The course of multidrug-resistant pulmonary tuberculosis in HIV-infected people with COVID-19

Authors

DOI:

https://doi.org/10.14739/2310-1210.2022.4.255884

Keywords:

MDR tuberculosis, HIV infection, COVID-19

Abstract

Aim. To analyze the course of multidrug-resistant tuberculosis (MDR-TB) in HIV-infected people, depending on the time to COVID-19 diagnosis, using the example of clinical cases from our own observation.

Materials and methods. The article presents 3 clinical cases of our own observation of MDR-TB in HIV-infected persons depending on the time to COVID-19 diagnosis in patients, who were treated in the Pulmonary Tuberculosis Department No. 2, clinical base of the Department of Tuberculosis and Pulmonology ZSMU – Municipal non-profit enterprise “Zaporizhzhia Regional Phthisiopulmonology Clinical Medical and Diagnostic Center” of Zaporizhzhia Regional Council.

Results. In clinical case 1, in an HIV-infected patient, MDR TB was detected after COVID-19. This clinical case has shown that after mild and treated COVID-19, even on the background of severe immunosuppression, but with AMBT and ART timely prescribed, MDR-TB in the patient had a favorable course with positive dynamics. In clinical case 2, in an HIV-infected patient, MDR-TB was detected concomitantly with COVID-19. The clinical case indicated that the patient received all 3 therapies for MDR-TB, HIV and COVID-19 in full and on time. In contrast to clinical case 1, the patient was diagnosed with a more severe process that required a longer period of treatment, although it was effective. In clinical case 3, an HIV-infected patient with COVID-19 was diagnosed after 5 months of MDR-TB treatment. Against this background, there was culture positivity. But after prescription of appropriate COVID-19 treatment against the background of AMBT and ART, positive dynamics and culture negativity were determined. All 3 patients completed antimycobacterial therapy of MDR-TB with results – recovery.

Conclusions. Regardless of the HIV infection duration with underlying severe immunosuppression (<200 CD4 lymphocyte cells) and the time to COVID-19 diagnosis (before, during or after the diagnosis of MDR-TB) on the background of timely therapy of MDR-TB, HIV and COVID-19, positive results can be achieved while saving the lives of patients.

 

Author Biographies

O. M. Raznatovska, Zaporizhzhia State Medical University, Ukraine

MD, PhD, DSc, Professor, Head of the Department of Phthisiology and Pulmonology

Yu. V. Myronchuk, Zaporizhzhia State Medical University, Ukraine

MD, Assistant of the Department of Phthisiology and Pulmonology

O. S. Shalmin, Zaporizhzhia State Medical University, Ukraine

MD, PhD, DSc, Professor of the Department of Phthisiology and Pulmonology

A. V. Fedorets, Zaporizhzhia State Medical University, Ukraine

MD, Assistant of the Department of Phthisiology and Pulmonology

References

  1. Hryshchuk, L. A., Gzhesik, K., Wolf, S. B., Alexo, O. M., & Sanukevych, T. H. (2021). Epidemiolohiia tuberkulozu v period pandemii COVID-19 [Epidemiology of tuberculosis during the COVID-19 pandemic]. Infektsiini khvoroby, (1), 4-12. [in Ukrainian]. https://doi.org/10.11603/1681-2727.2021.1.11946
  2. Todoriko L. D., Ostrovskyi M. M., Semianiv, I. O., & Shevchenko, O. S. (2020). Osoblyvosti perebihu tuberkulozu v umovakh pandemii COVID-19 [Features of tuberculosis in a COVID-19 pandemic]. Tuberkuloz, lehenevi khvoroby, VIL-infektsiia, (4), 52-63. [in Ukrainian]. http://doi.org/10.30978/TB2020-4-52.
  3. Tadolini, M., Codecasa, L. R., García-García, J. M., Blanc, F. X., Borisov, S., Alffenaar, J. W., Andréjak, C., Bachez, P., Bart, P. A., Belilovski, E., Cardoso-Landivar, J., Centis, R., D'Ambrosio, L., Luiza De Souza-Galvão, M., Dominguez-Castellano, A., Dourmane, S., Fréchet Jachym, M., Froissart, A., Giacomet, V., Goletti, D., … Migliori, G. B. (2020). Active tuberculosis, sequelae and COVID-19 co-infection: first cohort of 49 cases. The European respiratory journal, 56(1), 2001398. https://doi.org/10.1183/13993003.01398-2020
  4. Togun, T., Kampmann, B., Stoker, N. G., & Lipman, M. (2020). Anticipating the impact of the COVID-19 pandemic on TB patients and TB control programmes. Annals of clinical microbiology and antimicrobials, 19(1), 21. https://doi.org/10.1186/s12941-020-00363-1
  5. Gao, Y., Liu, M., Chen, Y., Shi, S., Geng, J., & Tian, J. (2021). Association between tuberculosis and COVID-19 severity and mortality: A rapid systematic review and meta-analysis. Journal of medical virology, 93(1), 194-196. https://doi.org/10.1002/jmv.26311
  6. Koupaei, M., Naimi, A., Moafi, N., Mohammadi, P., Tabatabaei, F. S., Ghazizadeh, S., Heidary, M., & Khoshnood, S. (2021). Clinical Characteristics, Diagnosis, Treatment, and Mortality Rate of TB/COVID-19 Coinfectetd Patients: A Systematic Review. Frontiers in medicine, 8, 740593. https://doi.org/10.3389/fmed.2021.740593
  7. Gül, Ş., Akalın Karaca, E. S., Özgün Niksarlıoğlu, E. Y., Çınarka, H., & Uysal, M. A. (2022). Coexistence of tuberculosis and COVID-19 pneumonia: A presentation of 16 patients from Turkey with their clinical features. Tüberküloz ve COVID-19 pnömonisi birlikteliği: Türkiye’den 16 hastanın klinik özellikleri ile sunumu. Tuberkuloz ve toraks, 70(1), 8-14. https://doi.org/10.5578/tt.20229902
  8. Pathak, L., Gayan, S., Pal, B., Talukdar, J., Bhuyan, S., Sandhya, S., Yeger, H., Baishya, D., & Das, B. (2021). Coronavirus Activates an Altruistic Stem Cell-Mediated Defense Mechanism that Reactivates Dormant Tuberculosis: Implications in Coronavirus Disease 2019 Pandemic. The American journal of pathology, 191(7), 1255-1268. https://doi.org/10.1016/j.ajpath.2021.03.011
  9. Song, W. M., Zhao, J. Y., Zhang, Q. Y., Liu, S. Q., Zhu, X. H., An, Q. Q., Xu, T. T., Li, S. J., Liu, J. Y., Tao, N. N., Liu, Y., Li, Y. F., & Li, H. C. (2021). COVID-19 and Tuberculosis Coinfection: An Overview of Case Reports/Case Series and Meta-Analysis. Frontiers in medicine, 8, 657006. https://doi.org/10.3389/fmed.2021.657006
  10. Tamuzi, J. L., Ayele, B. T., Shumba, C. S., Adetokunboh, O. O., Uwimana-Nicol, J., Haile, Z. T., Inugu, J., & Nyasulu, P. S. (2020). Implications of COVID-19 in high burden countries for HIV/TB: A systematic review of evidence. BMC infectious diseases, 20(1), 744. https://doi.org/10.1186/s12879-020-05450-4
  11. Visca, D., Ong, C., Tiberi, S., Centis, R., D'Ambrosio, L., Chen, B., Mueller, J., Mueller, P., Duarte, R., Dalcolmo, M., Sotgiu, G., Migliori, G. B., & Goletti, D. (2021). Tuberculosis and COVID-19 interaction: A review of biological, clinical and public health effects. Pulmonology, 27(2), 151-165. https://doi.org/10.1016/j.pulmoe.2020.12.012
  12. Crisan-Dabija, R., Grigorescu, C., Pavel, C. A., Artene, B., Popa, I. V., Cernomaz, A., & Burlacu, A. (2020). Tuberculosis and COVID-19: Lessons from the Past Viral Outbreaks and Possible Future Outcomes. Canadian respiratory journal, 2020, 1401053. https://doi.org/10.1155/2020/1401053

Downloads

Published

2022-09-06

How to Cite

1.
Raznatovska OM, Myronchuk YV, Shalmin OS, Fedorets AV. The course of multidrug-resistant pulmonary tuberculosis in HIV-infected people with COVID-19. Zaporozhye Medical Journal [Internet]. 2022Sep.6 [cited 2026May21];24(4):474-82. Available from: https://zmj.zsmu.edu.ua/article/view/255884

Issue

Vol. 24 No. 4 (2022)

Section

Case Reports

License

Authors who publish with this journal agree to the following terms:

Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.  Лицензия Creative Commons