Summer 2021 Publication

transmission. Both Mycobacterium
tuberculosis that causes TB and severe
acute respiratory syndrome coronavirus 2
(SARS-CoV-2) that causes COVID-19 are
transmitted from person to person
through secretions from the respiratory
tract [2-4]. They are both spread mainly
when a healthy person comes in contact
with the particles that contain the virus
(in the case of COVID-19) or the bacteria
(in TB) that are expelled when people
with the illness either cough, sneeze, or
talk. Even though the causative
organisms are different, the initial
clinical manifestations of both these
highly contagious diseases mainly involve
the respiratory tract, with similar
symptoms such as cough, fever, shortness
of breath, fatigue, and loss of appetite.
Although both tuberculosis and COVID-19
are transmitted through contact between
people, their modes of transmission are
distinct. TB bacilli remain suspended in
the air for several hours after a TB
patient coughs or sneezes, and those who
inhale them can become infected with
tuberculosis. TB is an opportunistic
infection. Based on the infected person’s
immune response, the TB-causing
bacteria can go into either an active or
latent state, ready to kick into action at a
later date when the immune system is
weakened and cannot fight back. The
spread of COVID-19 is mainly through
direct breathing of droplets discharged by
COVID-19 patients when they exhale,
speak, cough or sneeze. These droplets
may land on objects and surfaces, leading
to a COVID-19 infection when a person
touches these surfaces followed by
touching their eyes, nose, or mouth. TB
has a lengthier incubation period,
generally with a slow onset, while
COVID-19 has a shorter and immediate
incubation period, usually less than two
weeks.
There isn't enough evidence to
demonstrate that tuberculosis patients
aren't more likely to contract COVID-19
[5]. Individuals with pre-existing
tuberculosis, on the other hand, are far
more likely to develop serious
consequences if they contract COVID-19.
Given the weakened immune systems of
TB patients, they are at a substantially
higher risk of getting COVID-19 and may
further have poorer treatment outcomes
due to their compromised immune
systems, especially if their TB treatment
is suspended. Consequently, effective
preventative interventions and treatment
strategies are needed to reduce the risk
of COVID-19 severity in tuberculosis
patients. When a patient has a history of
previous respiratory disease, their
damaged lung function substantially
lowers their resistance to viruses.
Therefore, as recommended by health
officials, tuberculosis patients must take
protective measures while maintaining
their prescription tuberculosis drugs to
protect themselves from COVID-19.
Estimated Drug resistant TB Notification: % change by region in GF-supported
countries, 2020 vs 2019 (Image Credit: The 13th meeting of the South-East Asia
Regional Multidrug-resistant tuberculosis Advisory Committee)
Treating people who have both TB and
COVID-19 presents a unique set of
challenges. While the information on
joint management of both COVID-19
infection and TB remains limited, TB
treatment is not different in people with
or without COVID-19 infection. No
cautions on drug-drug interactions are
indicated at present since no medication
is currently recommended for COVID-19
[6]. To protect the patient's health,
decrease TB transmission, and avoid drug
resistance, TB treatment in COVID-19
patients should be continued
uninterrupted.
Estimated impact of the COVID-19 pandemic on
the global number of TB deaths in 2020, for
different combinations of decreases in case
detection and the duration of these decreases
(Image Credits: WHO 2020 Global TB Report)
The unprecedented negative impacts of
the COVID-19 pandemic are pervasive. It
is a social and an economic crisis just as
much as it is a health crisis, with its
severe, far-reaching repercussions felt
across the world and drawing attention
and resources from many other public
health services. The COVID-19 pandemic
has completely eclipsed and jeopardized
efforts to eliminate tuberculosis. The
COVID-19 pandemic's potential impact on
essential tuberculosis services is
pervasive. The efficiency of TB
prevention and treatment activities
around the world are being harmed by
EUNOIA GLOBAL HEALTH |21