Active or latent tuberculosis increases susceptibility to COVID-19 and disease severity

Yongyu Liu; Lijun Bi; Yu Chen; Yaguo Wang; Joy Fleming; Yanhong Yu; Ye Gu; Chang Liu; Lichao Fan; Xiaodan Wang; Moxin Cheng

To evaluate the implications of MTB infection history on the incidence and progression of COVID-19 disease, we addressed three questions. Does MTB co-infection: 1. increase susceptibility to SARS-COV-19 infection; 2. increase disease severity; and 3. lead to more rapid disease progression? We first assigned cases into two groups based on the severity of their COVID-19 pneumonia according to the Diagnostic and Treatment Guidelines of the National Health Commission of China (v6) 9 . Twenty-seven cases were mild/moderate (75%, Group 1) and nine cases were severe/critical (25%, Group 2) ( Table 2) . We then determined the MTB infection status of each patient by examining their clinical history and by performing X.DOT-TB IGRA assays (Table 1) To determine if MTB infection is a risk factor specific for COVID-19 pneumonia, or for pneumonia in general, we compared the MTB infection rate within these COVID-19 cases with data from a case-series comprised of 115 bacterial pneumonia and 62 viral pneumonia patients obtained from another study conducted in Shenyang (unpublished) ( Figure 1A ); MTB infection rates were considerably higher among COVID-19 patients than among bacterial pneumonia patients (36.11% vs 20%; p = 0.047 Figure 1A ) and viral pneumonia patients (36.11% vs 16.13%; p = 0.024),