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. 2024 Jan;30(1):136-140.
doi: 10.3201/eid3001.230924.

Tuberculosis Diagnostic Delays and Treatment Outcomes among Patients with COVID-19, California, USA, 2020

Emily Han, Scott A Nabity, Shom Dasgupta-Tsinikas, Ramon E Guevara, Marisa Moore, Ankita Kadakia, Hannah Henry, Martin Cilnis, Sonal Buhain, Amit Chitnis, Melony Chakrabarty, Ann Ky, Quy Nguyen, Julie Low, Seema Jain, Julie Higashi, Pennan M Barry, Jennifer Flood

Tuberculosis Diagnostic Delays and Treatment Outcomes among Patients with COVID-19, California, USA, 2020

Emily Han et al. Emerg Infect Dis. 2024 Jan.

Abstract

We assessed tuberculosis (TB) diagnostic delays among patients with TB and COVID-19 in California, USA. Among 58 persons, 43% experienced TB diagnostic delays, and a high proportion (83%) required hospitalization for TB. Even when viral respiratory pathogens circulate widely, timely TB diagnostic workup for at-risk persons remains critical for reducing TB-related illness.

Keywords: COVID-19; California; SARS-CoV-2; TB; United States; bacteria; coronavirus disease; coronaviruses; deaths; diagnostic delay; hospitalization; respiratory infections; severe acute respiratory syndrome coronavirus 2; treatment outcomes; tuberculosis; viruses.

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Figures

Figure 1
Figure 1
Flowchart of patients included in a study of TB diagnostic delays and treatment outcomes among patients with COVID-19, California, USA, 2020. TB high-burden counties included were Alameda (excluding the city of Berkeley), Los Angeles (excluding the cities of Long Beach and Pasadena), Orange, Sacramento, San Diego, and Santa Clara. Excluded cities maintain independent surveillance registries. *Includes TB patients also hospitalized for COVID-19. †Includes 3 patients with pleural TB only. TB, tuberculosis.
Figure 2
Figure 2
Timeline of 8 patients included in a study of TB diagnostic delays and treatment outcomes among patients with COVID-19, California, USA, 2020. Symptom onset is the date the first symptoms compatible with either TB or COVID-19 was identified. Symptom onset for patient 6 was in June 2019. Patient 7 was hospitalized for reasons unrelated to TB or COVID-19, and the TB diagnostic work-up was prompted by incidental findings on chest imaging. The healthcare visit of a missed opportunity to diagnose TB in a person with TB risk factors was a visit where >1 symptom or chest imaging finding was known. Yellow shading captures the number of days between the first missed opportunity and the first specimen collection for a TB diagnosis. Elevated COVID-19 incidence in California was considered >15 cases/100,000 population (7-day average rate). TB, tuberculosis.
See this image and copyright information in PMC

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