Abstract:
Background. Tuberculosis and COVID-19 co-infection is a major challenge, especially in
Moldova with high TB incidence. Overlapping symptoms and imaging findings complicate
diagnosis. Computed tomography is essential for detecting and assessing lung lesions in
patients with active TB and COVID-19 co-infection.
Objective(s). Characteristics of imaging findings and diagnosis of lung lesions caused by coinfection with COVID-19 and active pulmonary tuberculosis to enable timely evaluation and
diagnosis.
Materials and methods. A review of PubMed and Scopus (2020–2023) examined WHO,
ACR, ESR, and RSR guidelines on radiologic diagnosis of COVID-19 and active pulmonary
tuberculosis co-infection. Data from 55 cases confirmed by PCR and BAAR tests were
analyzed using CT and chest X-rays. The Brixia score was applied to quantify lung lesion
severity and monitor progression.
Results. Distribution of 55 COVID-19 and tuberculosis co-infection cases in Moldova: center
65.5%, north 27.6%, south 6.9%. Average age 45.82 years, 75.9% men. Diagnosis by PCR for
COVID-19 and BAAR test for tuberculosis. Imaging: CT and chest X-rays. Lesions include
ground-glass opacities, consolidations, cavities, and adenopathy. CT identified coexisting
lesions in 85% of cases. Typical COVID-19 patterns: ground-glass and “crazy paving.” The
Brixia score assessed severity and progression, ranging from mild to severe. CT is essential
and sensitive for diagnosis and differentiation in COVID-19 and active tuberculosis coinfection.
Conclusion(s). The study optimizes early identification of COVID-19 lung lesions in patients
with active tuberculosis. CT reveals specific patterns, with bilateral changes, ground-glass
opacities, Halo sign, lenticular nodules, and pleural effusion, essential for diagnosis and
treatment.
