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. 2022 Jan-Feb;55(1):1-5.
doi: 10.1590/0100-3984.2021.0070.

Concomitant COVID-19 and pulmonary tuberculosis: computed tomography aspects

Alexandre Dias Mançano  1 , Gláucia Zanetti  2 , Edson Marchiori  2
Affiliations

Concomitant COVID-19 and pulmonary tuberculosis: computed tomography aspects

Alexandre Dias Mançano et al. Radiol Bras. 2022 Jan-Feb.

Abstract
in English, Portuguese

Objective: To describe the relationship between coronavirus disease 2019 (COVID-19) and pulmonary tuberculosis during the current pandemic, as well as to describe the main computed tomography (CT) findings in patients suffering from both diseases simultaneously.

Materials and methods: This was a retrospective, cross-sectional observational study of the chest CT scans of 360 patients with COVID-19, as confirmed by RT-PCR.

Results: In four (1.1%) of the patients, changes suggestive of COVID-19 and tuberculosis were observed on the initial CT scan of the chest. On chest CT scans performed for the follow-up of COVID-19, cavitary lesions with bronchogenic spread were observed in two of the four patients, whereas alterations consistent with the progression of fibrous scarring related to previous tuberculosis were observed in the two other patients. The diagnosis of tuberculosis was confirmed by the isolation of Mycobacterium tuberculosis.

Conclusion: Albeit rare, concomitant COVID-19 and tuberculosis can be suggested on the basis of the CT aspects. Radiologists should be aware of this possibility, because initial studies indicate that mortality rates are higher in patients suffering from both diseases simultaneously.

Objetivo: Descrever a associação entre COVID-19 e tuberculose pulmonar durante a pandemia atual e descrever os principais achados tomográficos.

Materiais e métodos: Estudo retrospectivo transversal e observacional de tomografias computadorizadas de tórax realizadas em 360 pacientes com COVID-19 confirmada por RT-PCR.

Resultados: Em quatro pacientes (1,1%) foram encontradas alterações tomográficas sugestivas de associação entre COVID-19 e tuberculose. Em dois pacientes observaram-se escavações com disseminação broncogênica e em outros dois, alterações compatíveis com progressão de lesões fibrocicatriciais relacionadas a tuberculose prévia, em exames de controle para COVID-19. O diagnóstico foi confirmado pelo isolamento do Mycobacterium tuberculosis.

Conclusão: Apesar de incomum, a associação entre COVID-19 e tuberculose pode ser sugerida com base em aspectos tomográficos, devendo os radiologistas estar atentos a esta possibilidade, pois estudos iniciais indicam aumento da mortalidade nesses pacientes.

Keywords: COVID-19; Tomography, X-ray computed; Tuberculosis.

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Figures

Figure 1
Figure 1
A 22-year-old man with COVID-19 and tuberculosis. Chest CT showing multiple cavitary lesions in the right upper lobe, with thickening of the bronchial walls and a tree-in-bud pattern in both upper lobes.
Figure 2
Figure 2
A 50-year-old woman with COVID-19 and tuberculosis. Chest CT showing fibrous scar tissue in the right upper lobe (A), related to the history of tuberculosis reported by the patient, and multifocal ground-glass opacities in the periphery of the lower lobes (B–D), related to COVID-19.
Figure 3
Figure 3
Follow-up CT scan of the patient in Figure 2, performed three months later, with axial and coronal slices (A and B, respectively), showing signs of increased reticular opacities, with architectural distortion in the upper lobes, together with new opacities and some new small irregular nodules in the right lung, indicative of tuberculosis reactivation.
See this image and copyright information in PMC

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