COVID-19, the escalation of diabetes mellitus and the repercussions on tuberculosis.

The COVID-19 pandemic has significantly disrupted global tuberculosis (TB) control efforts. The mobilization of healthcare resources and personnel to combat the pandemic, and the nationwide lockdown measures resulted in an accumulation of a large number of undiagnosed TB cases. Exacerbating the situation, recent meta-analyses showed that COVID-19-induced diabetes mellitus (DM) is on the increase. DM is an established risk factor for TB disease and worsens outcomes. Patients with concurrent DM and TB had more lung cavitary lesions, and are more likely to fail TB treatment and suffer disease relapse. This may pose a significant challenge to TB control in low- and middle-income countries where a high TB burden is found. There is a need to step up the efforts to end the TB epidemic, which include increased screening for DM among patients with TB, optimizing glycemic control among patients with TB-DM, and intensifying TB-DM research to improve treatment outcomes for patients with TB-DM.