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Changes in the incidence, clinical features and outcomes of tuberculosis during COVID-19 pandemic.
Chan, King-Pui Florence; Ma, Ting-Fung; Sridhar, Siddharth; Lui, Macy Mei-Sze; Ho, James Chung-Man; Lam, David Chi-Leung; Ip, Mary Sau-Man; Ho, Pak-Leung.
Afiliación
  • Chan KF; Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region.
  • Ma TF; Department of Statistics, University of South Carolina, USA.
  • Sridhar S; Department of Microbiology, Queen Mary Hospital, University of Hong Kong, Hong Kong Special Administrative Region.
  • Lui MM; Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region.
  • Ho JC; Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region.
  • Lam DC; Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region.
  • Ip MS; Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region.
  • Ho PL; Department of Microbiology, Queen Mary Hospital, University of Hong Kong, Hong Kong Special Administrative Region; Carol Yu Centre for Infection, University of Hong Kong, Hong Kong Special Administrative Region. Electronic address: plho@hku.hk.
J Infect Public Health ; 17(9): 102511, 2024 09.
Article en En | MEDLINE | ID: mdl-39068731
ABSTRACT

BACKGROUND:

COVID-19 pandemic has disrupted tuberculosis (TB) services in many countries, but the impacts on sites of involvement, drug susceptibility, smear positivity and clinical outcomes, and clinical outcomes of co-infection with influenza and COVID-19 remain unclear.

METHODS:

Descriptive epidemiological study using episode-based and patient unique data of tuberculosis from Hospital Authority's territory-wide electronic medical record database, comparing baseline (January 2015-December 2019) and COVID-19 period (January 2020-December 2022), followed by univariate and multivariate analyses. Effects of co-infection with influenza and COVID-19 were investigated.

RESULTS:

The study included 10,473 episodes of laboratory-confirmed TB, with 6818 in baseline period and 3655 during COVID-19 period. During COVID-19 period, TB patients had a lower proportion of smear positivity (49.2 % vs 54.7 %, P < 0.001), and fewer cases of extrapulmonary TB (7.0 % vs 8.0 %, P = 0.078) and multidrug resistant TB (1.0 % vs 1.6 %, P = 0.020). Mortality was higher in TB patients with COVID-19 coinfection (OR 1.7, P = 0.003) and influenza coinfection (OR 2.6, P = 0.004). During COVID-19 period, there were higher rates of treatment delay (20.5 % vs 15.5 %, P < 0.001) and episodic death (15.1 % vs 13.3 %, P = 0.006). Factors associated with higher mortality included age ≥ 70 years (OR 7.24), treatment delay (OR 2.16), extrapulmonary TB (OR 2.13). smear positivity (OR 1.71) and Charlson comorbidity index score ≥ 3 (OR 1.37). Higher mortality was observed with co-infection by influenza (OR 1.18) and COVID-19 (OR 1.7).

CONCLUSIONS:

The epidemiology and outcomes of TB were changed during COVID-19 period. Mortality was higher during COVID-19 period and with co-infection by influenza and COVID-19.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tuberculosis / Gripe Humana / Coinfección / COVID-19 Límite: Adolescent / Adult / Aged / Aged80 / Child / Female / Humans / Male / Middle aged Idioma: En Revista: J Infect Public Health Asunto de la revista: DOENCAS TRANSMISSIVEIS / SAUDE PUBLICA Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tuberculosis / Gripe Humana / Coinfección / COVID-19 Límite: Adolescent / Adult / Aged / Aged80 / Child / Female / Humans / Male / Middle aged Idioma: En Revista: J Infect Public Health Asunto de la revista: DOENCAS TRANSMISSIVEIS / SAUDE PUBLICA Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido