SEVERE COVID-19 ASSOCIATED WITH ADVANCED FORMS OF PULMONARY TB DISEASE IN AN ENDEMIC AREA OF ROMANIA

TYPE: Abstract TOPIC: Lung Pathology PURPOSE: of the study consisted in assessing the prevalence and severity of COVID-19 among patients diagnosed with pulmonary tuberculosis (PTB) in an endemic Romanian TB area. METHODS: A prevalence study, performed in a Pneumology Hospital, during COVID-19 pandemic year, 2020, from March to December, included 128 PTB patients, tested by real-time polymerase chain reaction SARS CoV2. Confirmed COVID-19 patients were evaluated for severity of both diseases. RESULTS: The prevalence of COVID-19 among hospitalized PTB patients was 8.59% (n=11/128). The association was frequent reported in males (n=8/11; 72.72%), smokers (72.72%) and elderly (n=4/11; 36.36%). Moderate to severe forms of COVID-19 were predominantly diagnosed (n=6/11; 54.54%) and death outcome was reported in 2 males (18.18%) with cavitary PTB, but no other comorbidities. Positive smears and/or cultures for Mycobacterium tuberculosis (n=7/11; 63.63%) were mostly associated with cavitary lung lesions. Miliary TB with positive smears was reported in a single case of a 49 year-old alcoholic male. CONCLUSIONS: The risk of interaction between PTB and COVID-19 is high among males, elderly and smokers. Delayed diagnosis of advanced contagious forms of hospitalized PTB could be a possible risk factor of SARS CoV2 infection's increased severity and death. CLINICAL IMPLICATIONS: The immunological and epidemiological interactions between PTB and COVID-19 are still debating. It seems a dual risk of SARS CoV2 infection is capable to reactivate PTB disease and TB is capable to aggravate the evolution of COVID-19. Screening of tuberculosis disease is mandatory among all COVID-19 patients especially in endemic TB areas and vice versa. DISCLOSURE: Nothing to declare. KEYWORD: COVID-19