High Mortality and Clinical Challenges in Tuberculosis-COVID-19 Co-infection: A Multicenter Study from Senegal

Background: The syndemic interaction between tuberculosis (TB) and COVID-19 remains poorly characterized in high TB-burden African settings. This study investigates the clinical and epidemiological features of TB–COVID-19 co-infection in Senegal. Methods: We conducted a multicenter retrospective observational study from March 2020 to March 2022, enrolling hospitalized patients with confirmed COVID-19 (RT-PCR) and active TB (positive smear microscopy or GeneXpert). Demographic, clinical, and outcome data were systematically collected and analyzed. Results: Among 19 co-infected patients (mean age 48±20 years, 63.2% male), TB preceded COVID-19 diagnosis in 78.9% of cases. Common presentations included chronic cough (84.2%), fever (84.2%), and radiological findings of ground-glass opacities (52.6%). Notable laboratory abnormalities included lymphopenia (84.2%) and elevated inflammatory markers (CRP >12 mg/L in 100%). The case fatality rate reached 26.3%, with severe COVID-19 present in 36.8% of cases. Conclusion: Our findings show that active TB was associated with severe COVID-19 presentations and a high observed in-hospital mortality in this Senegalese cohort. These results underscore the need for integrated screening and management strategies in TB-endemic regions.