Previously treated latent tuberculosis infection is associated with less severe acute COVID-19: a cohort study
Scandrett, Katie Pallett, Scott Takwoingi, Yemisi Cunningham, Adam F Dedicoat, Martin O'Shea, Matthew K
Scandrett, Katie
Pallett, Scott
Takwoingi, Yemisi
Cunningham, Adam F
Dedicoat, Martin
O'Shea, Matthew K
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Publication date
2025-10-13
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Abstract
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.
Citation
Scandrett K, Pallett S, Takwoingi Y, Cunningham AF, Dedicoat M, O'Shea MK. Previously treated latent tuberculosis infection is associated with less severe acute COVID-19: a cohort study. BMJ Open Respir Res. 2025 Oct 13;12(1):e003003. doi: 10.1136/bmjresp-2024-003003.
Type
Journal Article