Tuberculosis in individuals who recovered from COVID-19: A systematic review of case reports

Ayinalem Alemu; Zebenay Workneh Bitew; Getachew Seid; Getu Diriba; Emebet Gashu; Nega Berhe; Solomon H. Mariam; Balako Gumi

doi:10.1371/journal.pone.0277807

Peer Review History

Original SubmissionJune 30, 2022
19 Sep 2022 Decision Letter - Shampa Anupurba, Editor PONE-D-22-18569 Tuberculosis in individuals who recovered from COVID-19: A Systematic Review of Case Reports PLOS ONE Dear Dr. Alemu, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please submit your revised manuscript by Nov 03 2022 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Shampa Anupurba, MD Academic Editor PLOS ONE Journal Requirements: When submitting your revision, we need you to address these additional requirements. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf 2. We note that this manuscript is a systematic review or meta-analysis; our author guidelines therefore require that you use PRISMA guidance to help improve reporting quality of this type of study. Please upload copies of the completed PRISMA checklist as Supporting Information with a file name “PRISMA checklist”. Additional Editor Comments: The language has to be thoroughly revised. A few corrections in additions to comments made by reviewer have been pointed out as follows: Line 58- 'caused' in place of causes Line 59 to 60-'... the others disease prevention and control programs including the tuberculosis' may be replaced by '...prevention and control of other diseases including tuberculosis'. Line 60- Delete 'prevention and control program' Line 62- Delete 'Studies conducted in' Line 69- 'increases' to be replaced by 'increased' Line 74- Insert 'versa' after vice Line 122- 'included' instead of include Line 132- 'contained' instead of contains Line 163- 'males' instead of male Lines 170-172- May be deleted as there is no relevance of smoking and alcohol consumption. Line 172- 'HIV' need not be written in italics. Line 173- Eleven cases were BCG vaccinated or vaccination status was available for only eleven cases? Line 183- 'COVID-19 was confirmed in 14 cases by PCR'- Please check whether it was PCR or RT-PCR as COVID-19 has always been diagnosed by RT-PCR. Line 185- 'confirmed by chest X-ray.' Chest X-ray could be suggestive of COVID-19. Line 254- 'previous TB treatment history that indicated the potential reactivation of TB'- cannot be proven whether it was endogenous reactivation or exogenous reinfection. Table 2- TB DNA, PCR have been mentioned separately in diagnostic methods for TB. Also Xpert MTB/RIF and Gene Xpert are actually the same.In Patient 13, NAT positive could also be Gene Xpert. In fact all the PCR should be checked whether they were in house PCR or a commercial assay or Gene Xpert 'Clatro' should be expanded to 'clarithromycin' in the footnote under Table 2.' [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: I congratulate the authors for taking up an interesting topic. The occurrence of TB post-COVID-19 recovery has been commonly observed since the start of the pandemic. It is surprising how little literature is still there on the topic; so, the authors’ effort is praiseworthy. I also appreciate the supplementary material that they have provided which lends further credence to the study. However, there are some suggestions that I have for improving the article. Major Comments 1. Why did the authors focus only on reactivation in search terms? New onset tuberculosis cases following COVID-19 may be missed in such a strategy. This is more so as the authors themselves write about new cases in lines 222-223. 2. Some perspective must be shared on the difference between the current study and the Tadolini study which the authors have rightly pointed out. In lines 168-169, since Tadolini’s study was also a systematic review, did you attempt to identify the individual case reports and see if any of those were missing in your study? Then the same may be added. 3. In line 210, how is situs inversus totalis a type of TB? 4. Some discussion is warranted on the relative prevalence of PTB and EPTB in the study as compared to world literature. Also, is this differential distribution seen only in the TB non-endemic country cases or even in the cases reported by the authors from TB-endemic countries? This information may be useful. 5. In lines 229-231, discuss the relevance of the low reporting from endemic countries. Many cases may have been missed because endemic countries’ scientists/doctors did not bother to report common TB cases. Another aspect worth discussing is the potential for low reactivation in countries where BCG is routinely administered. Both these angles need to be discussed. 6. The Discussion needs to be shortened and only the major findings need to be analyzed. Discussion on smoking and alcohol status may be removed as no salient features found. Similarly, the discussion on HIV status must be shortened to 1 sentence. The phrase, “The current study also revealed…” or similar phrases have been used many times. Please improve the English language in the Discussion and make it better to read. 7. Please check the tables provided carefully for appropriateness of all data. There may be minor mistakes. Example- In Table 1, for patient code 3-10, in second column with name of authors Unal et al, Patient 1 is written which makes it unclear. Similarly, which patient migrated from Syria is unclear. For the reference of Lee et al (Patient 11), country of origin is written as Vietennam which seems to be wrong spelling. In column on comorbidities it needs to be mentioned which comorbidity was there in the past so as not to confuse with current ones. For example, in the case of the Lee et al, lymphoma history was in past whereas cytomegalovirus was co-existent with COVID. Clarify such details for every case (all 34 cases). Please go through both tables carefully and check all the data and synchrony of lines and columns once more. (Very important as this is backbone of a systematic review of case reports) Minor Comments: 1. In line 41, write ‘…all 11 patients assessed for BCG vaccination status..’. 2. In line 48, write ‘It may take up to 7 months…’. 3. In line 49, 5/25 patients died. Was information missing for the remaining 9 patients? Please clarify. 4. In line 55, since treatment of latent TB is done only in TB non-endemic countries, please add this as a rejoinder. Same for lines 288-289. 5. The English language is inappropriate at many places in the manuscript. A thorough English editing is needed. For example, in line 58, it should start with “COVID-19 has caused a huge…”; in line 61, it should be “the COVID-19 epidemic..” instead of “epidemics”. Many such corrections need to be done throughout. 6. Lines 100-101- Please check. It seems “tuberculosis” has been repeated multiple times. 7. In line 176, mention the type of transplantation- kidney? 8. Lines 176-180 is repetition of Table 1 data and may be deleted. 9. In lines 217-218, why is M.simiae case described with MTB cases? 10. In lines 218-219, 19+5 is 24. What about the other patient? 11. In Supplementary Tables, numbering is S1,S2,S4. Shouldn’t it be S3? 12. In line 228, change the word ‘magnificent’ to ‘significant’. 13. Lines 237-238 needs to be deleted as this is not a finding of the current study where none of the patients were HIV positive. 14. Lines 260-262 may be modified as due to short window of decision making, it may not be possible to rule out tuberculosis before starting treatment for COVID. ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0277807.r001
Revision 1
4 Oct 2022 Author Response Revisions based on the Editor’s and the reviewers’ comments and suggestions Title: Tuberculosis in individuals who recovered from COVID-19: A Systematic Review of Case Reports (PONE-D-22-18569) Editor Comments and suggestions We would like to thank the editor and the reviewer for giving pertinent comments and suggestions that improve the quality of the paper. Journal Requirements: When submitting your revision, we need you to address these additional requirements. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. • Response: Thank you, we have uploaded all required documents. 2. We note that this manuscript is a systematic review or meta-analysis; our author guidelines therefore require that you use PRISMA guidance to help improve reporting quality of this type of study. Please upload copies of the completed PRISMA checklist as Supporting Information with a file name “PRISMA checklist”. • Response: Thank you. The completed PRISMA checklist was already uploaded fin the supplementary file and at this stage we have uploaded it separately. Additional Editor Comments: The language has to be thoroughly revised. A few corrections in additions to comments made by reviewer have been pointed out as follows: Line 58- 'caused' in place of causes • Response: Thank you. It is revised accordingly. Line 59 to 60-'... the others disease prevention and control programs including the tuberculosis' may be replaced by '...prevention and control of other diseases including tuberculosis'. • Response: Thank you. It is revised accordingly. Line 60- Delete 'prevention and control program' • Response: Thank you. It is deleted. Line 62- Delete 'Studies conducted in' • Response: Thank you. It is deleted. Line 69- 'increases' to be replaced by 'increased' • Response: Thank you. It is revised accordingly. Line 74- Insert 'versa' after vice • Response: Thank you. It is revised accordingly. Line 122- 'included' instead of include • Response: Thank you. It is revised accordingly. Line 132- 'contained' instead of contains • Response: Thank you. It is revised accordingly. Line 163- 'males' instead of male • Response: Thank you. It is revised accordingly. Lines 170-172- May be deleted as there is no relevance of smoking and alcohol consumption. • Response: Thank for the comment. We have deleted in the current version. Line 172- 'HIV' need not be written in italics. • Response: Thank you. It is revised accordingly. Line 173- Eleven cases were BCG vaccinated or vaccination status was available for only eleven cases? • Response: Thank you. It is revised Line 183- 'COVID-19 was confirmed in 14 cases by PCR'- Please check whether it was PCR or RT-PCR as COVID-19 has always been diagnosed by RT-PCR. • Response: Thank you. It was a clerical error and now revised accordingly. Line 185- 'confirmed by chest X-ray.' Chest X-ray could be suggestive of COVID-19. • Response: Thank you for the comment. The two cases were treated for COVID-19 by considering the chest X-ray result. Line 254- 'previous TB treatment history that indicated the potential reactivation of TB'- cannot be proven whether it was endogenous reactivation or exogenous reinfection. • Response: Thank you for this valuable comment. We have revised it accordingly. “The current study also revealed that among 14 patients with data on previous TB history, five patients had previous TB treatment history that might be due to the potential reactivation of TB after COVID-19 recovery. However, we are not sure whether it was due to endogenous reactivation or due to exogenous reinfection.” Table 2- TB DNA, PCR have been mentioned separately in diagnostic methods for TB. Also Xpert MTB/RIF and Gene Xpert are actually the same. In Patient 13, NAT positive could also be Gene Xpert. In fact all the PCR should be checked whether they were in house PCR or a commercial assay or Gene Xpert 'Clatro' should be expanded to 'clarithromycin' in the footnote under Table 2.' • Response: Thank you for the pertinent comments. We were directly presented what the primary authors described. Now, it is revised and a uniform naming is used (GeneXpert). Reviewers' comments: Reviewer #1: I congratulate the authors for taking up an interesting topic. The occurrence of TB post-COVID-19 recovery has been commonly observed since the start of the pandemic. It is surprising how little literature is still there on the topic; so, the authors’ effort is praiseworthy. I also appreciate the supplementary material that they have provided which lends further credence to the study. However, there are some suggestions that I have for improving the article. Major Comments 1. Why did the authors focus only on reactivation in search terms? New onset tuberculosis cases following COVID-19 may be missed in such a strategy. This is more so as the authors themselves write about new cases in lines 222-223 • Response: Thank you for the valuable comment. We have performed data base searching again using the key words; tuberculosis, COVID-19, SARS-CoV-2 and Case report. However, we didn’t get any other study to be eligible in the current systematic review. 2. Some perspective must be shared on the difference between the current study and the Tadolini study which the authors have rightly pointed out. In lines 168-169, since Tadolini’s study was also a systematic review, did you attempt to identify the individual case reports and see if any of those were missing in your study? Then the same may be added. • Response: Thank you for the comment. The study is not a systematic review rather it is the first-ever global cohort of current or former TB patients (post-TB treatment sequelae) with COVID-19, recruited by the Global Tuberculosis Network (GTN) in eight countries and three continents. https://erj.ersjournals.com/content/erj/56/1/2001398.full.pdf In this study, among 49 patients with COVID-19 and TB co-infection, in 14 patients COVID-19 preceded TB. However, the authors revealed that they could not report on the potential contribution of COVID-19 towards development of active TB disease because they did not follow individuals with latent TB infection overtime. Besides, the details of each patient is not reported that we were unable to find each patient’s data for the current systematic review. 3. In line 210, how is situs inversus totalis a type of TB? • Response: Thank you for the valuable comment. It was to describe there was a congenital TB in a child with situs inversus totalis. We revised it accordingly. 4. Some discussion is warranted on the relative prevalence of PTB and EPTB in the study as compared to world literature. Also, is this differential distribution seen only in the TB non-endemic country cases or even in the cases reported by the authors from TB-endemic countries? This information may be useful. • Response: Thank you for the pertinent comment. We have revised it accordingly both in the result section and discussion section. From 20 PTB cases, three cases were reported from the high TB burden countries, while all the 11 EPTB cases were reported from the countries that are not included in the list of high TB burden countries. For the remaining 2 cases, 1 miliary TB case was reported from a high TB burden country, while 1 disseminated case was reported from a country not included in the high TB burden countries list. 5. In lines 229-231, discuss the relevance of the low reporting from endemic countries. Many cases may have been missed because endemic countries’ scientists/doctors did not bother to report common TB cases. Another aspect worth discussing is the potential for low reactivation in countries where BCG is routinely administered. Both these angles need to be discussed. • Response: Thank you for the valuable comment, we have included sentences based on the given suggestion. 6. The Discussion needs to be shortened and only the major findings need to be analyzed. Discussion on smoking and alcohol status may be removed as no salient features found. Similarly, the discussion on HIV status must be shortened to 1 sentence. The phrase, “The current study also revealed…” or similar phrases have been used many times. Please improve the English language in the Discussion and make it better to read. • Response: Thank you for your important comment. We have revised it accordingly. At this stage, the English language was revised by some one with better English language understanding and skills. 7. Please check the tables provided carefully for appropriateness of all data. There may be minor mistakes. Example- In Table 1, for patient code 3-10, in second column with name of authors Unal et al, Patient 1 is written which makes it unclear. Similarly, which patient migrated from Syria is unclear. For the reference of Lee et al (Patient 11), country of origin is written as Vietennam which seems to be wrong spelling. In column on comorbidities it needs to be mentioned which comorbidity was there in the past so as not to confuse with current ones. For example, in the case of the Lee et al, lymphoma history was in past whereas cytomegalovirus was co-existent with COVID. Clarify such details for every case (all 34 cases). Please go through both tables carefully and check all the data and synchrony of lines and columns once more. (Very important as this is backbone of a systematic review of case reports) • Response: Thank you for the valuable comments and suggestions. We have revised the table and revised accordingly. In the Unal et al., 2021 study, the patient migrated from Syiria was not specified, rather they reported as one patient migrated from Syria. The Vietennam is now corrected to Vietnam. Regarding the co-morbidities, since almost all cases are chronic diseases the co-morbidities were present during TB detection. We have revised both tables for every case (all 33 cases). Since one M.simiae case is excluded in the current analysis, the cases become 33 in number. Minor Comments: 1. In line 41, write ‘…all 11 patients assessed for BCG vaccination status..’. • Response: Thank you. It is corrected accordingly. 2. In line 48, write ‘It may take up to 7 months…’. • Response: Thank you. It is corrected accordingly. 3. In line 49, 5/25 patients died. Was information missing for the remaining 9 patients? Please clarify. • Response: Thank you, we revised it. “Data on the final treatment outcome was found for 25 patients, and 5 patients died during the anti-TB treatment period.” 4. In line 55, since treatment of latent TB is done only in TB non-endemic countries, please add this as a rejoinder. Same for lines 288-289. • Response: Thank you for the pertinent comment and suggestion. Now it is revised as per the suggestion. 5. The English language is inappropriate at many places in the manuscript. A thorough English editing is needed. For example, in line 58, it should start with “COVID-19 has caused a huge…”; in line 61, it should be “the COVID-19 epidemic..” instead of “epidemics”. Many such corrections need to be done throughout. • Response: Thank you for your important comment. At this stage, the English language was revised by some one with better English language understanding and skills. 6. Lines 100-101- Please check. It seems “tuberculosis” has been repeated multiple times. • Response: Thank you. At this stage, we performed the search again based on the given suggestion and we presented the new search string. 7. In line 176, mention the type of transplantation- kidney? • Response: Thank you, it is revised. 8. Lines 176-180 is repetition of Table 1 data and may be deleted. • Response: Thank you for the comment. Now we deleted it. 9. In lines 217-218, why is M.simiae case described with MTB cases? • Response: Thank you for the critical comment. Now, we excluded the study from this review and the whole manuscript is revised accordingly. 10. In lines 218-219, 19+5 is 24. What about the other patient? • Response: Thank you for the critical comment. It was due to clerical error. Now it is revised. “The mortality status of the patients was described in 25 cases, where 20 were alive and five died during the anti-TB treatment period. While for the remaining 9 cases, their anti-TB treatment outcome is not described in the studies.” 11. In Supplementary Tables, numbering is S1,S2,S4. Shouldn’t it be S3? • Response: Thank you, now it is revised. 12. In line 228, change the word ‘magnificent’ to ‘significant’. • Response: Thank you, now it is revised. 13. Lines 237-238 needs to be deleted as this is not a finding of the current study where none of the patients were HIV positive. • Response: Thank you. We have deleted the sentence 14. Lines 260-262 may be modified as due to short window of decision making, it may not be possible to rule out tuberculosis before starting treatment for COVID. • Response: Thank you, now it is revised. Attachments Attachment Submitted filename: Response to reviewers.docx https://doi.org/10.1371/journal.pone.0277807.r002
19 Oct 2022 Decision Letter - Shampa Anupurba, Editor PONE-D-22-18569R1Tuberculosis in individuals who recovered from COVID-19: A Systematic Review of Case ReportsPLOS ONE Dear Dr. Alemu, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please submit your revised manuscript by Dec 03 2022 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Shampa Anupurba, MD Academic Editor PLOS ONE Journal Requirements: Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. Additional Editor Comments: All queries have been addressed. However, there are some minor corrections. Line 28- 'resulted' may be replaced by 'resulting' Lines 28/29- delete 'due to' Line 30- delete 'it' Line 39, 239- delete 'were' Line 39- HIV need not be in italics Line 41, 180- 'any' to be replaced by 'some' Line 64- insert 'it was' before 'observed' Line 77- 'recovery' instead of 'recovered' Line 176- 'is' to be replaced by 'was', 'so' to be inserted before 'that' Line 179- It should be '16' patients instead of '17' as total number of patients is 33 Line 186- Instead of 'nine', antibody to SARS CoV2 was positive in '11' cases.As per your Table 2. Line 245- It is not clear how being HIV seronegative indicates diminished immune status Line 249- 'as a' may be replaced by 'in' [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: All comments have been addressed ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: The paper is acceptable. No further comments are made. The authors have successfully addressed all previous comments. ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0277807.r003
Revision 2
20 Oct 2022 Author Response PONE-D-22-18569R1 Tuberculosis in individuals who recovered from COVID-19: A Systematic Review of Case Reports Editor comments Journal Requirements: Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. Response: Thank you for the pertinent comment. All the included references are available in the web and in the revised manuscript we have included the link (DOI) for the studies. Additional Editor Comments: All queries have been addressed. However, there are some minor corrections. Line 28- 'resulted' may be replaced by 'resulting' Response: Thank you, it is replaced. Lines 28/29- delete 'due to' Response: Thank you, it is deleted. Line 30- delete 'it' Response: Thank you, it is deleted. Line 39, 239- delete 'were' Response: Thank you, it is deleted. Line 39- HIV need not be in italics Response: Thank you, it is corrected Line 41, 180- 'any' to be replaced by 'some' Response: Thank you, we made a replacement Line 64- insert 'it was' before 'observed' Response: Thank you, we made a change accordingly Line 77- 'recovery' instead of 'recovered' Response: Thank you, we changed it Line 176- 'is' to be replaced by 'was', 'so' to be inserted before 'that' Response: Thank you, revised per the suggestion. Line 179- It should be '16' patients instead of '17' as total number of patients is 33 Response: Thank you, it was a clerical error. Now, it is corrected. Line 186- Instead of 'nine', antibody to SARS CoV2 was positive in '11' cases. As per your Table 2. Response: Thank you. Antibody to SARS CoV2 was positive in 11 cases. As displayed in table 2 among 8 patients in the same study (patient 3-patient 10), antibody was positive in 6 patients and for the remaining 2 cases it was not described. Thus including the remaining 3 cases it becomes nine. Line 245- It is not clear how being HIV seronegative indicates diminished immune status Response: Thank you, we have revised it. Our assumption was that the immune suppressed status of COVID-19 infected individuals might led to developing TB. This is a common phenomenon in HIV positive individuals. Line 249- 'as a' may be replaced by 'in' Response: Thank you, we made a replacement per the comment. Attachments Attachment Submitted filename: Response to reviewers.docx https://doi.org/10.1371/journal.pone.0277807.r004
4 Nov 2022 Decision Letter - Shampa Anupurba, Editor Tuberculosis in individuals who recovered from COVID-19: A Systematic Review of Case Reports PONE-D-22-18569R2 Dear Dr. Alemu, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Shampa Anupurba, MD Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #2: All comments have been addressed ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #2: (No Response) ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #2: (No Response) ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #2: (No Response) ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #2: (No Response) ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #2: (No Response) ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #2: No ******** https://doi.org/10.1371/journal.pone.0277807.r005
Formally Accepted
7 Nov 2022 Acceptance Letter - Shampa Anupurba, Editor PONE-D-22-18569R2 Tuberculosis in individuals who recovered from COVID-19: A Systematic Review of Case Reports Dear Dr. Alemu: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Shampa Anupurba %CORR_ED_EDITOR_ROLE% PLOS ONE https://doi.org/10.1371/journal.pone.0277807.r006

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