Despite the high number of victims of COVID-19, tuberculosis (TB) remains as the leading cause of death among infectious diseases worldwide. Since the beginning of the pandemic, there is an increasing number of studies trying to elucidate the interactions between Mycobacterium tuberculosis and SARS-CoV-2. The first case reports point to a worsening of respiratory symptoms in co-infected TB/COVID-19 individuals. However, data from the cohort studies has shown some conflicting results. This study proposes to conduct a systematic review on the current literature on TB/COVID-19 co-infection cohorts, evaluating clinical and epidemiological data, focusing on its implications to the immune system. From an immunological perspective, the TB/COVID-19 co-infection has the potential to generate a "perfect storm". The disorders induced by each pathogen to the immune modulation tend to induce an unbalanced inflammatory response, which can promote the progression and worsening of both diseases. Understanding the nature of the interactions between M. tuberculosis and SARS-CoV-2 will be crucial for the development of therapeutic strategies against co-infection.

中文翻译：

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结核病/COVID-19 合并感染的病理学：幽灵威胁

尽管 COVID-19 的受害者人数很多，但结核病 (TB) 仍然是全球传染病中导致死亡的主要原因。自大流行开始以来，越来越多的研究试图阐明结核分枝杆菌和 SARS-CoV-2 之间的相互作用。第一份病例报告指出，同时感染 TB/COVID-19 的个体呼吸道症状恶化。然而，队列研究的数据显示了一些相互矛盾的结果。本研究拟对 TB/COVID-19 合并感染队列的现有文献进行系统回顾，评估临床和流行病学数据，重点关注其对免疫系统的影响。从免疫学角度来看，结核病/COVID-19双重感染有可能引发一场“完美风暴”。每种病原体引起的免疫调节紊乱往往会诱发不平衡的炎症反应，从而促进两种疾病的进展和恶化。了解结核分枝杆菌和 SARS-CoV-2 之间相互作用的性质对于制定针对合并感染的治疗策略至关重要。