Increase in Tuberculosis Diagnostic Delay During First Wave of the COVID-19 Pandemic: Data from an Italian Infectious Disease Referral Hospital

Overview

Journal Antibiotics (Basel)

Specialty Pharmacology

Date 2021 Apr 3

PMID 33800406

Citations 59

Authors

Francesco Di Gennaro

Gina Gualano

Laura Timelli

Pietro Vittozzi

Virginia Di Bari

Raffaella Libertone

Carlotta Cerva

Luigi Pinnarelli

Carla Nisii

Stefania Ianniello

Silvia Mosti

Nazario Bevilacqua

Fabio Iacomi

Annalisa Mondi

Simone Topino

Delia Goletti

Francesco Vaia

Giuseppe Ippolito

Enrico Girardi

Fabrizio Palmieri

Affiliations

Soon will be listed here.

Abstract

Background: The WHO advised that the impact of COVID-19 pandemic on TB services was estimated to be dramatic due to the disruption of TB services.

Methods: A retrospective data collection and evaluation was conducted to include all the patients hospitalized for TB at INMI from 9 March to 31 August 2020 (lockdown period and three months thereafter). For the purpose of the study, data from patients hospitalized in the same period of 2019 were also collected.

Results: In the period of March-August 2019, 201 patients were hospitalized with a diagnosis of TB, while in the same period of 2020, only 115 patients, with a case reduction of 43%. Patients with weight loss, acute respiratory failure, concurrent extrapulmonary TB, and higher Timika radiographic scores were significantly more frequently hospitalized during 2020 vs. 2019. The median patient delay was 75 days (IQR: 40-100) in 2020 compared to 30 days (IQR: 10-60) in 2019 ( < 0.01). Diagnostic delays in 2020 remain significant in the multiple logistic model (AOR = 6.93, 95%CI: 3.9-12.3).

Conclusions: Our experience suggests that COVID-19 pandemic had an impact on TB patient care in terms of higher diagnostic delay, reduction in hospitalization, and a greater severity of clinical presentations.

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