Correlation between immunity from BCG and the morbidity and mortality of COVID-19

• Main Authors: Dakshitha Wickramasinghe, Nilanka Wickramasinghe, Sohan Anjana Kamburugamuwa, Carukshi Arambepola, Dharmabandhu N. Samarasekera
• Format: Article
• Language: English
• Published: BMC 2020-08-01
• Series: Tropical Diseases, Travel Medicine and Vaccines
• Subjects: COVID-19; BCG vaccination; Tuberculosis; Fatality
• Online Access: http://link.springer.com/article/10.1186/s40794-020-00117-z

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.