背景:SARS-CoV-2感染通常会导致人体免疫失调。对结核分枝杆菌(Mtb)或HIV合并感染引起的免疫学变化的研究有限。
方法:我们进行了一项针对COVID-19患者的回顾性研究。共有550名感染SARS-CoV-2的患者被纳入我们的研究,并根据合并感染的存在分为四组;166名Delta感染的患者,其中103名患者没有合并感染,52人同时感染了Mtb,11人同时感染了艾滋病毒,还有384名受Omicron感染的病人.通过收集流行病学信息的数据,实验室发现,治疗,和临床结果,我们分析并比较了临床和免疫学特征。
结果:与Delta组相比,白细胞中位数,Mtb组和HIV组的CD4+T细胞和B细胞计数较低。除了Omicron集团的人,三组中超过一半的患者胸部CT表现异常.在三组中,任何细胞因子均无显著差异。与三角洲集团相比,Mtb组和HIV组的病程和LOS均更长.对于未接种疫苗的Delta感染患者,在Mtb和HIV组,B细胞和CD4+T细胞数量低于Delta组,LOS或疾病持续时间没有显着差异。在Mtb组中,3例(6%)患者的病程超过4个月,淋巴细胞和IL17A计数降低,可能是由于SARS-CoV-2和结核分枝杆菌引起的肺部双重感染。
结论:我们发现合并感染Mtb或HIV的SARS-CoV-2患者表现出更长的病程和更长的LOS,随着B细胞和CD4+T细胞的减少,表明这些细胞与免疫功能有关。细胞因子水平的变化表明与Mtb或HIV的共同感染不会导致免疫应答的失调。重要的是,我们发现了一个慢性共感染过程,包括超过四个月的Mtb和SARS-CoV-2感染。
BACKGROUND: SARS-CoV-2 infections usually cause immune dysregulation in the human body. Studies of immunological changes resulting from coinfections with Mycobacterium tuberculosis (Mtb) or HIV are limited.
METHODS: We conducted a retrospective study focusing on patients with COVID-19. A total of 550 patients infected with SARS-CoV-2 were enrolled in our study and categorized into four groups based on the presence of coinfections; 166 Delta-infected patients, among whom 103 patients had no coinfections, 52 who were coinfected with Mtb, 11 who were coinfected with HIV, and 384 Omicron-infected patients. By collecting data on epidemiologic information, laboratory findings, treatments, and clinical outcomes, we analyzed and compared clinical and immunological characteristics.
RESULTS: Compared with those in the Delta group, the median white blood cell, CD4 + T-cell and B-cell counts were lower in the Mtb group and the HIV group. Except for those in the Omicron group, more than half of the patients in the three groups had abnormal chest CT findings. Among the three groups, there were no significant differences in any of the cytokines. Compared with those in the Delta group, the disease duration and LOS were longer in the Mtb group and the HIV group. For unvaccinated Delta-infected patients, in the Mtb and HIV groups, the number of B cells and CD4 + T cells was lower than that in the Delta group, with no significant difference in the LOS or disease duration. In the Mtb group, three (6%) patients presented with a disease duration greater than four months and had decreased lymphocyte and IL17A counts, possibly due to double infections in the lungs caused by SARS-CoV-2 and M. tuberculosis.
CONCLUSIONS: We found that SARS-CoV-2 patients coinfected with Mtb or HIV exhibited a longer disease duration and longer LOS, with a decrease in B cells and CD4 + T cells, suggesting that these cells are related to immune function. Changes in cytokine levels suggest that coinfection with Mtb or HIV does not result in dysregulation of the immune response. Importantly, we discovered a chronic course of coinfection involving more than four months of Mtb and SARS-CoV-2 infection.