Previously treated latent tuberculosis infection is associated with less severe acute COVID-19: a cohort study

IntroductionThere is significant potential for respiratory infections, such as tuberculosis (TB) and COVID-19, to overlap but little is known about such co-infection. We aimed to study the impact of active TB and latent TB on the incidence of severe COVID-19 in a large cohort of individuals in a set...

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Vydáno v:	BMJ open respiratory research Ročník 12; číslo 1; s. e003003
Hlavní autoři:	Scandrett, Katie, Pallett, Scott, Takwoingi, Yemisi, Cunningham, Adam F, Dedicoat, Martin, O’Shea, Matthew K
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	England British Thoracic Society 13.10.2025 BMJ Publishing Group LTD BMJ Publishing Group
Témata:	Adult Aged Cohort Studies Coinfection - epidemiology COVID-19 COVID-19 - epidemiology COVID-19 - mortality Diabetes Disease transmission Female Health care access Hospital Mortality Hospitals Humans Hypertension Immunity (Disease) Incidence Intensive care Intensive Care Units - statistics & numerical data Latent Tuberculosis - drug therapy Latent Tuberculosis - epidemiology Length of Stay - statistics & numerical data Male Middle Aged Nosocomial infections Pandemics Pathogens SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 Severity of Illness Index Tuberculosis Viral infection United Kingdom > UK Viral infection Tuberculosis
ISSN:	2052-4439, 2052-4439
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Abstract	IntroductionThere is significant potential for respiratory infections, such as tuberculosis (TB) and COVID-19, to overlap but little is known about such co-infection. We aimed to study the impact of active TB and latent TB on the incidence of severe COVID-19 in a large cohort of individuals in a setting of low TB endemicity.MethodsClinical data of patients admitted to hospital with acute SARS-CoV-2 were merged with a database of patients with a history of previous or current active TB, latent TB or healthy controls. We assessed the incidence of COVID-19 in these groups, length of hospital stay, admission to the intensive care unit (ICU) and in-hospital mortality.ResultsCOVID-19 incidence among individuals with current active TB was 6.2% (12/194) and previous active TB 0.67% (30/4496). In contrast, the incidence in previously treated latent TB was 0.09% (4/4542) and among TB contacts 0.24% (34/13 391). There were similar rates of ICU admission and mortality among individuals with COVID-19 and current active TB, TB contacts and other patients. No individuals with previously treated latent TB and COVID-19 were admitted to the ICU or died.ConclusionsIndividuals with a history of latent TB seem to be at reduced risk of severe COVID-19 and have better outcomes than those with active TB and even uninfected controls. Further studies are required to understand the mechanistic basis of this observation.
AbstractList	IntroductionThere is significant potential for respiratory infections, such as tuberculosis (TB) and COVID-19, to overlap but little is known about such co-infection. We aimed to study the impact of active TB and latent TB on the incidence of severe COVID-19 in a large cohort of individuals in a setting of low TB endemicity.MethodsClinical data of patients admitted to hospital with acute SARS-CoV-2 were merged with a database of patients with a history of previous or current active TB, latent TB or healthy controls. We assessed the incidence of COVID-19 in these groups, length of hospital stay, admission to the intensive care unit (ICU) and in-hospital mortality.ResultsCOVID-19 incidence among individuals with current active TB was 6.2% (12/194) and previous active TB 0.67% (30/4496). In contrast, the incidence in previously treated latent TB was 0.09% (4/4542) and among TB contacts 0.24% (34/13 391). There were similar rates of ICU admission and mortality among individuals with COVID-19 and current active TB, TB contacts and other patients. No individuals with previously treated latent TB and COVID-19 were admitted to the ICU or died.ConclusionsIndividuals with a history of latent TB seem to be at reduced risk of severe COVID-19 and have better outcomes than those with active TB and even uninfected controls. Further studies are required to understand the mechanistic basis of this observation. There is significant potential for respiratory infections, such as tuberculosis (TB) and COVID-19, to overlap but little is known about such co-infection. We aimed to study the impact of active TB and latent TB on the incidence of severe COVID-19 in a large cohort of individuals in a setting of low TB endemicity. Clinical data of patients admitted to hospital with acute SARS-CoV-2 were merged with a database of patients with a history of previous or current active TB, latent TB or healthy controls. We assessed the incidence of COVID-19 in these groups, length of hospital stay, admission to the intensive care unit (ICU) and in-hospital mortality. COVID-19 incidence among individuals with current active TB was 6.2% (12/194) and previous active TB 0.67% (30/4496). In contrast, the incidence in previously treated latent TB was 0.09% (4/4542) and among TB contacts 0.24% (34/13 391). There were similar rates of ICU admission and mortality among individuals with COVID-19 and current active TB, TB contacts and other patients. No individuals with previously treated latent TB and COVID-19 were admitted to the ICU or died. Individuals with a history of latent TB seem to be at reduced risk of severe COVID-19 and have better outcomes than those with active TB and even uninfected controls. Further studies are required to understand the mechanistic basis of this observation. Introduction There is significant potential for respiratory infections, such as tuberculosis (TB) and COVID-19, to overlap but little is known about such co-infection. We aimed to study the impact of active TB and latent TB on the incidence of severe COVID-19 in a large cohort of individuals in a setting of low TB endemicity.Methods Clinical data of patients admitted to hospital with acute SARS-CoV-2 were merged with a database of patients with a history of previous or current active TB, latent TB or healthy controls. We assessed the incidence of COVID-19 in these groups, length of hospital stay, admission to the intensive care unit (ICU) and in-hospital mortality.Results COVID-19 incidence among individuals with current active TB was 6.2% (12/194) and previous active TB 0.67% (30/4496). In contrast, the incidence in previously treated latent TB was 0.09% (4/4542) and among TB contacts 0.24% (34/13 391). There were similar rates of ICU admission and mortality among individuals with COVID-19 and current active TB, TB contacts and other patients. No individuals with previously treated latent TB and COVID-19 were admitted to the ICU or died.Conclusions Individuals with a history of latent TB seem to be at reduced risk of severe COVID-19 and have better outcomes than those with active TB and even uninfected controls. Further studies are required to understand the mechanistic basis of this observation. There is significant potential for respiratory infections, such as tuberculosis (TB) and COVID-19, to overlap but little is known about such co-infection. We aimed to study the impact of active TB and latent TB on the incidence of severe COVID-19 in a large cohort of individuals in a setting of low TB endemicity.INTRODUCTIONThere is significant potential for respiratory infections, such as tuberculosis (TB) and COVID-19, to overlap but little is known about such co-infection. We aimed to study the impact of active TB and latent TB on the incidence of severe COVID-19 in a large cohort of individuals in a setting of low TB endemicity.Clinical data of patients admitted to hospital with acute SARS-CoV-2 were merged with a database of patients with a history of previous or current active TB, latent TB or healthy controls. We assessed the incidence of COVID-19 in these groups, length of hospital stay, admission to the intensive care unit (ICU) and in-hospital mortality.METHODSClinical data of patients admitted to hospital with acute SARS-CoV-2 were merged with a database of patients with a history of previous or current active TB, latent TB or healthy controls. We assessed the incidence of COVID-19 in these groups, length of hospital stay, admission to the intensive care unit (ICU) and in-hospital mortality.COVID-19 incidence among individuals with current active TB was 6.2% (12/194) and previous active TB 0.67% (30/4496). In contrast, the incidence in previously treated latent TB was 0.09% (4/4542) and among TB contacts 0.24% (34/13 391). There were similar rates of ICU admission and mortality among individuals with COVID-19 and current active TB, TB contacts and other patients. No individuals with previously treated latent TB and COVID-19 were admitted to the ICU or died.RESULTSCOVID-19 incidence among individuals with current active TB was 6.2% (12/194) and previous active TB 0.67% (30/4496). In contrast, the incidence in previously treated latent TB was 0.09% (4/4542) and among TB contacts 0.24% (34/13 391). There were similar rates of ICU admission and mortality among individuals with COVID-19 and current active TB, TB contacts and other patients. No individuals with previously treated latent TB and COVID-19 were admitted to the ICU or died.Individuals with a history of latent TB seem to be at reduced risk of severe COVID-19 and have better outcomes than those with active TB and even uninfected controls. Further studies are required to understand the mechanistic basis of this observation.CONCLUSIONSIndividuals with a history of latent TB seem to be at reduced risk of severe COVID-19 and have better outcomes than those with active TB and even uninfected controls. Further studies are required to understand the mechanistic basis of this observation.
Author	Takwoingi, Yemisi Scandrett, Katie Dedicoat, Martin Pallett, Scott Cunningham, Adam F O’Shea, Matthew K
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not affect mycobacterial loads publication-title: Front Immunol doi: 10.3389/fimmu.2023.1240419 – ident: 2025111801563573000_12.1.e003003.14 – ident: 2025111801563573000_12.1.e003003.4 – volume: 8 year: 2021 ident: 2025111801563573000_12.1.e003003.7 article-title: COVID-19 and Tuberculosis Coinfection: An Overview of Case Reports/Case Series and Meta-Analysis publication-title: Front Med (Lausanne) doi: 10.3389/fmed.2021.657006 – volume: 131 year: 2021 ident: 2025111801563573000_12.1.e003003.16 article-title: Relationship of SARS-CoV-2-specific CD4 response to COVID-19 severity and impact of HIV-1 and tuberculosis coinfection publication-title: J Clin Invest doi: 10.1172/JCI149125 – ident: 2025111801563573000_12.1.e003003.3 – ident: 2025111801563573000_12.1.e003003.5 doi: 10.1016/S2213-2600(22)00092-3 – volume: 2 year: 2022 ident: 2025111801563573000_12.1.e003003.17 article-title: Higher BCG-induced trained immunity prevalence predicts protection from COVID-19: Implications for ongoing BCG trials publication-title: Clin Transl Discov doi: 10.1002/ctd2.60 – volume: 27 start-page: 766 year: 2023 ident: 2025111801563573000_12.1.e003003.12 article-title: Outcomes of TB contact tracing and predictors of success: a 10-year retrospective cohort analysis in Birmingham, UK publication-title: Int J Tuberc Lung Dis doi: 10.5588/ijtld.22.0575 – volume: 13 year: 2022 ident: 2025111801563573000_12.1.e003003.10 article-title: Immune responses in COVID-19 and tuberculosis coinfection: A scoping review publication-title: Front Immunol doi: 10.3389/fimmu.2022.992743 – ident: 2025111801563573000_12.1.e003003.19 doi: 10.1016/S0140-6736(15)00151-8
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Snippet	IntroductionThere is significant potential for respiratory infections, such as tuberculosis (TB) and COVID-19, to overlap but little is known about such... There is significant potential for respiratory infections, such as tuberculosis (TB) and COVID-19, to overlap but little is known about such co-infection. We... Introduction There is significant potential for respiratory infections, such as tuberculosis (TB) and COVID-19, to overlap but little is known about such...
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SubjectTerms	Adult Aged Cohort Studies Coinfection - epidemiology COVID-19 COVID-19 - epidemiology COVID-19 - mortality Diabetes Disease transmission Female Health care access Hospital Mortality Hospitals Humans Hypertension Immunity (Disease) Incidence Intensive care Intensive Care Units - statistics & numerical data Latent Tuberculosis - drug therapy Latent Tuberculosis - epidemiology Length of Stay - statistics & numerical data Male Middle Aged Nosocomial infections Pandemics Pathogens SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 Severity of Illness Index Tuberculosis Viral infection
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Title	Previously treated latent tuberculosis infection is associated with less severe acute COVID-19: a cohort study
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