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Tuberculosis and COVID-19

Tuberculosis (TB) disease may put you at risk of having more severe COVID-19 illness. Coinfections with COVID-19 and TB are a concern and not yet well studied.

Last updated: May 26, 2022


TB Care

People with active TB or those who are recovering

If you have TB or are recovering from TB, you may be at risk of developing more severe illness if you get a respiratory infection, including COVID-19.

If you have TB and test positive for COVID-19

  1. Keep taking your TB medicines as prescribed.
  2. Contact your health care provider right away so they can check if you are eligible for COVID-19 treatment.

You may qualify for COVID-19 treatment if you have mild or moderate symptoms and any of the following high-risk conditions:

For the COVID-19 treatment to be most effective, it needs to be started within 5 days of symptoms starting.

It is important to keep taking your TB medication, as we know that people have worse health outcomes if their TB treatment is stopped or interrupted.

COVID-19 prevention for people with TB

There are many ways people with TB can protect themselves from getting very sick with COVID-19.

  • Keep your COVID-19 vaccinations up-to-date, including booster doses
  • Stay on your TB treatment as advised by your health care provider
  • Follow public health recommendations and restrictions, such as cleaning your hands and safer social interactions.
  • Take steps to support good lung health and prevent poor outcomes such as stopping tobacco, vaping, or e-cigarette use.

It is recommended that people who have had TB, especially those who required lung surgery, or have post-TB lung disease closely follow public health recommendations to prevent and treat COVID-19. See "Your personal toolkit" for more information.

COVID-19 Vaccination and TB

If you are taking treatment for TB disease or latent TB infection, it is safe to receive the COVID-19 vaccine.

If you are not tolerating your TB treatment, you should discuss the timing of your next COVID-19 vaccine with your health care provider. It is not a safety concern, but it is important to be able to separate the side effects of your TB treatment from other causes.

At this time, TB Services is not providing the COVID-19 vaccine to patients. Find more information about getting a COVID-19 vaccine and other health considerations on the BCCDC COVID-19 vaccine page.

Receiving care at our TB clinics

If you are receiving treatment at our TB clinics:

  • Please keep your scheduled TB clinic appointments.
  • TB clinics follow strict infection prevention and control practices to keep patients and staff safe.
  • TB clinics are open for in-person appointments. They offer virtual appointments by phone or computer whenever possible.

People with latent TB infection

Currently, there is no evidence to suggest that latent TB infection (LTBI) alone puts you at higher risk of getting COVID-19. If you are generally in good health, it is unlikely that LTBI influences the symptoms associated with COVID-19. 

Recently, there is some evidence that if you develop severe COVID-19, you may be at increased risk of progressing to active TB if you have untreated TB infection. This may happen when COVID-19 infection causes a significant abnormal immune response and/or some COVID-19 treatments weaken the immune system.

Prevention includes completing all prescribed doses of LTBI therapy and staying up-to-date with your COVID-19 vaccines.

TB medication and COVID-19

The medications used to treat TB disease and TB infection are not the same medicines used to treat COVID-19 patients.

If you are on TB medication, you should continue to take your medication as prescribed and continue with appointments, tests and medication refills as scheduled by your health care provider. 

Comparison of TB and COVID-19 

TB and COVID-19 both affect the respiratory system and share many symptoms. However, TB can take more time to develop. 

Many risk factors for TB disease are also risk factors for severe COVID-19 infection, such as diabetes, immune suppression due to medical conditions or treatments, malnutrition. 

The chart below provides a comparison of the two diseases. Visit the BCCDC website for further information on TB symptoms and COVID-19 symptoms

If you have symptoms of COVID-19 complete the BC COVID-19 Self-Assessment Tool. If you have symptoms of TB, contact your health care provider or local Health Unit.

Tuberculosis

  • Cough, often productive; bloody sputum, shortness of breath, fever, unexplained weight loss, night sweats, feeling very tired. Symptoms may develop gradually and persist for weeks or months.
COVID-19
  • Key symptoms include fever or chills, cough, loss of sense of smell or taste, difficulty breathing. 

  • Other symptoms may include sore throat, loss of appetite, runny nose, sneezing, extreme fatigue or tiredness, headache, body aches, nausea, vomiting, and/or diarrhea. Symptoms develop quickly and if infection is mild to moderate illness resolves after a few days to weeks

 

Tuberculosis

The TB germ is found in very small droplets (aerosols) that can remain in the air for several hours after someone with lung TB disease coughs, sneezes, shouts or sings. Good air ventilation and sunlight decreases the amount of TB germs in the air.


COVID-19

The coronavirus (SARS-CoV-2) is found inside droplets released by people who have the infection when they breathe, cough, sneeze, talk or sing. Droplets can range in size. Large droplets are heavier and usually fall to the ground within 2 meters. Smaller droplets (aerosols) are lighter and can remain in the air for a longer time, especially in poorly ventilated indoor spaces. The most common type of spread is from close contact with an infected person. 

 

Tuberculosis

  • Sputum tests for those with cough. Other samples depending on symptoms.
COVID-19
  • Nasal and/or throat swabs
  • Saline gargle test

 

Tuberculosis

  • Mycobacterium tuberculosis complex

COVID-19

  • Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)  

Tuberculosis

  • Taking TB preventive therapy for those with known contact to TB, prompt diagnosis and treatment of active TB, appropriate infection control measures to help limit transmission (eg. self-isolation while infectious, mask wearing).

COVID-19

  • Getting vaccinated, staying home if sick, physical distancing, mask wearing, well ventilated indoor spaces, and hand hygiene. 
 

Tuberculosis

  • Antibiotics


COVID-19

  • There are therapies available in BC that are appropriate for some patients. See COVID-19 Treatments for more information.  

Tuberculosis

  • BCG has some protective effects, particularly for children.

COVID-19

Anxiety about TB and COVID-19

Coping with a TB diagnosis itself can be difficult and cause a lot of worry. Having concerns about a COVID-19 infection is understandable. It can help to know the facts from credible sources, connect with people you trust, and find time to practice self-care and wellness at home.

For more information and access to mental health services, visit the BCCDC website Mental well-being during COVID-19.

Stigma associated with COVID-19

Stigma has a very powerful impact on our health and well-being. In our society, both TB and now COVID-19 are associated with social stigma.

Stigma can cause significant harms such as discrimination, labelling, and stereotyping. If you or someone close to you is experiencing stigma, reach out to a friend or a community or health care provider for support.

If you are interested in understanding ways to help stop stigma, visit the Centre for Addiction and Mental Health (CAMH) website on mental health, stigma and prejudice during the COVID-19 pandemic.

If you have more questions about COVID-19 visit the Common Questions section of the BCCDC website.


SOURCE: Tuberculosis and COVID-19 ( )
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