Long-term outcomes of the global tuberculosis and COVID-19 co-infection cohort
Authors:   Global Tuberculosis Network and TB/COVID-19 Global Study Group, Casco Nicolas , Jorge Alberto Levi , Palmero Domingo Juan , Alffenaar Jan-Willem , Fox Greg J. , Ezz Wafaa , Cho Jin-Gun , Denholm Justin , Skrahina Alena , Solodovnikova Varvara , Arbex Marcos Abdo , Alves Tatiana , Rabahi Marcelo Fouad , Pereira Giovana Rodrigues , Sales Roberta , Silva Denise Rossato , Saffie Muntasir M. , Salinas Nadia Escobar , Miranda Ruth Caamaño , Cisterna Catalina , Concha Clorinda , Fernandez Israel , Villalón Claudia , Vera Carolina Guajardo , Tapia Patricia Gallegos , Cancino Viviana , Carbonell Monica , Cruz Arturo , Muñoz Eduardo , Muñoz Camila , Navarro Indira , Pizarro Rolando , Cristina Sánchez Gloria Pereira , Vergara Riquelme Maria Soledad , Vilca Evelyn , Soto Aline , Flores Ximena , Garavagno Ana , Bahamondes Martina Hartwig , Merino Luis Moyano , Pradenas Ana María , Revillot Macarena Espinoza , Rodriguez Patricia , Salinas Angeles Serrano , Taiba Carolina , Valdés Joaquín Farías , Subiabre Jorge Navarro , Ortega Carlos , Palma Sofia , Castillo Patricia Perez , Pinto Mónica , Bidegain Francisco Rivas , Venegas Margarita , Yucra Edith , Li Yang , Cruz Andres , Guelvez Beatriz , Victoria Plaza Regina , Tello Hoyos Kelly Yoana , Cardoso-Landivar José , Van Den Boom Martin , Andréjak Claire , Blanc François-Xavier , Dourmane Samir , Froissart Antoine , Izadifar Armine , Rivière Frédéric , Schlemmer Frédéric , Manika Katerina , Diallo Boubacar Djelo , Hassane-Harouna Souleymane , Artiles Norma , Mejia Licenciada Andrea , Gupta Nitesh , Ish Pranav , Mishra Gyanshankar , Patel Jigneshkumar M. , Singla Rupak , Udwadia Zarir F. , Alladio Francesca , Angeli Fabio , Calcagno Andrea , Centis Rosella , Codecasa Luigi Ruffo , De Lauretis Angelo , Esposito Susanna M.R. , Formenti Beatrice , Gaviraghi Alberto , Giacomet Vania , Goletti Delia , Gualano Gina , Matteelli Alberto , Migliori Giovanni Battista , Motta Ilaria , Palmieri Fabrizio , Pontali Emanuele , Prestileo Tullio , Riccardi Niccolò , Saderi Laura , Saporiti Matteo , Sotgiu Giovanni , Spanevello Antonio , Stochino Claudia , Tadolini Marina , Torre Alessandro , Villa Simone , Visca Dina , Kurhasani Xhevat , Furjani Mohammed , Rasheed Najia , Danila Edvardas , Diktanas Saulius , Ridaura Ruy López , Luna López Fátima Leticia , Torrico Marcela Muñoz , Rendon Adrian , Akkerman Onno W. , Chizaram Onyeaghala , Al-Abri Seif , Alyaquobi Fatma , Althohli Khalsa , Aguirre Sarita , Teixeira Rosarito Coronel , De Egea Viviana , Irala Sandra , Medina Angélica , Sequera Guillermo , Sosa Natalia , Vázquez Fátima , Llanos-Tejada Félix K. , Manga Selene , Villanueva-Villegas Renzo , Araujo David , Sales Marques Raquel DuarteTânia , Socaci Adriana , Barkanova Olga , Bogorodskaya Maria , Borisov Sergey , Mariandyshev Andrei , Kaluzhenina Anna , Vukicevic Tatjana Adzic , Stosic Maja , Beh Darius , Ng Deborah , Ong Catherine W.M. , Solovic Ivan , Dheda Keertan , Gina Phindile , Caminero José A. , De Souza Galvão Maria Luiza , Dominguez-Castellano Angel , García-García José-María , Pinargote Israel Molina , Fernandez Sarai Quirós , Sánchez-Montalvá Adrián , Huguet Eva Tabernero , Murguiondo Miguel Zabaleta , Bart Pierre-Alexandre , Mazza-Stalder Jesica , D'Ambrosio Lia , Kamolwat Phalin , Bakko Freya , Barnacle James , Bird Sophie , Brown Annabel , Chandran Shruthi , Killington Kieran , Man Kathy , Papineni Padmasayee , Ritchie Flora , Tiberi Simon , Utjesanovic Natasa , Zenner Dominik , Hearn Jasie L. , Heysell Scott , Young Laura 
Published: October 2023

Background

Longitudinal cohort data of patients with tuberculosis (TB) and coronavirus disease 2019 (COVID-19) are lacking. In our global study, we describe long-term outcomes of patients affected by TB and COVID-19.

Methods

We collected data from 174 centres in 31 countries on all patients affected by COVID-19 and TB between 1 March 2020 and 30 September 2022. Patients were followed-up until cure, death or end of cohort time. All patients had TB and COVID-19; for analysis purposes, deaths were attributed to TB, COVID-19 or both. Survival analysis was performed using Cox proportional risk-regression models, and the log-rank test was used to compare survival and mortality attributed to TB, COVID-19 or both.

Results

Overall, 788 patients with COVID-19 and TB (active or sequelae) were recruited from 31 countries, and 10.8% (n=85) died during the observation period. Survival was significantly lower among patients whose death was attributed to TB and COVID-19versusthose dying because of either TB or COVID-19 alone (p<0.001). Significant adjusted risk factors for TB mortality were higher age (hazard ratio (HR) 1.05, 95% CI 1.03–1.07), HIV infection (HR 2.29, 95% CI 1.02–5.16) and invasive ventilation (HR 4.28, 95% CI 2.34–7.83). For COVID-19 mortality, the adjusted risks were higher age (HR 1.03, 95% CI 1.02–1.04), male sex (HR 2.21, 95% CI 1.24–3.91), oxygen requirement (HR 7.93, 95% CI 3.44–18.26) and invasive ventilation (HR 2.19, 95% CI 1.36–3.53).

Conclusions

In our global cohort, death was the outcome in >10% of patients with TB and COVID-19. A range of demographic and clinical predictors are associated with adverse outcomes.