Screening for tuberculosis in patients with COVID-19 infection in Georgia

Background: Pulmonary tuberculosis (PTB) and COVID-19 infection have similar respiratory symptoms, which may lead to the masking of PTB in TB/COVID-19 co-infected patients. Aims and objectives: We sought to evaluate the prevalence of LTBI and the risk of developing active TB in COVID-19 infected patients. Methods: From September 1, 2020, to December 31, 2020, patients diagnosed with COVID-19 infection at the Georgian National Center for Tuberculosis and Lung Disease were screened for latent tuberculosis infection (LTBI) using QuantiFERON-TB Gold Plus (QFT-Plus) test. The data was evaluated on February 1, 2021. Results: Of 220 COVID-19 patients with a mean age of 55 (STD-15) years, 121 (55%) were female. One hundred thirteen persons (51.4%) tested positive for QFT-Plus. Other co-morbidities had 58 (26.4%) patients. In none of the cases was revealed active PTB. Viral pneumonia occurred in 62.8% (71/113) of cases with LTBI vs. 62.6% (67/107) without. None of the patients developed active tuberculosis within 1-4 months of follow-up including a patient with post-TB sequelae. One QFT-Plus–negative patient died with acute respiratory failure, viral pneumonia, uncontrolled diabetes, and obesity; all others were cured with COVID-19 infection regardless of LTBI status. Conclusion: In our cohort, we found no differences in the development of viral pneumonia between patients with or without LTBI. During the observation period, COVID-19 infection did not cause the progression of LTBI to active disease. Larger studies and longer follow-up are needed to elucidate the interactions between Mycobacterium tuberculosis and SARS-CoV-2.