The Truth about Having COVID & TB at The Same Time

Learn what it’s like to live with both

South Africa has a massive COVID-19 problem, but if it were a competition, TB would be winning.

What is Tuberculosis (TB)?

Tuberculosis (TB) is caused by a bacterium called Mycobacterium tuberculosis. These bacteria usually attack the lungs, but they can attack any part of the body like the kidney, spine, and brain. Not everyone infected with TB bacteria becomes sick. As a result, two TB-related conditions exist: a latent TB infection (LTBI) and TB disease. Unfortunately, if this disease is not treated properly, TB can be fatal.

TB in South Africa

TB, or Tuberculosis, is the leading cause of death worldwide from a single infectious agent at 1.5 million people per year (Stochino et al., 2020). This disease also kills thousands of South Africans every year. In 2018 our partner, the National Institute for Communicable Diseases, did a study on respiratory (breathing) diseases like TB which estimated that 301 000 people had TB and 63 000 had died from the disease in South Africa just that year. Statistically, TB was the leading cause of death in SA for 3 years running, from 2016 to 2018 (Stats SA, 2016; Stats SA, 2017; Stats SA, 2018). Plus, we also have a big problem with multi-drug resistant TB (the bacteria is immune from lots of different TB medications), which makes the virus incredibly hard to treat (Makhado et al., 2018).

But this is not to say COVID-19 is a non-issue. South Africa has the highest number of COVID-19 cases in Africa, as we host 34% of all cases on the continent (Karim, 2022). So, it’s not surprising that South Africans are at risk of catching both viruses, and when they do meet in one person the results are not recommended.

What Are Experts Saying?

To shed more light on this important issue, scientists from the European Respiratory Journal have recently released a study on what a ‘coinfection’ of TB and COVID looks like (TB/COVID-19 Global Study Group, 2022).

They found that of the 767 patients in their study, 74% had TB before they caught COVID-19. But this does not necessarily mean that TB makes patients more vulnerable to catching COVID-19, as it is likely that patients with active TB have a lot of time to get exposed to COVID-19 infection due to lengthy chronic course of TB (Khurana, 2020).

85 of the people in the study died, which represents a mortality (chance of dying) of 11.08% as seen in this study. This is higher than the mortality rate of just having a COVID-19 infection in South Africa, which has killed 2.7% of those infected (Coronatracker, 2022; TB/COVID-19 Global Study Group, 2022). However, it should be noted that there were ‘significant external risk factors’ (important things that can affect the studies results) that could have played a part in the patients deaths (Khurana, 2020). For example, many of those who died were over 65 years old and had one or more co-morbidity (e.g. diabetes) (Khurana, 2020; TB/COVID-19 Global Study Group, 2022).


Having a COVID diagnosis complicates treating TB patients and is very dangerous. Because many South Africans battle with TB and are being exposed to COVID-19 during the pandemic, it is something many people in our country are struggling with and deserves further research.

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