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Review
. 2021 Jun 1;25(6):436-446.
doi: 10.5588/ijtld.21.0148.

The impact of COVID-19 on TB: a review of the data

C F McQuaid  1 , A Vassall  2 , T Cohen  3 , K Fiekert  4 , R G White  1
Affiliations
Review

The impact of COVID-19 on TB: a review of the data

C F McQuaid et al. Int J Tuberc Lung Dis. .

Abstract
in English, French

Early in the COVID-19 pandemic, models predicted hundreds of thousands of additional TB deaths as a result of health service disruption. To date, empirical evidence on the effects of COVID-19 on TB outcomes has been limited. Here we summarise the evidence available at a country level, identifying broad mechanisms by which COVID-19 may modify TB burden and mitigation efforts. From the data, it is clear that there have been substantial disruptions to TB health services and an increase in vulnerability to TB. Evidence for changes in Mycobacterium tuberculosis transmission is limited, and it remains unclear how the resources required and available for the TB response have changed. To advocate for additional funding to mitigate the impact of COVID-19 on the global TB burden, and to efficiently allocate resources for the TB response, requires a significant improvement in the TB data available.

Au début de la pandémie de COVID-19, les modèles prévoyaient des centaines de milliers de décès supplémentaires dus à la TB en raison des perturbations des services de santé. Jusqu’à présent, les preuves empiriques des effets de COVID-19 sur les résultats de la TB ont été limitées. Nous résumons ici les preuves disponibles au niveau national, en identifiant les mécanismes généraux par lesquels COVID-19 pourrait modifier la charge de la TB et les efforts d’atténuation. Lorsque les données sont disponibles, il est clair qu’il y a eu d’importantes perturbations des services de santé de la TB et une augmentation de la vulnérabilité à la TB. Les preuves de changements dans la transmission de Mycobacterium tuberculosis sont limitées, et l’évolution des ressources nécessaires et disponibles pour la réponse à la TB n’est pas claire. Une amélioration significative des données sur la TB est nécessaire pour obtenir des fonds supplémentaires afin d’atténuer l’impact de COVID-19 sur le fardeau mondial de la TB et pour allouer efficacement les ressources à la réponse à la TB.

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Conflict of interest statement

Conflicts of interest: none declared.

Figures

Figure 1.
Figure 1.
Potential impact of COVID-19 on the TB care cascade. Arrows indicate an increase or a decrease in number of patients at that point of the cascade, including the logic behind the change. black arrows indicate an impact on health service delivery and demand, grey arrows indicate an impact on vulnerability to TB, and light grey arrows indicate an impact on M. tuberculosis transmission. BCG = bacilli Calmette-Guérin; DST = drug susceptibility testing.
Figure 2.
Figure 2.
Outline of priority gaps that remain for understanding and mitigating the impact of COVID-19 on TB.
See this image and copyright information in PMC

Comment in

  • COVID-19 and TB: a progression-regression conundrum.
    Teo AKJ, Ong CWM, Hsu LY. Teo AKJ, et al. Int J Tuberc Lung Dis. 2021 Jun 1;25(6):421-423. doi: 10.5588/ijtld.21.0219. Int J Tuberc Lung Dis. 2021. PMID: 34049602 No abstract available.
  • TB and COVID-19 coinfection.
    Kozińska M, Podlasin R, Ropelewska-Łącka K, Wojtycha-Kwaśnica B, Bajera-Mitschein I, Augustynowicz-Kopeć E. Kozińska M, et al. Int J Tuberc Lung Dis. 2021 Sep 1;25(9):776-777. doi: 10.5588/ijtld.21.0358. Int J Tuberc Lung Dis. 2021. PMID: 34802504 No abstract available.
  • Decline in TB incidence during the COVID-19 pandemic.
    Zamani S, Honarvar MR, Behnampour N, Sheikhy M, Sedaghat M, Ghaemi S, Ghaemi EA. Zamani S, et al. Int J Tuberc Lung Dis. 2021 Dec 1;25(12):1043-1044. doi: 10.5588/ijtld.21.0548. Int J Tuberc Lung Dis. 2021. PMID: 34886939 No abstract available.
  • Decreased notification of TB cases during the COVID-19 pandemic.
    Ortiz-Martínez Y, Rodríguez-Morales AJ, Henao-Martínez AF. Ortiz-Martínez Y, et al. Int J Tuberc Lung Dis. 2022 Feb 1;26(2):177-178. doi: 10.5588/ijtld.21.0651. Int J Tuberc Lung Dis. 2022. PMID: 35086633 No abstract available.
  • The COVID-19 pandemic does not bode well for TB control.
    Ahmed J, Bir R, Bala K, Singh UB. Ahmed J, et al. Int J Tuberc Lung Dis. 2022 Sep 1;26(9):897-901. doi: 10.5588/ijtld.22.0286. Int J Tuberc Lung Dis. 2022. PMID: 35996276 No abstract available.

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