3).
• Individuals with DM had a 2.7-fold higher odds of TB without prior COVID-19.
• This risk escalated to a 7.9-fold higher odds of TB among those with both DM and a history of COVID-19.

Conclusions:

• Type 2 diabetes mellitus and past COVID-19 interact synergistically, significantly magnifying TB risk.
• Recommends latent TB screening and prophylactic treatment for individuals with a history of COVID-19 and DM.
• Highlights the need for longitudinal studies with larger sample sizes to validate these findings.