Correlation between immunity from BCG and the morbidity and mortality of COVID-19
- PDF / 898,535 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 6 Downloads / 197 Views
RESEARCH
Open Access
Correlation between immunity from BCG and the morbidity and mortality of COVID-19 Dakshitha Wickramasinghe1*, Nilanka Wickramasinghe2, Sohan Anjana Kamburugamuwa1, Carukshi Arambepola3 and Dharmabandhu N. Samarasekera1
Abstract Background: To investigate the association between parameters indicating immunity from BCG at country level (presence of BCG vaccination policy, BCG coverage, age-specific incidence of tuberculosis (TB)) and the morbidity and mortality of COVID-19. Methods: Country-specific data for COVID-19 cases and deaths, demographic details, BCG coverage and policy, age-specific TB incidence and income level were obtained. The crude COVID-19 cases and deaths per 100,000 population were calculated and assessed against the parameters indicating immunity from BCG using linear regression analysis. Results: Univariate analysis identified higher income level of a country to be significantly associated with COVID-19 cases (p < 0.0001) and deaths (p < 0.0001) but not with its case fatality rate. The association between COVID-19 and TB was strongest for TB incidence in patients > 65-years (Cases (rs = − 0.785,p = 0.0001)) and deaths (rs = − 0.647,p = 0.0001). Multivariate analysis identified the higher income level of a country and not having a universal BCG vaccination policy to affect the COVID-19 cases. The deaths were inversely affected by the presence of BCG vaccination policy and coverage; and positively by the TB incidence in patients > 65-years. Conclusion: Significant inverse correlations observed between cases and deaths of COVID-19 and BCG related parameters highlights immunity from BCG as a likely explanation for the variation in COVID-19 across countries. Keywords: COVID-19, BCG vaccination, Tuberculosis, Fatality
Introduction The COVID-19 outbreak started in December 2019 in Wuhan Province, China [1] and has by now spread to six continents. It is caused by SARS-CoV-2 [2]. It has overwhelmed the health system capacity in many countries. No specific treatment has been effective to date, while the thrust in controlling it is placed on public * Correspondence: [email protected] 1 Department of Surgery, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka Full list of author information is available at the end of the article
health interventions. Available literature suggests the mortality to be higher in patients of advanced age and comorbidities [1]. Bacillus Calmette–Guérin (BCG) is a live-attenuated vaccine primarily developed to protect against childhood meningitis and disseminated tuberculosis (TB) [3]. The World Health Organization (WHO) recommends BCG vaccination at birth in countries with both universal and selective vaccination policies [4]. Furthermore, multiple meta-analyses have confirmed the effectiveness of BCG against pulmonary and extra-pulmonary TB in adults
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reprodu
Data Loading...
