Implications of COVID-19 in high burden countries for HIV/TB.

The triple burden of coronavirus disease 2019 (COVID-19), tuberculosis (TB) and human immunodeficiency virus (HIV) is one of the major global health challenges of the twenty-first century. A thorough understanding of HIV/TB and COVID-19 pandemics is important as the three diseases interact. A systematic review was conducted to evaluate different studies on SARS-CoV, MERS-CoV or COVID-19 associated with HIV/TB co-infection or only TB, to understand the interactions between HIV, TB and COVID-19 and its implications on the burden of the COVID-19 among HIV/TB co-infected or TB patients, screening algorithm and clinical management. Fourteen studies were included for descriptive analysis and seven studies were included in the meta-analysis. The COVID-19/TB group was at high risk of developing severe/critical COVID-19 compared to the COVID-19 only group, the recovery rate was high among patients with only COVID-19 compared to those with COVID-19/TB irrespective of HIV status and the mortality was reduced among non-TB group. TB was a risk factor for COVID-19 both in terms of severity and mortality irrespective of HIV status. Structured diagnostic algorithms and clinical management are suggested to improve COVID-19/HIV/TB or COVID-19/TB co-infections outcomes.

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DSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis