RESUMEN
BACKGROUND: Longitudinal cohort data of patients with tuberculosis (TB) and coronavirus disease 2019 (COVID-19) are lacking. In our global study, we describe long-term outcomes of patients affected by TB and COVID-19. METHODS: We collected data from 174 centres in 31 countries on all patients affected by COVID-19 and TB between 1 March 2020 and 30 September 2022. Patients were followed-up until cure, death or end of cohort time. All patients had TB and COVID-19; for analysis purposes, deaths were attributed to TB, COVID-19 or both. Survival analysis was performed using Cox proportional risk-regression models, and the log-rank test was used to compare survival and mortality attributed to TB, COVID-19 or both. RESULTS: Overall, 788 patients with COVID-19 and TB (active or sequelae) were recruited from 31 countries, and 10.8% (n=85) died during the observation period. Survival was significantly lower among patients whose death was attributed to TB and COVID-19 versus those dying because of either TB or COVID-19 alone (p<0.001). Significant adjusted risk factors for TB mortality were higher age (hazard ratio (HR) 1.05, 95% CI 1.03-1.07), HIV infection (HR 2.29, 95% CI 1.02-5.16) and invasive ventilation (HR 4.28, 95% CI 2.34-7.83). For COVID-19 mortality, the adjusted risks were higher age (HR 1.03, 95% CI 1.02-1.04), male sex (HR 2.21, 95% CI 1.24-3.91), oxygen requirement (HR 7.93, 95% CI 3.44-18.26) and invasive ventilation (HR 2.19, 95% CI 1.36-3.53). CONCLUSIONS: In our global cohort, death was the outcome in >10% of patients with TB and COVID-19. A range of demographic and clinical predictors are associated with adverse outcomes.
Asunto(s)
COVID-19 , Coinfección , Infecciones por VIH , Tuberculosis Miliar , Humanos , Masculino , COVID-19/complicaciones , Infecciones por VIH/complicaciones , Factores de Riesgo , Estudios RetrospectivosRESUMEN
Se estudia en forma prospectiva un grupo de 30 pacientes cirróticos alcohólicos con ascitis pero sin complicaciones aparentes ingresados al servicio de medicina del Hospital Félix Bulnes entre junio de 1983 y septiembre de 1984. En 4 de estos pscientes (13.3-) se diagnostica la existencia de peritonitis bacteriana espontánea, en base a la presencia en todos de más de 500 células en el líquido ascítico, con más de un 75% de polimorfonucleares y en 3 de ellos por un cultivo positivo a escherichia coli con más de 10**5 por milímitro