Association of the past epidemic of Mycobacterium tuberculosis with mortality and incidence of COVID-19.
Association of the past epidemic of Mycobacterium tuberculosis with mortality and incidence of COVID-19.
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DOI：
10.1371/journal.pone.0253169
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Kashima S
中科院分区：
文献类型：
--
作者：
Inoue K;Kashima S
由严重急性呼吸道综合征冠状病毒2型（SARS-CoV-2）引起的2019冠状病毒病（COVID-19）大流行在每个国家都产生了显著而不同的影响，引发了广泛关注的呼声。最近，卡介苗（BCG）接种被认为是解释这种差异的潜在候选者。在此，我们假设，过去流行的结核分枝杆菌（M。结核病）可能是COVID-19对死亡率和发病率影响的全球差异的潜在解释因素。我们比较了两个指标的过去流行的M。结核病，特别是发病率（1990年90个国家）和死亡率（1950年28个国家），以及COVID-19的死亡率和发病率。我们确定，M的过去流行指标之间存在反比关系。结核病和当前COVID-19的影响。结核病发病率（每10万人）每下降1个单位，COVID-19累计死亡率/100万人的率比为2. 70（95%置信区间[CI]：1. 09 - 6. 68）。COVID-19累计发病率/百万的率比为2. 07（95% CI：1. 30 - 3. 30）。即使在调整了潜在的混杂因素后，（65岁以上人口比率、糖尿病患病率、心血管疾病死亡率和人均国内生产总值），导致COVID-19死亡率的调整比率为2.44，（95%CI：1.32-4.52）和COVID-19发病率为1.31（95%CI：0.97-1.78）。潜伏感染后，分枝杆菌在人体内存活，并可能继续刺激训练免疫力。这项研究提出了COVID-19影响中基于区域的变化的可能机制。
The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has created a remarkable and varying impact in every country, inciting calls for broad attention. Recently, the Bacillus Calmette-Guérin (BCG) vaccination has been regarded as a potential candidate to explain this difference. Herein, we hypothesised that the past epidemic of Mycobacterium tuberculosis (M. tuberculosis) may act as a latent explanatory factor for the worldwide differences seen in COVID-19 impact on mortality and incidence. We compared two indicators of past epidemic of M. tuberculosis, specifically, incidence (90 countries in 1990) and mortality (28 countries in 1950), with the mortality and incidence of COVID-19. We determined that an inverse relationship existed between the past epidemic indicators of M. tuberculosis and current COVID-19 impact. The rate ratio of the cumulative COVID-19 mortality per 1 million was 2.70 (95% confidence interval [CI]: 1.09–6.68) per 1 unit decrease in the incidence rate of tuberculosis (per 100,000 people). The rate ratio of the cumulative COVID-19 incidence per 1 million was 2.07 (95% CI: 1.30–3.30). This association existed even after adjusting for potential confounders (rate of people aged 65 over, diabetes prevalence, the mortality rate from cardiovascular disease, and gross domestic product per capita), leading to an adjusted rate ratio of COVID-19 mortality of 2.44, (95% CI: 1.32–4.52) and a COVID-19 incidence of 1.31 (95% CI: 0.97–1.78). After latent infection, Mycobacterium survives in the human body and may continue to stimulate trained immunity. This study suggests a possible mechanism underlying the region-based variation in the COVID-19 impact.
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