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. 2022 Nov 28;48(6):e20220240.
doi: 10.36416/1806-3756/e20220240.

Clinical forms and diagnosis of tuberculosis in children and adolescents during the COVID-19 pandemic

[Article in English, Portuguese]
Michely Alexandrino de Souza Pinheiro  1 , Rafaela Baroni Aurilio  1 , Ana Alice Amaral Ibiapina Parente  1   2 , Maria de Fátima Bazhuni Pombo Sant'Anna  2 , Ana Cristina Cisne Frota  1 , Cristina Barroso Hofer  2 , Thalita Fernandes de Abreu  2 , Sidnei Ferreira  2 , Clemax Couto Sant'Anna  2
Affiliations

Clinical forms and diagnosis of tuberculosis in children and adolescents during the COVID-19 pandemic

[Article in English, Portuguese]
Michely Alexandrino de Souza Pinheiro et al. J Bras Pneumol. .

Abstract
in English, Portuguese

Objective: The present study aimed to describe the clinical forms and the time taken to diagnose new tuberculosis cases and to statistically analyze the isolated and combined forms of the disease in children and adolescents treated at a university hospital in Rio de Janeiro during the first year of the COVID-19 pandemic in Brazil.

Methods: This was a cross-sectional study that used retrospective data on children (0-9 years old) and adolescents (10-18 years old) with pulmonary (PTB), extrapulmonary (EPTB), and combined tuberculosis (PTB + EPTB) followed up at the outpatient clinic from January 2019 to March 2021. Categorical data were analyzed by descriptive statistics and expressed as frequency and proportions. Categorical variables were compared using the Chi-square test, and numerical variables using Student's T-test.

Results: A total of 51 cases were included, 63% (32/51) of which comprised patients in the year of the pandemic (group A), while 37% (19/51) were patients attended in previous years (group B). In group A, 19% (6/32) of the patients presented PTB, 59% (16/32) had EPTB, and 31% (10/32) had PTB+EPTB. In group B, 42% (8/19) of the patients presented PTB, 42% (8/19) had EPTB, and 16% (3/19) had PTB+EPTB.

Conclusion: Our study revealed more tuberculosis cases in the first year of the pandemic than in the same period of the previous year, with greater variation of sites affected by the disease, including rarer and more severe forms.

Objetivo:: O presente estudo teve como objetivo descrever as formas clínicas e o tempo de diagnóstico de novos casos de tuberculose e analisar estatisticamente as formas isoladas e combinadas da doença em crianças e adolescentes atendidos em um hospital universitário do Rio de Janeiro durante o primeiro ano da pandemia de COVID-19 no Brasil.

Métodos:: Este estudo transversal utilizou dados retrospectivos de crianças (0-9 anos) e adolescentes (10-18 anos) com tuberculose pulmonar (TBP), extrapulmonar (TBEP) e combinada (TBP + TBEP) acompanhados no ambulatório de janeiro de 2019 a março de 2021. Os dados categóricos foram analisados por estatística descritiva e expressos em frequência e proporções. As variáveis categóricas foram comparadas pelo teste Qui-quadrado e as variáveis numéricas pelo teste T de Student.

Resultados:: Foram incluídos 51 casos, sendo 63% (32/51) pacientes no ano da pandemia (grupo A) e 37% (19/51) pacientes atendidos em anos anteriores (grupo B). No grupo A, 19% (6/32) dos pacientes apresentavam TBP, 59% (16/32) TBEP e 31% (10/32) TBP+TBEP. No grupo B, 42% (8/19) dos pacientes apresentavam TBP, 42% (8/19) TBEP e 16% (3/19) TBP+TBEP.

Conclusão:: Nosso estudo evidenciou mais casos de tuberculose no primeiro ano da pandemia do que no mesmo período do ano anterior, com maior variação de locais acometidos pela doença, incluindo formas mais raras e mais graves.

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Figures

Figure 1
Figure 1. Graph indicating the number of active tuberculosis cases diagnosed at the IPPMG-UFRJ from 2019-2021.
Figure 2
Figure 2. Flowchart of tuberculosis distribution by clinical presentation. EPTB: extrapulmonary tuberculosis; PTB: pulmonary tuberculosis. Group A - 2020-2021; Group B - 2019-2020.
Figure 3
Figure 3. Box plot graph for the time variable for tuberculosis diagnosis in the period from 2019-2021.
See this image and copyright information in PMC

References

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