Late tuberculosis reactivation after severe COVID-19
  • Tom Dormans
    Department of Intensive Care, Zuyderland Medical Centre, Heerlen, The Netherlands
  • Eric Zandijk
    Department of Intensive Care, Zuyderland Medical Centre, Heerlen, The Netherlands
  • Frans Stals
    Department of Microbiology, Zuyderland Medical Centre, Heerlen, The Netherlands

Keywords

Tuberculosis reactivation, COVID-19, treatment modality given to COVID-19

Abstract

Background: Although there is no specific therapy for COVID-19, it is recommended that patients with severe SARS-CoV-2 infection are treated with corticosteroids and anti-IL-6 receptor monoclonal antibodies. Both COVID-19 itself and the treatment modalities mentioned above have suppressive effects on the immune system which may lead to an increased susceptibility to other infections. In patients with latent tuberculosis (TB) reactivation of TB infection after recovery from severe COVID-19 has been described. Most of these cases have occurred in parts of the world where tuberculosis is endemic.
Case description: The patient is a female in her 70s who was born and raised in Southeast Asia and has lived in the Netherlands for more than 30 years. She was treated for a severe COVID-19 requiring mechanical ventilation for several weeks and pharmaceutical treatment with corticosteroids and anti-IL-6 receptor monoclonal antibodies (Sarilumab). She recovered well. Two years later she was readmitted with symptoms of a serious pulmonary infection and meningitis. Her condition deteriorated in a short time. An active TB infection was diagnosed. Despite adequate antibiotic treatment and supportive therapy her condition worsened and four days after admission to the ICU she deceased.
Discussion: Reactivation of latent TB after recovery from a severe COVID-19 has been described several times and may occur several months after the SARS-CoV-2 infection. In this case the reactivation presented two years after COVID-19. This case illustrates that long-term follow-up of patients with latent TB that recover from a severe COVID-19 may be indicated.

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References

  • Boogaard J van den, Kampst-van Agterveld MP, Schimmel HJ, Slump E, van Soolingen D, de Vries G. Tuberculosis in the Netherlands 2021. RIVM 2022. Available from: https://www.rivm.nl/publicaties/tuberculose-in-nederland-2021-surveillancerapport
  • Gopalaswamy R, Subbian S. Corticosteroids for COVID-19 therapy: potential implications on tuberculosis. Int J Mol Sci 2021;22:3773.
  • Alemu A, Bitew ZW, Seid G, Diriba G, Gashu E, Berhe N, et al. Tuberculosis in individuals who recovered from COVID-19: a systematic review of case reports. PLoS One 2022;17:e0277807.
  • Dale KD, Karmakar M, Snow KJ, Menzies D, Trauer JM, Denholm JT. Quantifying the rates of late reactivation tuberculosis: a systematic review. Lancet Infect Dis 2021;21:e303–e317.
  • Qiu B, Wu Z, Tao B, Li Z, Song H, Tian D, et al. Risk factors for types of recurrent tuberculosis (reactivation versus reinfection): a global systematic review and meta-analysis. Int J Infect Dis. 2022;116:14–20.
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    Published: 2024-04-03
    Issue: 2024: LATEST ONLINE (view)


    How to cite:
    1.
    Dormans T, Zandijk E, Stals F. Late tuberculosis reactivation after severe COVID-19. EJCRIM 2024;11 doi:10.12890/2024_004406.