Tuberculosis, COVID-19 and migrants: preliminary analysis of deaths occurring in 69 patients from two cohorts

Motta, Ilaria; Centis, Rosella; D’Ambrosio, Lia; García-García, José-María; Goletti, Delia; Gualano, Gina; Lipani, Filippo; Palmieri, Fabrizio; Sánchez-Montalvá, Adrián; Pontali, Emanuele; Sotgiu, Giovanni; Spanevello, Antonio; Stochino, Claudia; Tabernero, Eva; Tadolini, Marina; van den Boom, Martin; Villa, Simone; Visca, Dina; Migliori, Giovanni Battista

Abstract Little is known about the relationship between the COVID-19 and tuberculosis (TB). The aim of this study is to describe a group of patients who died with TB (active disease or sequelae) and COVID-19 in two cohorts. Data from 49 consecutive cases in 8 countries (cohort A) and 20 hospitalized patients with TB and COVID-19 (cohort B) were analysed and patients who died were described. Demographic and clinical variables were retrospectively collected, including co-morbidities and risk factors for TB and COVID-19 mortality. Overall, 8 out of 69 (11.6%) patients died, 7 from cohort A (14.3%) and one from cohort B (5%). Out of 69 patients 43 were migrants, 26/49 (53.1%) in cohort A and 17/20 (85.0%) in cohort B. Migrants: 1) were younger than natives; in cohort A the median (IQR) age was 40 (27-49) VS. 66 (46-70) years, whereas in cohort B 37 (27-46) VS. 48 (47-60) years; 2) had a lower mortality rate than natives (1/43, 2.3% versus 7/26, 26.9%; p-value: 0.002); 3) had fewer co-morbidities than natives (23/43, 53.5 % versus 5/26- 19.2%) natives; p-value: 0.005). The study findings show that: 1) mortality is likely to occur in elderly patients with co-morbidities; 2) TB might not be a major determinant of mortality and 3) migrants had lower mortality, probably because of their younger age and lower number of co-morbidities. However, in settings where advanced forms of TB frequently occur and are caused by drug-resistant strains of M. tuberculosis, higher mortality rates can be expected in young individuals.