PDF(Pubmed)
Abstract：
In India, tuberculosis (TB) has the second highest disease burden following diabetes mellitus. During the COVID-19 pandemic, there was a surge of several opportunistic infections. In this case series, we report five patients, including three adults and two adolescents, who have developed various forms of TB disease after symptomatic COVID-19 pneumonia. The average time for development of post-COVID TB was 48 days. Adolescent patients have developed disseminated TB, which can be due to COVID-19-induced immunological injury or its treatment-related immune suppression. All the adult patients had high CT severity scores (CTSS) and required the administration of intravenous steroids during their COVID-19 pneumonia. Various presentations of TB were secondary spontaneous pneumothorax, miliary TB, consolidation, and nodular infiltrates. One patient had a drug-induced liver injury, which complicated the treatment of that patient. Factors that may contribute to the development of post-COVID TB are diabetes mellitus, increased severity of COVID-19 pneumonia manifested by CTSS, and administration of intravenous steroids. Bidirectional screening of TB had to be done when patients present with symptoms of COVID-19 pneumonia.
摘要：
在印度,结核病（TB）是仅次于糖尿病的第二高疾病负担。在COVID-19大流行期间，有几次机会性感染激增。在这个系列中,我们报告了5个病人,包括三名成年人和两名青少年，他们在有症状的COVID-19肺炎后患上了各种形式的结核病。COVID后结核病的平均发展时间为48天。青少年患者发展为播散性结核病，这可能是由于COVID-19诱导的免疫损伤或其治疗相关的免疫抑制。所有成年患者的CT严重程度评分（CTSS）都很高，并且在COVID-19肺炎期间需要静脉注射类固醇。结核病的各种表现是继发性自发性气胸，miliaryTB,合并，和结节浸润.一个病人有药物性肝损伤,使病人的治疗变得复杂.可能导致COVID后结核病发展的因素是糖尿病，CTSS表现为COVID-19肺炎的严重程度增加，和静脉注射类固醇。当患者出现COVID-19肺炎症状时，必须进行结核病的双向筛查。
