SARS‐CoV‐2 coinfection in children with severe airway obstruction due to pulmonary tuberculosis

Introduction The severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) pandemic had a significant impact on tuberculosis (TB) control globally, with the number of new TB diagnoses decreasing. Coinfection with some viruses, especially measles, could aggravate TB in children. This is presumably...

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Bibliographic Details
Published in:Pediatric pulmonology 2024-12, Vol.59 (12), p.3446-3456
Main Authors: Goussard, P., Van Wyk, L., Venkatakrishna, S., Rabie, H., Schubert, P., Frigati, L., Walzl, G., Burger, C., Doruyter, A., Andronikou, S., Gie, A. G., Rhode, D., Jacobs, C., Van der Zalm, M.
Format: Article
Language:English
Subjects:
Adolescent
Airway management
Airway Obstruction - etiology
Bronchoscopy
Child
Child, Preschool
Coinfection
complicated pulmonary tuberculosis
COVID-19 - complications
Female
Humans
Infant
Male
Original
Retrospective Studies
SARS-CoV-2
Severe acute respiratory syndrome
South Africa - epidemiology
TB airway obstruction
Tuberculosis
Tuberculosis, Pulmonary - complications
Tuberculosis, Pulmonary - diagnostic imaging
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Summary:Introduction The severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) pandemic had a significant impact on tuberculosis (TB) control globally, with the number of new TB diagnoses decreasing. Coinfection with some viruses, especially measles, could aggravate TB in children. This is presumably a result of depressed cellular immunity. Reports on children with TB and SARS‐CoV‐2 coinfection are limited. Methods A retrospective analysis of children up to 13 years old admitted to Tygerberg Hospital, Cape Town, South Africa, from March 2020 to December 2022 with suspected TB‐induced airway compression requiring bronchoscopy. Children were included if they presented with severe intrathoracic airway obstruction and/or radiographic evidence of complicated TB. The patients were divided into two groups based on SARS‐CoV‐2 respiratory polymerase chain reaction results. Demographics, TB exposure, microbiology, SARS‐CoV‐2 laboratory data, imaging, inflammatory cytokine levels, and bronchoscopy data were collected. Statistical analyses compared SARS‐CoV‐2 positive and negative groups. Results Of the 50 children undergoing bronchoscopy for TB airway obstruction, 7 (14%) were SARS‐CoV‐2 positive. Cough was more prevalent in the SARS‐CoV‐2 positive group (p = 0.04). There was no difference in TB culture yield between groups. However, SARS‐CoV‐2 positive children showed slower radiological improvement at 1 month (p = 0.01), pleural effusions (p 
ISSN:8755-6863
1099-0496
1099-0496
DOI:10.1002/ppul.27232