Tuberculosis and COVID-19 interaction: A review of biological, clinical and public health effects
Open accessAbstract
Evidence is accumulating on the interaction between tuberculosis (TB) and COVID-19. The aim of the present review is to report the available evidence on the interaction between these two infections. Differences and similarities of TB and COVID-19, their immunological features, diagnostics, epidemiological and clinical characteristics and public health implications are discussed. The key published documents and guidelines on the topic have been reviewed. Based on the immunological mechanism involved, a shared dysregulation of immune responses in COVID-19 and TB has been found, suggesting a dual risk posed by co-infection worsening COVID-19 severity and favouring TB disease progression. The available evidence on clinical aspects suggests that COVID-19 happens regardless of TB occurrence either before, during or after an active TB diagnosis. More evidence is required to determine if COVID-19 may reactivate or worsen active TB disease. The role of sequeale and the need for further rehabilitation must be further studied Similarly, the potential role of drugs prescribed during the initial phase to treat COVID-19 and their interaction with anti-TB drugs require caution. Regarding risk of morbidity and mortality, several risk scores for COVID-19 and independent risk factors for TB have been identified: including, among others, age, poverty, malnutrition and co-morbidities (HIV co-infection, diabetes, etc.). Additional evidence is expected to be provided by the ongoing global TB/COVID-19 study.
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Existing literature suggests that laryngeal TB is increasingly being identified in immunocompetent individuals, especially post-COVID-19, contrasting with historical cases where it was predominantly seen in immunocompromised populations.
“Moreover, existing literature suggests that laryngeal TB is increasingly being identified in immunocompetent individuals, especially post-COVID-19, contrasting with historical cases where it was predominantly seen in immunocompromised populations.”
From Head and Neck Tuberculosis: A Rare Diagnosis and the Role of Surgical Biopsy and Histopathological Evaluation in Extrapulmonary Disease (2025) · cites this paper as [51]
The Biological interactions and Conclusions sections discuss TB–COVID-19 interactions and possible TB reactivation, but not laryngeal TB. Searches for laryngeal TB in immunocompetent and immunocompromised people found no passage addressing the claimed post-COVID-19 increase or historical comparison. (LLM, conf=0.76)
Experimental — accuracy not yet measuredRoutine histopathological exams of suspicious laryngeal lesions are needed regardless of patient immune status or pulmonary TB history.
“This further supports the need for routine histopathological exams of suspicious laryngeal lesions, regardless of patient immune status or pulmonary TB history [51].”
From Head and Neck Tuberculosis: A Rare Diagnosis and the Role of Surgical Biopsy and Histopathological Evaluation in Extrapulmonary Disease (2025) · cites this paper as [51]
The Methods section on diagnostic tests discusses culture, microscopy and molecular tests for TB, but not histopathological examination of laryngeal lesions. Searches for laryngeal lesions, biopsy, immune status and pulmonary TB history found no passage supporting the claimed recommendation; page numbers are unavailable in our copy. (LLM, conf=0.75)
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References 90 · Cited by 328
Research works printed but not linked: 6
- [17]Sheerin D. Abhimanyu Wang X. Johnson W.E. Coussens A. Systematic evaluation of transcriptomic disease risk and diagnostic biomarker overlap between COVID-19 and tuberculosis: a patient-level meta-analysis medRxiv Nov 2020 10.1101/2020.11.25.20236646 2020.11.25.20236646 · DOI
- [53]Press Release Regeneron Regeneron’s Casirivimab and Imdevimab Antibody Cocktail for COVID-19 is First Combination Therapy to Receive FDA Emergency Use Authorization 2020 November 21, Available at: https://investor.regeneron.com/news-releases/news-release-details/regenerons-regen-cov2-first-antibody-cocktail-covid-19-receive. Accessed 9 December 2020
- [66]World Health Organization Fluorescent light-emitting diode (LED) microscopy for diagnosis of tuberculosis: policy statement. WHO/HTM/TB/2011.8 2011 World Health Organization Geneva Available at: https://apps.who.int/iris/bitstream/handle/10665/44602/9789241501613_eng.pdf;jsessionid=DA5CF0944176120288D5755A7D702C86?sequence=1. Accessed 9 December 2020 23586120
- [68]World Health Organization The use of loop-mediated isothermal amplification (TB-LAMP) for the diagnosis of pulmonary tuberculosis: policy guidance. WHO/HTM/TB/2016.11 2016 World Health Organization Geneva Available at: https://apps.who.int/iris/bitstream/handle/10665/249154/9789241511186-eng.pdf?sequence=1. Accessed 9 December 2020 27606385
- [72]World Health Organization Same-day diagnosis of tuberculosis by microscopy: policy statement. WHO/HTM/TB/2011.7 2011 World Health Organization Geneva Available at: https://apps.who.int/iris/bitstream/handle/10665/44603/9789241501606_eng.pdf?sequence=1. Accessed 9 December 2020 23586121
- [73]World Health Organization Automated real-time nucleic acid amplification technology for rapid and simultaneous detection of tuberculosis and rifampicin resistance: Xpert MTB/RIF system: policy statement. WHO/HTM/TB/2011.4 2011 World Health Organization Geneva Available at: https://apps.who.int/iris/bitstream/handle/10665/44586/9789241501545_eng.pdf?sequence=1&isAllowed=y. Accessed 9 December 2020 26158191
- Authors
- Visca, D., Ong, C. W. M., Tiberi, S., Centis, R., D’Ambrosio, L., Chen, B., Mueller, J., Mueller, P., Duarte, R., Dalcolmo, M., Sotgiu, G., Migliori, G. B., & Goletti, D.
- Affiliations
- University of Insubria (IT)
- National University of Singapore (SG)
- National Health Service (GB)
- Istituti Clinici Scientifici Maugeri (IT)
- Public Health Consulting Group
- The Mueller Health Foundation
- Universidade do Porto (PT)
- Escola Nacional de Saúde Pública Sergio Arouca (BR)
- University of Sassari (IT)
- Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani (IT)
- Corresponding author
- Migliori, G.B.
- ORCID
- Venue
- Pulmonology
- Publisher
- Informa UK Limited
- Published
- 2021-03-30
- Volume
- 27
- Issue
- 2
- Pages
- 151-165
- ISSN
- 2531-0429 (ISSN-L)
- 2531-0437
- PMC
- PMC7825946
- OpenAlex
- W3122300259
- Cited by
- 328
- References
- 90
- Citations by year
- 2026: 12 · 2025: 42 · 2024: 66 · 2023: 74 · 2022: 90 · 2021: 44
- FWCI
- 8.01
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- Locations
- Pulmonology (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- National University of Singapore (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- IrInSubria (University of Insubria) (submittedVersion, other-oa)
- UnissResearch (Università degli Studi di Sassari) (submittedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Surgery › Infectious Diseases and Tuberculosis
- Keywords
- tuberculosis, COVID-19 pandemic, immune dysregulation, tuberculosis reactivation, COVID-19 risk factors, HIV coinfection, drug interactions, antitubercular agents, malnutrition, public health implications
- MeSH terms
- COVID-19, SARS-CoV-2, Humans, Public Health, Tuberculosis, Comorbidity, Coinfection
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