Pulmonary Tuberculosis and COVID-19 Co-infections in Lahore, Pakistan: A retrospective cohort study

Pulmonary Tuberculosis and COVID-19 Co-infections

Abstract

Tuberculosis (TB) and Coronavirus disease-2019 (COVID-19) are two major re-emerging diseases that poses significant health issues. Increase in disease burden and subsequent misuse of anti-TB drugs has become a serious health challenge. Early diagnosis followed by antibiotic susceptibility testing can lower the increase in occurrence of multidrug resistant TB. The present study was designed to compare the performance of GeneXpert and microscopy to the gold standard (culture) in sputum and broncho-alveolar lavage samples (n = 2862) and to check the prevalence of COVID-19 coinfections among the TB patients in Lahore, Pakistan. Results of the present study showed that, a total of 642 samples were found positive for TB via BD MGIT Liquid cultures method, 483 using Ziehl-Neelsen staining technique, 507 with fluorescent staining technique and 663 using GeneXpert respectively. In overall, 23% prevalence of TB was seen in the current study. The positive ratio of TB using GeneXpert in broncho alveolar lavage samples (24.56%) was more as compare to the Sputum (23.07%). Out of these 663 TB positive patients, a total of 197 were having COVID-19 like symptoms and were tested for COVID-19 using PCR. Among these 197 cases, 13 were found positive for COVID-19, from which 3 were resistant to Rifampicin (Rif). The diagnostic tests like GeneXpert have made improvements in the rapid diagnosis of TB and has high specificity and sensitivity.