Covid Coughs Up New Problem: Does It Lead To Greater Vulnerability To Tuberculosis?

Are lung damage and low immunity caused by coronavirus predisposing some people to get tuberculosis?

Are lung damage and low immunity caused by coronavirus predisposing some people to get tuberculosis?

Well, many concerns related to this is being raised by many doctors as there has been a significant increase in the diagnosis of bacterial infection over the past few months.

According to World Health Organisation (WHO), 2-3 billion people in the world are latently infected with mycobacterium tuberculosis which means that the person has an infection, but not the disease because his or her immune system is able to fight the bacteria to stop it from growing.

About 5%-15% of the people suffering from dormant TB are at risk of recurrence of TB says WHO. However, according to a recent study it has been found that for patients being treated with steroids, the risk of TB reactivation increased from 2.8 to 7.7-has increased.

Tuberculosis is already an endemic disease in India. Post-COVID there seems to be an increase in a number of cases with tuberculosis. The reasons are multifactorial. Important is Delayed presentation in fear of exposure to COVID. This also leads to further spread of TB in particularly by patients with Pulmonary TB. We have seen multiple members of the family being turned positive with TB. Also, patients who received steroids for COVID disease may have reactivation of TB or new TB disease due to low immunity. Also, many patients are coming with extrapulmonary TB as well. Post-COVID 2nd wave, there is a 30-40% increase in TB cases. In Respiratory disease they are forming a major chunk of lung infection cases said, Dr Vikas Maurya, Director and HOD, Pulmonology, Fortis Hospital, Shalimar Bagh.

While the Health Ministry in July said there is not enough evidence to suggest that there is an increase in cases of tuberculosis (TB) due to COVID-19 infection.

In a statement, the Ministry of Health and Family Welfare (MoHFW) said there have been some media reports alleging that a sudden rise in cases of Tuberculosis (TB) has been noticed among patients who were infected with COVID-19 recently, leaving the doctors worried on receiving around a dozen similar cases every day.

It is clarified that Tuberculosis (TB) screening for all COVID-19 positive patients and COVID-19 screening for all diagnosed TB patients has been recommended by Ministry of Health and Family Welfare (MoHFW). States/UTs have been asked for convergence in efforts for better surveillance and case finding of TB and COVID-19, as early as August 2020.

Apart from this, multiple advisories and guidance have also been issued by MoHFW to reiterate the need for bi-directional screening of TB-COVID and TB-ILI/SARI. The States/ UTs have been implementing the same.

Due to the impact of COVID-19 related restrictions, case notifications for TB had decreased by about 25% in 2020 but special efforts are being made to mitigate this impact through intensified case finding in OPD settings as well as through active case finding campaigns in the community by all States.

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