Emergency surgical care for patients with COVID-19 and tuberculosis coinfection at multispecialty hospital

About authors

Moscow Research and Clinical Center for TB Control, Moscow, Russia

Correspondence should be addressed: Mikhail N. Reshetnikov
Barbolina, 3, Moscow, 107014; ur.kb@loxat

About paper

Author contribution: Reshetnikov MN proposed the concept, collected patient data and wrote the manuscript; Plotkin DV analyzed and interpreted the obtained data, prepared the manuscript and photos for publication; Zuban ON proposed the concept and edited the manuscript; Bogorodskaya EM edited the manuscript and prepared its final version.

Compliance with ethical standards: the study was approved by the Ethics Committee of Moscow Research and Clinical Center for TB Control (Protocol № 10 dated December 17, 2020). Informed consent was obtained from all study participants.

Received: 2021-04-12 Accepted: 2021-05-19 Published online: 2021-05-31

The double burden of the novel coronavirus infection and tuberculosis (TB) is a global challenge. The aspects of emergency surgical care for patients with COVID-19 and TB coinfection remain understudied. The aim of this study was to assess treatment outcomes in acute surgical patients with COVID-19 and preexisting TB coinfection. In 2020, our Center delivered surgical care to 465 patients with COVID-19 and preexisting TB; a total of 64 emergency surgeries were performed on 36 (5.6%) patients, of whom 16 had HIV. Thirteen patients (36.1%) were diagnosed with pulmonary TB; 23 patients (63.9%) had disseminated TB. Chest CT scans showed >25% lung involvement in 61.9% of the patients with COVID-19 pneumonia, 25–50% lung involvement in 30.6% of the patients, and 50–75% lung involvement in 5.6% of the patients. By performing abdominal CT, we were able to detect abdominal TB complications, including perforated tuberculous ulcers of the intestine, intestinal obstruction and tuberculous peritonitis, as well as tuberculous spondylitis complicated by psoas abscess. Of all surgical interventions, 28.2% were abdominal, 23.2% were thoracic, 15.6% were surgeries for soft tissue infection, and 32.8% were other types of surgery. Postoperative mortality was 22.2%. We conclude that COVID-19 did not contribute significantly to postoperative mortality among acute surgical patients with TB.

Keywords: tuberculosis, HIV, COVID-19, emergency surgery