Fig. 1: Radiographic appearances of combined SARS-CoV-2 and M. tuberculosis infection and relationship between radiographic (Brixia and British Society for Thoracic Imaging (BSTI)) score and clinical severity assessed by WHO COVID-19 ordinal scale.

A, B Chest radiographs and computed tomographic pulmonary angiography (CTPA) of two COVID-19 patients. A1: 43-year-old HIV-1 uninfected male (patient number 58) presenting with consolidation and cavitation in the right upper lobe (red arrow), 3+ sputum smear positive and also SARS-CoV-2 RT-PCR positive (threshold cycle: 32.45). A2: Because of persistent hypoxia and tachypnoea he underwent CTPA which showed bi-basal wedge-shaped opacities in keeping with pulmonary embolism (PE) and/or consolidation related to COVID-19. Discharged after 22 days. B1: 43-year-old HIV-1 uninfected female (patient number 36) presenting with SARS-CoV-2 positive RT-PCR (threshold cycle: 21.2) with diffuse bilateral pulmonary opacification with ground glass and consolidation on the chest radiograph who deteriorated necessitating intubation and ventilation for 36 days. The patient remained O2 dependent after extubation and a CTPA (B2) for suspected PE instead revealed cavitation associated with opacification and air bronchograms in the superior segment of the right lower lobe (arrow) together with subcarinal and pretracheal lymphadenopathy. The patient was found Gene Xpert MTB/Rif positive. C BSTI classification of RT-PCR proven SARS-CoV-2 cases in the absence or presence of HIV-1 and/or tuberculosis. The increase in the proportion of radiographs classified as Non-COVID like tended to increase in those with coincident tuberculosis. Comparisons were performed by Chi-square test. D Brixia radiographic and, E BSTI, severity scores in relation to WHO clinical severity scale in N = 104 SARS-CoV-2 participants. Comparisons were performed using a Kruskal-Wallis test. F Brixia score in relation to the presence or absence of HIV-1 and/or tuberculosis co-infection in N = 104 SARS-CoV-2 participants. The extent of changes related COVID-19 was decreased amongst those with coincident HIV-1 associated tuberculosis. Comparisons were performed using a Kruskal-Wallis test with Dunn’s correction. G WHO ordinal scale at presentation in N = 104 SARS-CoV-2 participants in relation to the presence or absence of HIV-1 and/or tuberculosis co-infection. Comparisons were performed using a Kruskal-Wallis test with Dunn’s correction.