{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T11:07:31Z","timestamp":1788174451399,"version":"build-2803163510"},"reference-count":22,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"unspecified","delay-in-days":12,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/W015374\/1"],"award-info":[{"award-number":["MR\/W015374\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Resp Res"],"accepted":{"date-parts":[[2025,9,5]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>There is significant potential for respiratory infections, such as tuberculosis (TB) and COVID-19, to overlap but little is known about such co-infection. We aimed to study the impact of active TB and latent TB on the incidence of severe COVID-19 in a large cohort of individuals in a setting of low TB endemicity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Clinical data of patients admitted to hospital with acute SARS-CoV-2 were merged with a database of patients with a history of previous or current active TB, latent TB or healthy controls. We assessed the incidence of COVID-19 in these groups, length of hospital stay, admission to the intensive care unit (ICU) and in-hospital mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>COVID-19 incidence among individuals with current active TB was 6.2% (12\/194) and previous active TB 0.67% (30\/4496). In contrast, the incidence in previously treated latent TB was 0.09% (4\/4542) and among TB contacts 0.24% (34\/13 391). There were similar rates of ICU admission and mortality among individuals with COVID-19 and current active TB, TB contacts and other patients. No individuals with previously treated latent TB and COVID-19 were admitted to the ICU or died.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Individuals with a history of latent TB seem to be at reduced risk of severe COVID-19 and have better outcomes than those with active TB and even uninfected controls. Further studies are required to understand the mechanistic basis of this observation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjresp-2024-003003","type":"journal-article","created":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T10:45:27Z","timestamp":1760352327000},"page":"e003003","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Previously treated latent tuberculosis infection is associated with less severe acute COVID-19: a cohort study"],"prefix":"10.1136","volume":"12","author":[{"given":"Katie","family":"Scandrett","sequence":"first","affiliation":[{"name":"Department of Applied Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham, UK"},{"name":"NIHR Birmingham Biomedical Research Centre, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9465-5299","authenticated-orcid":false,"given":"Scott","family":"Pallett","sequence":"additional","affiliation":[{"name":"Centre of Defence Pathology, Royal Centre for Defence Medicine, Birmingham, UK"},{"name":"St George\u2019s University of London Institute for Infection and Immunity, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yemisi","family":"Takwoingi","sequence":"additional","affiliation":[{"name":"Department of Applied Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham, UK"},{"name":"NIHR Birmingham Biomedical Research Centre, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam F","family":"Cunningham","sequence":"additional","affiliation":[{"name":"Department of Immunology and Immunotherapy, College of Medicine and Health, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Dedicoat","sequence":"additional","affiliation":[{"name":"Department of Infection, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew K","family":"O\u2019Shea","sequence":"additional","affiliation":[{"name":"Centre of Defence Pathology, Royal Centre for Defence Medicine, Birmingham, UK"},{"name":"Department of Immunology and Immunotherapy, College of Medicine and Health, University of Birmingham, Birmingham, UK"},{"name":"Department of Infection, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,10,13]]},"reference":[{"key":"2026010701513030000_12.1.e003003.1","unstructured":"Global tuberculosis report 2024. Geneva World Health Organization; 2024."},{"key":"2026010701513030000_12.1.e003003.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2001017"},{"key":"2026010701513030000_12.1.e003003.3","unstructured":"WHO coronavirus (COVID-19) dashboard. Available: https:\/\/covid19.who.int\/table [Accessed 09 Apr 2025]."},{"key":"2026010701513030000_12.1.e003003.4","unstructured":"Tuberculosis surveillance and monitoring in Europe 2024 \u2013 2022 data. Copenhagen: WHO regional office for Europe and Stockholm: European centre for disease prevention and control: European centre for disease prevention and control, WHO regional office for Europe. 2024."},{"key":"2026010701513030000_12.1.e003003.5","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(22)00092-3"},{"key":"2026010701513030000_12.1.e003003.6","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2023.1234785","article-title":"The impact of the COVID-19 pandemic on the global tuberculosis epidemic","volume":"14","author":"Falzon","year":"2023","journal-title":"Front Immunol"},{"key":"2026010701513030000_12.1.e003003.7","doi-asserted-by":"crossref","DOI":"10.3389\/fmed.2021.657006","article-title":"COVID-19 and Tuberculosis Coinfection: An Overview of Case Reports\/Case Series and Meta-Analysis","volume":"8","author":"Song","year":"2021","journal-title":"Front Med (Lausanne)"},{"key":"2026010701513030000_12.1.e003003.8","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0259006","article-title":"Active pulmonary tuberculosis and coronavirus disease 2019: A systematic review and meta-analysis","volume":"16","author":"Aggarwal","year":"2021","journal-title":"PLoS One"},{"key":"2026010701513030000_12.1.e003003.9","first-page":"418","article-title":"Impact of SARS-CoV-2 infection on tuberculosis outcome and follow-up in Italy during the first COVID-19 pandemic wave: a nationwide online survey","volume":"30","author":"Canetti","year":"2022","journal-title":"Infez Med"},{"key":"2026010701513030000_12.1.e003003.10","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2022.992743","article-title":"Immune responses in COVID-19 and tuberculosis coinfection: A scoping review","volume":"13","author":"Flores-Lovon","year":"2022","journal-title":"Front Immunol"},{"key":"2026010701513030000_12.1.e003003.11","doi-asserted-by":"crossref","DOI":"10.1136\/bmjhci-2020-100294","article-title":"Infrastructure and operating processes of PIONEER, the HDR-UK Data Hub in Acute Care and the workings of the Data Trust Committee: a protocol paper","volume":"28","author":"Gallier","year":"2021","journal-title":"BMJ Health Care Inform"},{"key":"2026010701513030000_12.1.e003003.12","doi-asserted-by":"crossref","first-page":"766","DOI":"10.5588\/ijtld.22.0575","article-title":"Outcomes of TB contact tracing and predictors of success: a 10-year retrospective cohort analysis in Birmingham, UK","volume":"27","author":"Andrews","year":"2023","journal-title":"Int J Tuberc Lung Dis"},{"key":"2026010701513030000_12.1.e003003.13","unstructured":"Health of the region 2020: addressing health and wellbeing inequalities and the impacts of COVID-19 in the West Midlands. Birmingham, 2020."},{"key":"2026010701513030000_12.1.e003003.14","unstructured":"TB incidence and epidemiology in England, 2021. London UK Health Security Agency; 2021."},{"key":"2026010701513030000_12.1.e003003.15","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2021-006434","article-title":"The isolated effect of age on the risk of COVID-19 severe outcomes: a systematic review with meta-analysis","volume":"6","author":"Romero Starke","year":"2021","journal-title":"BMJ Glob Health"},{"key":"2026010701513030000_12.1.e003003.16","doi-asserted-by":"crossref","DOI":"10.1172\/JCI149125","article-title":"Relationship of SARS-CoV-2-specific CD4 response to COVID-19 severity and impact of HIV-1 and tuberculosis coinfection","volume":"131","author":"Riou","year":"2021","journal-title":"J Clin Invest"},{"key":"2026010701513030000_12.1.e003003.17","doi-asserted-by":"crossref","DOI":"10.1002\/ctd2.60","article-title":"Higher BCG-induced trained immunity prevalence predicts protection from COVID-19: Implications for ongoing BCG trials","volume":"2","author":"Singh","year":"2022","journal-title":"Clin Transl Discov"},{"key":"2026010701513030000_12.1.e003003.18","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro2236"},{"key":"2026010701513030000_12.1.e003003.19","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00151-8"},{"key":"2026010701513030000_12.1.e003003.20","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(24)00028-6"},{"key":"2026010701513030000_12.1.e003003.21","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2023.1240419","article-title":"Co-infection of mice with SARS-CoV-2 and Mycobacterium tuberculosis limits early viral replication but does not affect mycobacterial loads","volume":"14","author":"Baker","year":"2023","journal-title":"Front Immunol"},{"key":"2026010701513030000_12.1.e003003.22","doi-asserted-by":"crossref","first-page":"108869","DOI":"10.1016\/j.isci.2024.108869","article-title":"Heat-killed Mycobacterium tuberculosis induces trained immunity in vitro and in vivo administered systemically or intranasally","volume":"27","author":"Minute","year":"2024","journal-title":"iScience"}],"container-title":["BMJ Open Respiratory Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjresp-2024-003003","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T09:52:48Z","timestamp":1767779568000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopenrespres.bmj.com\/lookup\/doi\/10.1136\/bmjresp-2024-003003"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":22,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,10,13]]},"published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1136\/bmjresp-2024-003003"],"URL":"https:\/\/doi.org\/10.1136\/bmjresp-2024-003003","relation":{},"ISSN":["2052-4439"],"issn-type":[{"value":"2052-4439","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]}}}