COVID-19 in Patients with Drug-Resistant Tuberculosis in Lesotho

In Lesotho, there are approximately 200 rifampicin-resistant TB patients in treatment at any given time, and this number has remained largely stable for the past few years, even during the COVID-19 pandemic. Since the beginning of the COVID-19 pandemic, all patients are screened for symptoms of COVID-19 at all encounters at ambulatory clinics or hospitals and, if deemed appropriate, tested with a SARS-CoV-2 rapid antigen test (SD Biosensor, San Diego, CA).

From July 2020 to June 2022, 351 rapid antigen tests were done, of which 33 (9.4%) were positive. Sixteen patients (48%) required hospitalization, oxygen, and corticosteroids. Four patients (12%) died during their hospital stay, similar to the hospitalized COVID-19 mortality rate reported in Uganda and other countries. Compared with the Ugandan cohort, a larger percentage of patients were HIV-positive (61%), as expected given the higher HIV seroprevalence in Lesotho. COVID-19 vaccines became available to the general population of Lesotho at the end of 2021, so most of the patients in this cohort were likely unvaccinated at the time of their SARS-CoV-2 infection.