COVID-19 in Tuberculosis Patients: Single Сare Center Experience

Abstract

Background. Little is known about the relationship between the COVID-19, HIV and tuberculosis (TB). The aim of this study is to describe a group of patients with triple infection: TB (active disease or sequelae)/HIV and COVID-19.

Materials and methods. Data from 526 hospitalized patients with TB and COVID-19 were analyzed. HIV(+) were 113 (21.5%) patients (median age 39 y.o.), HIV(-) – 413 (78.5%) (median age 42 y.o.).

Results. The susceptibility of HIV/TB patients to SARS-CoV-2 (COVID-19) is most typical in age from 31 till 50 years old (86.0%), in men mostly (75.2%) and unemployed of working age (97.3%). A proportion of residents was 35.4% and 39.0% in groups 1 and 2 respectively, others were migrants (p > 0,05). Homeless people dominate in group of triple infection: 32.7% vs 16,0% (p < 0,05). Mortality rate was higher in COVID-19/HIV/TB patients: 8,9% vs 6,8% in HIV(-) (p < 0,05). Overall, 38 out of 526 (7.2%) patients died. The most (7 – 70.0%) deceased out of 10 in group 1 died from HIV complications and TB, and only 3 (30,0%) of them died from COVID-19. The main cause of mortality in group 2 was COVID-19 – in 15 (53.6%) cases out of 28, HIV+TB complications – in 8 (28.6%) and TB – in 5 (17.9%). Active tuberculosis diagnosed in 106 (93.8%) in group 1, sequelae – in 5 (17.9%). The health status of triple infection patients is determined mainly by stage of HIV (100% were in IV B and IVC stages), TB and others secondary and concomitant diseases. There are 1.7 localizations of tuberculosis and 3.2 associated diseases per patient. Less than half (44.2%) of HIV/ TB patients with COVID-19 receive HAART, 46.9% have serum CD4⁺ levels below 100 cells/mm³, and 15.0% range from 100 to 350 cells/mm³.