Long-term outcomes of the global TB and COVID-19 coinfection cohort

Background Longitudinal cohort data of patients with tuberculosis (TB) and COVID-19 are lacking. In our global study, we describe long-term outcomes of patients affected by TB and COVID-19. Methods We collected data from 174 centres in 31 countries on all patients affected by COVID-19 and TB between 1 March 2020 and 30 September 2022. Patients were followed-up until cure, death or end of cohort time. All patients had TB and COVID-19; for analysis purposes, deaths were attributed to TB, COVID-19 or both. Survival analysis was performed using Cox proportional risk regression models, and the log rank test was used to compare survival and mortality attributed to TB, COVID-19 or both. Results Overall, 788 patients with COVID-19 and TB (active or sequelae) were recruited from 31 countries, and 10.8% (n=85) died during the observation period. Survival was significantly lower among patients whose death was attributed to TB and COVID-19 versus those dying because of either TB or COVID-19 alone (p<0.001). Significant adjusted risk factors for TB mortality were higher age (Hazard Ratio-HR 1.05, 95% confidence interval-CI 1.03–1.07), HIV infection (HR 2.29, CI 1.02–5.16), and invasive ventilation (HR 4.28, CI 2.34–7.83). For COVID-19 mortality the adjusted risks were: higher age (HR 1.03, CI 1.02–1.04), male sex (HR 2.21, CI 1.24–3.91), oxygen requirement (HR 7.93, CI 3.44–18.26), and invasive ventilation (HR 2.19, CI1.36–3.53). Conclusions In our global cohort, death was the outcome in more than 10% of patients with TB and COVID-19. A range of demographic and clinical predictors are associated with adverse outcomes.