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

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 2...

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Vydané v:Antibiotics (Basel) Ročník 10; číslo 3; s. 272
Hlavní autori: Di Gennaro, Francesco, Gualano, Gina, Timelli, Laura, Vittozzi, Pietro, Di Bari, Virginia, Libertone, Raffaella, Cerva, Carlotta, Pinnarelli, Luigi, Nisii, Carla, Ianniello, Stefania, Mosti, Silvia, Bevilacqua, Nazario, Iacomi, Fabio, Mondi, Annalisa, Topino, Simone, Goletti, Delia, Vaia, Francesco, Ippolito, Giuseppe, Girardi, Enrico, Palmieri, Fabrizio
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Switzerland MDPI AG 08.03.2021
MDPI
Predmet:
Coronaviruses
COVID 19
Data collection
Delay
diagnostic delay
Diagnostic systems
Health facilities
Health services
Hospitalization
Hospitals
Infectious diseases
pandemic
Pandemics
Patients
Public health
Reduction
SARS CoV2
Severe acute respiratory syndrome coronavirus 2
Tuberculosis
Weight loss
SARS CoV2
diagnostic delay
COVID 19
pandemic
tuberculosis
ISSN:2079-6382, 2079-6382
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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 (p < 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.
AbstractList 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 (p < 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.
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.BACKGROUNDThe WHO advised that the impact of COVID-19 pandemic on TB services was estimated to be dramatic due to the disruption of TB services.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.METHODSA 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.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 (p < 0.01). Diagnostic delays in 2020 remain significant in the multiple logistic model (AOR = 6.93, 95%CI: 3.9-12.3).RESULTSIn 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 (p < 0.01). Diagnostic delays in 2020 remain significant in the multiple logistic model (AOR = 6.93, 95%CI: 3.9-12.3).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.CONCLUSIONSOur 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.
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. 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. 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). 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.
Author Pinnarelli, Luigi
Ippolito, Giuseppe
Di Bari, Virginia
Vittozzi, Pietro
Cerva, Carlotta
Mosti, Silvia
Iacomi, Fabio
Palmieri, Fabrizio
Libertone, Raffaella
Vaia, Francesco
Gualano, Gina
Topino, Simone
Girardi, Enrico
Ianniello, Stefania
Goletti, Delia
Bevilacqua, Nazario
Mondi, Annalisa
Timelli, Laura
Nisii, Carla
Di Gennaro, Francesco
AuthorAffiliation 1 National Institute for Infectious Diseases “L. Spallanzani” IRCCS, 00161 Rome, Italy; gina.gualano@inmi.it (G.G.); laura.timelli@inmi.it (L.T.); pietro.vittozzi@inmi.it (P.V.); virginia.dibari@inmi.it (V.D.B.); Raffaella.libertone@inmi.it (R.L.); Carlotta.cerva@inmi.it (C.C.); carla.nisii@inmi.it (C.N.); stefania.ianniello@inmi.it (S.I.); silvia.mosti@inmi.it (S.M.); nazario.bevilacqua@inmi.it (N.B.); Fabio.iacomi@inmi.it (F.I.); annalisa.mondi@inmi.it (A.M.); simone.topino@inmi.it (S.T.); delia.goletti@inmi.it (D.G.); Francesco.vaia@inmi.it (F.V.); giuseppe.ippolito@inmi.it (G.I.); enrico.girardi@inmi.it (E.G.); fabrizio.palmieri@inmi.it (F.P.)
2 Department of Epidemiology of Lazio Regional Health Service, 00147 Rome, Italy; l.pinnarelli@deplazio.it
AuthorAffiliation_xml – name: 1 National Institute for Infectious Diseases “L. Spallanzani” IRCCS, 00161 Rome, Italy; gina.gualano@inmi.it (G.G.); laura.timelli@inmi.it (L.T.); pietro.vittozzi@inmi.it (P.V.); virginia.dibari@inmi.it (V.D.B.); Raffaella.libertone@inmi.it (R.L.); Carlotta.cerva@inmi.it (C.C.); carla.nisii@inmi.it (C.N.); stefania.ianniello@inmi.it (S.I.); silvia.mosti@inmi.it (S.M.); nazario.bevilacqua@inmi.it (N.B.); Fabio.iacomi@inmi.it (F.I.); annalisa.mondi@inmi.it (A.M.); simone.topino@inmi.it (S.T.); delia.goletti@inmi.it (D.G.); Francesco.vaia@inmi.it (F.V.); giuseppe.ippolito@inmi.it (G.I.); enrico.girardi@inmi.it (E.G.); fabrizio.palmieri@inmi.it (F.P.)
– name: 2 Department of Epidemiology of Lazio Regional Health Service, 00147 Rome, Italy; l.pinnarelli@deplazio.it
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/33800406$$D View this record in MEDLINE/PubMed
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ContentType Journal Article
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– notice: 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
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Issue 3
Keywords SARS CoV2
diagnostic delay
COVID 19
pandemic
tuberculosis
Language English
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TB-INMI Working Group: Fabrizio Palmieri, Gina Gualano, Andrea Antinori, Nazario Bevilacqua, Maria Capobianchi, Carmine Ciaralli, Gilda Cuzzi, Alessia De Angelis, Antonino Di Caro, Franca Del Nonno, Gianpiero D’Offizi, Emanuela Ercoli, Delia Goletti, Fabio Iacomi, Stefania Ianniello, Giuseppe Ippolito, Luisa Marchioni, Annelisa Mastrobattista, Maria Musso, Paola Mencarini, Annalisa Mondi, Silvia Mosti, Silvia Murachelli, Emanuele Nicastri, Carla Nisii, Carlo Pareo, Antonella Petrecchia, Nicola Petrosillo, Vincenza Puro, Silvia Rosati, Vincenzo Schininà, Paola Scognamiglio, Tommaso Speranza, Simone Topino, Francesco Vaia.
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Snippet 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...
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. A retrospective data...
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.BACKGROUNDThe WHO advised...
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StartPage 272
SubjectTerms Coronaviruses
COVID 19
Data collection
Delay
diagnostic delay
Diagnostic systems
Health facilities
Health services
Hospitalization
Hospitals
Infectious diseases
pandemic
Pandemics
Patients
Public health
Reduction
SARS CoV2
Severe acute respiratory syndrome coronavirus 2
Tuberculosis
Weight loss
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