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BackgroundThere is growing literature on the association of SARS-CoV-2 and other chronic respiratory conditions, such as COPD and asthma. However, little is known about the relationship between coinfection with tuberculosis (TB) and COVID-19. We aimed to compare the risk and survival time of death and recovery among COVID-19 patients with and without TB.MethodsWe created a 4:1 propensity score matched sample of COVID-19 patients without and with TB, using SARS-CoV-2 surveillance data in the Philippines. We conducted a longitudinal cohort analysis of matched COVID-19 patients as of May 17, 2020, following them until June 15, 2020. The primary analysis estimated the risk ratios of death and recovery comparing COVID-19 patients with and without TB. Kaplan-Meier curves described time-to-death and time-to-recovery stratified by TB status, and differences in survival were assessed using the Wilcoxon test. We also conducted the same analysis on a subsample of admitted COVID-19 patients only.ResultsThe risk of death in COVID-19 patients with TB was 2.17 times greater compared to those without TB (95% CI: 1.40-3.37). The risk of recovery in TB patients was 25% less than the risk among those without TB (RR=0.75, 0.63-0.91). Similarly, time-to-death among COVID-19 patients with TB was significantly shorter (p=0.0031) and time-to-recovery in TB patients was significantly longer than patients without TB (p=0.0046).Among those admitted, COVID-19 TB patients also had a similar significant increase in risk of death (RR=2.25, 95% CI: 1.35-3.75); however, the risk of recovery was not significantly less (RR=0.84, 95% CI: 0.68-1.06). Time-to-death among those with TB was also significantly longer (p=0.0031) than those without TB, but there was no difference in time-to-recovery (p=0.17).ConclusionsOur findings show that coinfection with tuberculosis increases morbidity and mortality in COVID-19 patients. Our findings reiterate the need to prioritize routine and testing services for tuberculosis, even with increased disruptions to health systems during the SARS-CoV-2 pandemic. Additional research needs to focus on the interrelationship between TB and COVID-19 for appropriate planning and resource allocation, as SARS-CoV-2 continues to spread worldwide.