Co-infection of COVID-19 and pulmonary tuberculosis: a case report on lung and liver damage

Abstract

Background: Co-infection with COVID-19 and tuberculosis (TB) often leads to symptoms such as fever, coughing, low blood pressure, altered blood cell counts, elevated liver enzyme levels, and reduced hemoglobin. Additionally, there is significant concern regarding lung damage caused by severe COVID-19, which increases susceptibility to TB.

Case presentation: On May 19, 2022, a 50-year-old retired Black African woman visited the emergency department with a sore throat, a 12 kg weight loss over the previous month, and shortness of breath that began a day earlier. She also experienced muscle weakness, fever, a productive cough, loss of appetite, headache, and 3 days of night sweats. Chest auscultation revealed reduced breath sounds in the right upper and middle lung regions. A throat swab polymerase chain reaction (PCR) test confirmed a COVID-19 diagnosis 36 hours later. During her hospital stay, the patient required continuous oxygen therapy via a nasal cannula at 4 L per minute for the first 5 days. She remained on anti-tubercular medication and received intravenous ceftriaxone at a dosage of 1 g daily for 5 days to prevent hospital-acquired infections.

Clinical discussion: Patients with active pulmonary tuberculosis (TB) have a poorer prognosis and are at risk of developing COVID-19. Both TB and COVID-19 are infectious diseases that primarily target the lungs. Mortality rates associated with COVID-19 are notably higher in individuals with active pulmonary TB.

Conclusion: COVID-19 and Mycobacterium tuberculosis are among the most critical global health challenges. TB infection is linked to a heightened risk of severe COVID-19 outcomes.

Keywords: COVID-19; Mycobacterium tuberculosis; SARS-CoV-2; case report; pulmonary tuberculosis.