Fiocruz participates in study on co-infection of tuberculosis and COVID-19

Despite the restrictions imposed due to the pandemic, the team at the Laboratory for Clinical Research on Mycobacterioses of the Evandro Chagas National Institute of Infectology (INI/Fiocruz) considers 2021 a year of great advances. "Besides the adaptation to work in home office and the remote service implementation for patients, we have been contemplated in different national and international initiatives. This allows us to carry out new studies to improve the tuberculosis diagnosis and treatment, which is a serious public health problem in the country", said Valeria Rolla, head of the laboratory.

The major highlight is the Project on COVID-19 impact on clinical manifestations, diagnosis, treatment outcome, and immune response for pulmonary tuberculosis, which aims to collect and store biological samples from patients with pulmonary tuberculosis (TB) and/or COVID-19-associated TB in biorepositories located in the respective participating countries. All material will be used in understanding the impact caused by the new coronavirus on the host immune response associated with tuberculosis.

The study will recruit 450 patients in total, being 150 at the INI/Fiocruz's Laboratory for Clinical Research on and the Mycobacterioses Hospital Center for the COVID-19 Pandemic, 150 at the Indian Council of Medical Research/National Institute for Research Tuberculosis (ICMR/NIRT), at Chennai (India), and 150 at the University of the Witwatersrand, in South Africa, all with pulmonary tuberculosis confirmed diagnosis, with and without coinfection by the new coronavirus. The study, led by Valeria, was selected in the CNPq's edict for Brics countries in partnership with South Africa and India and will last for two years. 

This project was successfully applied for in the call for proposals offered by the RePORT International Coordination Center (RICC) and will receive funding from the National Institutes of Health (NIH) in the United States for 24 months. The funding will be made available through CRDF Global, an independent non-profit organization that promotes safety, security, and sustainability through science and innovation.

Finally, the Abricot initiative (Associative Brics Research in Covid-19 and Tuberculosis), will investigate the effects of the new coronavirus, in the severe and mild/moderate forms, on the immunopathogenesis of tuberculosis, and how this affects - and if it affects - the results of TB treatment. Coordinated by Valeria Rolla, with partnerships of Bruno Andrade (Gonçalo Moniz Institute/Fiocruz Bahia), Timothy Sterling (Vanderbilt Medical Center/USA), Bavesh Kana (University of the Witwatersrand/South Africa) and Subash Babu (International Center for Excellence in Research/India), the study gains an innovation that is the use of swabs to collect tongue samples, cheek and one mouthwash with distilled water for the tuberculosis diagnosis on the Xpert-MTB-RIF Ultra (a more modern version of a test recommended by the World Health Organization to simultaneously detect Mycobacterium tuberculosis and resistance to rifampicin - a drug to treat the disease - in people diagnosed with tuberculosis). The utility will be important for patients who are hospitalized, dyspneic, and unable to obtain respiratory samples, among others, even at the outpatient level and who are unable to provide sputum.

The research has already started in the Laboratory for Clinical Research on Mycobacterioses at INI/Fiocruz, due to the fast approval by the National Research Ethics Committee (CONEP) and is waiting for acceptance in the other collaborating countries. "This initiative type values the BRICS countries, which still have a tuberculosis high burden, strengthening partnerships and strengthening future collaborations with our unit", concluded Valeria.