Tuberculosis, or TB, remains one of the most common infectious diseases in Indonesia. The WHO Global TB Report 2021 places Indonesia among the three countries with the highest TB burden worldwide. Before the rise of COVID-19, TB was the leading infectious cause of death.

Both TB and COVID-19 can cause coughing. How can you tell these coughs apart?

Differences Between TB and COVID-19 Coughs

Coughing is the body’s way to clear irritants from the airways. Causes range from allergies, asthma, and acid reflux to infections such as TB and COVID-19. Sadly, many people downplay a persistent cough, which can delay treatment for these contagious illnesses.

Although both involve coughing, the two conditions show different patterns. According to covid19.go.id, key differences include the following:

1. Different causes

Tuberculosis is a bacterial infection caused by Mycobacterium tuberculosis. This infection usually attack the lungs, but they can also affect other organs, including the kidneys, spine, brain, and lymph nodes. When the lungs are infected, the condition is called pulmonary TB, often marked by chronic productive coughs and fever.

COVID-19 is caused by a coronavirus infection. People without symptoms can still spread it to others. In contrast, a person who carries TB bacteria but has no symptoms does not transmit TB to others (latent TB infection).

2. Different symptoms and duration of coughs

Coughing in people with TB infection tends to have distinctive features. The Mayo Clinic notes typical signs such as:

• Chronic cough that lasts for 2 weeks or more
• Phlegm that is green or yellow because of bacteria
• Fever
• Night sweats
• Marked weight loss

Some people with TB may also cough up blood due to bleeding from inflamed tissue.

A cough from COVID-19 more often presents with:

• Cough that lasts less than 2 weeks
• Fever
• Fatigue

COVID-19 may also cause loss of taste and smell, shortness of breath, and headache. In some cases, symptoms worsen several days later, leading to breathing difficulty or pneumonia.

3. Different sampling methods for diagnosis

Both TB and COVID-19 can be diagnosed with Molecular Rapid Testing (TCM) and Polymerase Chain Reaction (PCR). The difference lies in the specimen. TB testing uses a sputum sample. COVID-19 testing uses a swab from the nasopharynx or oropharynx.

4. Different treatments

Treating TB takes time, usually 6 to 9 months. Drug combinations are chosen based on disease stage. Strict adherence is vital. Skipping doses can lead to antibiotic resistance, which makes TB far harder to cure because fewer medicines remain effective against the bacteria.

Researchers continue to refine COVID-19 therapy. Options that may be prescribed include paxlovid, molnupiravir, and remdesivir, along with symptom-specific treatments. Management for COVID-19 commonly lasts about five days or longer.

TB and COVID-19 coughs can overlap and be confusing. Proper testing can identify the cause early and guide the right care. If you have a cough that persists for two weeks, see a doctor promptly.

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