Activation of tuberculosis in recovered COVID-19 patients: a case report

Currently, coronavirus disease 2019 (COVID-19) and tuberculosis (TB) are among the most important causes of respiratory infections around the world. Both of them are sources of concern for human health and life safety. COVID-19 caused the deaths of millions of people, and many of them suffered from what has become known as 'post-COVID squeal'. Immunosuppression is one of the most important of these symptoms that leave patients susceptible to severe infections like TB.

Case presentation: In these two cases, the authors observed the development of active TB after a period of COVID recovery. Two patients who were admitted to the hospital complained mainly, among other symptoms, of fever and a continuous cough after a period of COVID-19 recovery.

Clinical discussion: Radiological examination revealed a caving density in the two cases, and the Gene-Xpert test proved the presence of Mycobacterium tuberculosis bacteria despite the negative result of the Ziehl-Neelsen stain. The two patients were improved after standard TB treatment.

Conclusion: Patients with post-COVID-19 chronic respiratory symptoms should be screened for TB, especially in TB-endemic areas, even though the result of the Ziehl-Neelsen stain was negative.