Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2024 May 13;18(5):e0012136.
doi: 10.1371/journal.pntd.0012136. eCollection 2024 May.

Systematic review and meta-analysis of Tuberculosis and COVID-19 Co-infection: Prevalence, fatality, and treatment considerations

Quan Wang  1   2 , Yanmin Cao  3 , Xinyu Liu  3 , Yaqun Fu  1 , Jiawei Zhang  1 , Yeqing Zhang  4 , Lanyue Zhang  1 , Xiaolin Wei  5 , Li Yang  1
Affiliations
Meta-Analysis

Systematic review and meta-analysis of Tuberculosis and COVID-19 Co-infection: Prevalence, fatality, and treatment considerations

Quan Wang et al. PLoS Negl Trop Dis. .

Abstract

Background: Tuberculosis (TB) and COVID-19 co-infection poses a significant global health challenge with increased fatality rates and adverse outcomes. However, the existing evidence on the epidemiology and treatment of TB-COVID co-infection remains limited.

Methods: This updated systematic review aimed to investigate the prevalence, fatality rates, and treatment outcomes of TB-COVID co-infection. A comprehensive search across six electronic databases spanning November 1, 2019, to January 24, 2023, was conducted. The Joanna Briggs Institute Critical Appraisal Checklist assessed risk of bias of included studies, and meta-analysis estimated co-infection fatality rates and relative risk.

Results: From 5,095 studies screened, 17 were included. TB-COVID co-infection prevalence was reported in 38 countries or regions, spanning both high and low TB prevalence areas. Prevalence estimates were approximately 0.06% in West Cape Province, South Africa, and 0.02% in California, USA. Treatment approaches for TB-COVID co-infection displayed minimal evolution since 2021. Converging findings from diverse studies underscored increased hospitalization risks, extended recovery periods, and accelerated mortality compared to single COVID-19 cases. The pooled fatality rate among co-infected patients was 7.1% (95%CI: 4.0% ~ 10.8%), slightly lower than previous estimates. In-hospital co-infected patients faced a mean fatality rate of 11.4% (95%CI: 5.6% ~ 18.8%). The pooled relative risk of in-hospital fatality was 0.8 (95% CI, 0.18-3.68) for TB-COVID patients versus single COVID patients.

Conclusion: TB-COVID co-infection is increasingly prevalent worldwide, with fatality rates gradually declining but remaining higher than COVID-19 alone. This underscores the urgency of continued research to understand and address the challenges posed by TB-COVID co-infection.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. The results of included searches of databases.
Fig 2
Fig 2. Fatality rate of total TB-COVID co-infection patients.
Fig 3
Fig 3. Fatality rate of hospitalized TB-COVID co-infection patients.
Fig 4
Fig 4. Fatality rate of active/previous TB-COVID co-infection patients.
A: Total active TB-COVID co-infection patients; B: Total previous TB-COVID co-infection patients; C: Hospitalized active TB-COVID co-infection patients; D: Hospitalized previous TB-COVID co-infection patients.
See this image and copyright information in PMC

References

    1. Burki T. Tuberculosis control: getting back on track in the era of COVID-19. Lancet Respir Med. 2022;10(12):e112. Epub 20221110. doi: 10.1016/S2213-2600(22)00442-8 ; PubMed Central PMCID: PMC9645818. - DOI - PMC - PubMed
    1. Dzinamarira T, Moyo E, Moyo P, Pierre G, Mpabuka E, Kahere M, et al.. Childhood immunization services accessibility and utilization during the COVID-19 pandemic in Africa. J Infect. 2022;85(4):436–80. Epub 20220730. doi: 10.1016/j.jinf.2022.07.020 ; PubMed Central PMCID: PMC9338170. - DOI - PMC - PubMed
    1. Chakaya J, Khan M, Ntoumi F, Aklillu E, Razia F, Mwaba P, et al.. Global Tuberculosis Report 2020—Reflections on the Global TB burden, treatment and prevention efforts. Int J Infect Dis. 2021. Epub 2021/03/16. doi: 10.1016/j.ijid.2021.02.107 . - DOI - PMC - PubMed
    1. World Health Organization. Global tuberculosis report 2022. Geneva: World Health organization; 2022.
    1. Dheda K, Perumal T, Moultrie H, Perumal R, Esmail A, Scott AJ, et al.. The intersecting pandemics of tuberculosis and COVID-19: population-level and patient-level impact, clinical presentation, and corrective interventions. Lancet Respir Med. 2022;10(6):603–22. Epub 20220323. doi: 10.1016/S2213-2600(22)00092-3 ; PubMed Central PMCID: PMC8942481. - DOI - PMC - PubMed

Publication types