TB and COVID-19 coinfection: Investigating the clinical and biological interactions between Mycobacterium tuberculosis and SARS-CoV-2

UKRI priority areas include understanding the interaction between SARS-CoV-2 and other pathogens. M.tb and SARS-CoV-2 have significant potential to interact and therefore impact on clinical outcomes.The two major knowledge gaps to be addressed by this project are: 1 The reciprocal biological impact of SARS-CoV-2 and M.tb on immunity to each other 2 How the pandemic has affected outcomes and the provision of TB services. Research to date has focussed on retrospective studies exploring relationships between TB and COVID-19 and suggest M.tb increases susceptibility to SARS-CoV-2 and disease severity. The control of LTBI requires the maintenance of effective T-cell responses. When these are perturbed (e.g. HIV infection, anti-TNF treatment), the risk of reactivation increases significantly. SARS-CoV- 2 infections may cause lymphopenia and the impact of this on M.tb-specific T-cell response is unknown, nor is it clear if these return to normal levels. One reason for the lack of understanding of the relationship between these pathogens is the limited availability of sufficiently-sized populations of M.tb-infected patients and the clinical infrastructure to assess them. The assembled team has the appropriate expertise to address these issues and the cohorts of patients within a single joined-up health region.