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 (r s = − 0.785, p = 0.0001)) and deaths (r s = − 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.
【저자키워드】 COVID-19, Tuberculosis, fatality, BCG vaccination, 【초록키워드】 Immunity, Variation, Coverage, BCG, Patient, death, morbidity and mortality, incidence, association, Multivariate analysis, Analysis, COVID-19 cases, deaths, COVID-19 case, Linear regression analysis, Fatality rate, inverse correlation, parameter, Affect, country, highlight, Result, affected, significantly, calculated, Significant, with COVID-19, 【제목키워드】 Immunity, BCG, morbidity and mortality,