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Impact of Latent Tuberculosis on Severity and Outcomes in Admitted COVID-19 Patients

Background There is limited data on coronavirus disease 2019 (COVID-19) and latent tuberculosis infection (LTBI). Methodology We analyzed data of admitted COVID-19 patients evaluated for LTBI to examine the impact of LTBI on severity, laboratory parameters, and COVID-19 outcome. Prospectively collec...

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Autores principales: Madan, Manu, Baldwa, Bhvya, Raja, Arun, Tyagi, Rahul, Dwivedi, Tanima, Mohan, Anant, Mittal, Saurabh, Madan, Karan, Hadda, Vijay, Tiwari, Pawan, Guleria, Randeep
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8709920/
https://www.ncbi.nlm.nih.gov/pubmed/34966601
http://dx.doi.org/10.7759/cureus.19882
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author Madan, Manu
Baldwa, Bhvya
Raja, Arun
Tyagi, Rahul
Dwivedi, Tanima
Mohan, Anant
Mittal, Saurabh
Madan, Karan
Hadda, Vijay
Tiwari, Pawan
Guleria, Randeep
author_facet Madan, Manu
Baldwa, Bhvya
Raja, Arun
Tyagi, Rahul
Dwivedi, Tanima
Mohan, Anant
Mittal, Saurabh
Madan, Karan
Hadda, Vijay
Tiwari, Pawan
Guleria, Randeep
author_sort Madan, Manu
collection PubMed
description Background There is limited data on coronavirus disease 2019 (COVID-19) and latent tuberculosis infection (LTBI). Methodology We analyzed data of admitted COVID-19 patients evaluated for LTBI to examine the impact of LTBI on severity, laboratory parameters, and COVID-19 outcome. Prospectively collected data were analyzed for 60 patients who were administered the Mantoux tuberculosis skin test (TST) using five tuberculin units of purified protein derivative. All patients were administered TST irrespective of Bacille Calmette-Guérin (BCG) vaccination status. Comorbidities, clinical features, radiologic involvement, laboratory parameters, and clinical course were analyzed concerning LTBI. Results The mean age was 45.9 (±15.2) years, and 35 (58.3%) patients had non-severe disease. The vast majority (n = 56/60; 93.3%) had been vaccinated with single-dose BCG in infancy or early childhood, as per national immunization guidelines. LTBI was diagnosed in 15 (25%) patients. LTBI prevalence was lower in severe (n = 1/25; 4%) than non-severe (n = 14/35; 40%) COVID-19 (p = 0.01) patients. LTBI patients had lower percentage neutrophil count, higher lymphocyte percentage, higher monocyte count, lower neutrophil-lymphocyte (NL) ratio, lower alanine aminotransferase, lower C-reactive protein, and lesser radiologic involvement compared to those without LTBI (p < 0.05). Similarly, among the mild COVID-19 subgroup, those with LTBI had higher lymphocyte and monocyte counts and lesser radiologic involvement than those without LTBI (p < 0.05). Conclusions LTBI patients appear to have milder disease, higher lymphocyte and monocyte count, higher NL ratio, and lesser radiographic involvement. This observation needs to be studied in larger studies using interferon release assays.
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spelling pubmed-87099202021-12-28 Impact of Latent Tuberculosis on Severity and Outcomes in Admitted COVID-19 Patients Madan, Manu Baldwa, Bhvya Raja, Arun Tyagi, Rahul Dwivedi, Tanima Mohan, Anant Mittal, Saurabh Madan, Karan Hadda, Vijay Tiwari, Pawan Guleria, Randeep Cureus Internal Medicine Background There is limited data on coronavirus disease 2019 (COVID-19) and latent tuberculosis infection (LTBI). Methodology We analyzed data of admitted COVID-19 patients evaluated for LTBI to examine the impact of LTBI on severity, laboratory parameters, and COVID-19 outcome. Prospectively collected data were analyzed for 60 patients who were administered the Mantoux tuberculosis skin test (TST) using five tuberculin units of purified protein derivative. All patients were administered TST irrespective of Bacille Calmette-Guérin (BCG) vaccination status. Comorbidities, clinical features, radiologic involvement, laboratory parameters, and clinical course were analyzed concerning LTBI. Results The mean age was 45.9 (±15.2) years, and 35 (58.3%) patients had non-severe disease. The vast majority (n = 56/60; 93.3%) had been vaccinated with single-dose BCG in infancy or early childhood, as per national immunization guidelines. LTBI was diagnosed in 15 (25%) patients. LTBI prevalence was lower in severe (n = 1/25; 4%) than non-severe (n = 14/35; 40%) COVID-19 (p = 0.01) patients. LTBI patients had lower percentage neutrophil count, higher lymphocyte percentage, higher monocyte count, lower neutrophil-lymphocyte (NL) ratio, lower alanine aminotransferase, lower C-reactive protein, and lesser radiologic involvement compared to those without LTBI (p < 0.05). Similarly, among the mild COVID-19 subgroup, those with LTBI had higher lymphocyte and monocyte counts and lesser radiologic involvement than those without LTBI (p < 0.05). Conclusions LTBI patients appear to have milder disease, higher lymphocyte and monocyte count, higher NL ratio, and lesser radiographic involvement. This observation needs to be studied in larger studies using interferon release assays. Cureus 2021-11-25 /pmc/articles/PMC8709920/ /pubmed/34966601 http://dx.doi.org/10.7759/cureus.19882 Text en Copyright © 2021, Madan et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Madan, Manu
Baldwa, Bhvya
Raja, Arun
Tyagi, Rahul
Dwivedi, Tanima
Mohan, Anant
Mittal, Saurabh
Madan, Karan
Hadda, Vijay
Tiwari, Pawan
Guleria, Randeep
Impact of Latent Tuberculosis on Severity and Outcomes in Admitted COVID-19 Patients
title Impact of Latent Tuberculosis on Severity and Outcomes in Admitted COVID-19 Patients
title_full Impact of Latent Tuberculosis on Severity and Outcomes in Admitted COVID-19 Patients
title_fullStr Impact of Latent Tuberculosis on Severity and Outcomes in Admitted COVID-19 Patients
title_full_unstemmed Impact of Latent Tuberculosis on Severity and Outcomes in Admitted COVID-19 Patients
title_short Impact of Latent Tuberculosis on Severity and Outcomes in Admitted COVID-19 Patients
title_sort impact of latent tuberculosis on severity and outcomes in admitted covid-19 patients
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8709920/
https://www.ncbi.nlm.nih.gov/pubmed/34966601
http://dx.doi.org/10.7759/cureus.19882
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