Covid may be tragic for the patient with latent Tuberculosis. Medeor hospital Manesar reports a Covid case having Pulmonary Tuberculosis with overlapping symptoms such as cough, fever and difficulty in breathing with haemoptysis (blood in sputum).
In another rare instance, Medeor Hospital, Manesar at Gurugram – a dedicated covid-19 hospital successfully treats a 27 year-old Covid positive male diagnosed with latent pulmonary tuberculosis. The patient was discharged after 10 day COVID treatment ongoing ATT (Anti Tubercular Treatment) with a regular follow-up on telemedicine. The patient who was totally asymptomatic a week before, tested positive for corona virus infection and complained of symptoms like fever, breathlessness, blood in sputum (haemoptysis) and chest pain. His CT chest and other tests were found to be normal except for the sputum that revealed tubercular bacilli indicating active tuberculosis in the lungs.
Sharing his opinion about this case, Dr. Sanjay Gupta, Senior Consultant and HOD, Internal Medicine, Medeor Hospital Manesar says, “Clinically COVID-19 and Tuberculosis may show overlapping symptoms such as cough, fever and difficulty breathing with haemoptysis (Bloody Sputum). Both the diseases primarily attack lungs and both biological agents transmit mainly via close contacts. However, the incubation period from exposure to disease in tuberculosis is longer, with often a slow onset. Hence patients of Covid-19 if detected with a bloody sputum, must be investigated for pulmonary tuberculosis.”
He further added, “In this case, we started the treatment of the patient as per the WHO guidelines on Tuberculosis with on-going Covid-19 management. Limited literature is available explaining the progress of latent pulmonary tuberculosis to an active disease in presence of the Covid-19 infection; but our medical team was able to successfully tackle with the situation and provide necessary treatment. This case has insights on how Covid-19 infection may aggravate a latent or an occult tubercular infection, but more studies and cases are needed to understand the role played by SARS-CoV-2 in the progression of tubercular infection.”
TB pathogeh may vause severe COVID-19 pneumonia:
The WHO has issued an information note urging the continuity of essential services for people with tuberculosis during the pandemic. It is socioeconomic development and poverty that drive tuberculosis rates globally, thus fighting tuberculosis in the context of COVID-19 demands that we address social determinants as well as clinical care. Therefore, for COVID 19 patients with suggestive symptoms (like haemoptysis) clinical workup and testing for possibility of latent tuberculosis can benefit in fighting both the diseases.
The COVID-19 pandemic is likely to be the defining global health crisis of our generation. It is likely to have catastrophic effects on tuberculosis, another global pandemic. Tuberculosis has long been the world’s leading infectious killer, until on April 1st, 2020 when COVID-19 overtook tuberculosis as the infectious disease killing the most people per day. It is no coincidence that the areas of the world predicted to be most affected by the social and economic consequences of COVID-19 are also the areas with the highest tuberculosis burden.
Risk factors associated with COVID-19 is always a concern for patients as well as doctors because the medical resources and timely attention can be given for those at highest risk of severe COVID-19 complications. Infection with Mycobacterium tuberculosis (MTB), the pathogen that causes TB and latently infects ~25% of the global population, may be a risk factor for SARS-CoV-2 infection and severe COVID-19 pneumonia.
