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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Published in:BMJ open respiratory research Vol. 12; no. 1; p. e003003
Main Authors: Scandrett, Katie, Pallett, Scott, Takwoingi, Yemisi, Cunningham, Adam F, Dedicoat, Martin, O’Shea, Matthew K
Format: Journal Article
Language:English
Published: England British Thoracic Society 13.10.2025
BMJ Publishing Group LTD
BMJ Publishing Group
Subjects:
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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Summary: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.
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ISSN:2052-4439
2052-4439
DOI:10.1136/bmjresp-2024-003003