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

Based on our findings, we make the following recommendations for the management and treatment of patients with a history of MTB infection (LTBI or active TB) and possible SARS-CoV-2 coinfection. First, the medical and wider community should be informed that latent/active TB is a risk factor for SARS-CoV-2 infection, and those at risk should be encouraged to pay special attention to preventive measures. Ideally, this vulnerable group should be monitored regularly at community-based medical centers in situations when resources are available. Second, the MTB infection status (history and IGRA response) of suspected/confirmed COVID-19 cases should be checked routinely on admission to ensure coinfected cases are placed in appropriate isolation wards if active TB is detected. Third, special medical resources (such as ECMO therapy) should be arranged in advance for coinfected patients in view of the increased likelihood of rapid development of severe or critical symptoms. Fourth, therapeutic approaches for cases known to be coinfected both SARS-CoV-2 and MTB should bear their MTB infection history in mind; for example, treatments involving immunosuppressive agents should be reconsidered, as they hold the potential to reactivate latent TB infections. . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.