COVID-19, the escalation of diabetes mellitus and the repercussions on tuberculosis

Thong, Pei Min; Chong, Hai Tarng; Chang, Anabel J.W.; Ong, Catherine W. M.

doi:10.1016/j.ijid.2023.02.009

Cited by 3 publications

(2 citation statements)

References 35 publications

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“…This is also consistent with our finding that the proportion of people diagnosed with TB increased in groups at higher risk for COVID-19, specifically older populations and people with diabetes. These are two commonly known risk factors for severe COVID-19 ( 19 , 20 ).…”

Section: Discussionmentioning

confidence: 99%

COVID-19 pandemic and other factors associated with unfavorable tuberculosis treatment outcomes—Almaty, Kazakhstan, 2018–2021

Gabdullina,

Maes,

Horth

et al. 2023

Front. Public Health

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IntroductionThe COVID-19 pandemic negatively influenced the availability of tuberculosis (TB) services, such as detection, diagnosis and treatment, around the world, including Kazakhstan. We set out to estimate the COVID-19 pandemic influence on TB treatment outcomes by comparing outcomes among people starting treatment before the pandemic (2018–2019) and during the pandemic (2020–2021) and to determine risk factors associated with unfavorable outcomes.MethodsWe conducted a retrospective cohort study among all people newly diagnosed with drug-sensitive pulmonary or extrapulmonary TB at least 18 years old who initiated treatment from 2018 to 2021 in Almaty. We abstracted data from the national electronic TB register. Unfavorable treatment outcomes were ineffective treatment, death, loss to follow-up, results not evaluated, and transferred. We used multivariable Poisson regression to calculate adjusted relative risk (aRR) and 95% confidence intervals (95%CI).ResultsAmong 1548 people newly diagnosed with TB during the study period, average age was 43 years (range 18–93) and 52% were male. The number of people initiating treatment was higher before than the pandemic (935 vs. 613, respectively). There was significantly different proportions before compared to during the pandemic for people diagnosed through routine screening (39% vs. 31%, p < 0.001), 60 years and older (16% vs. 22%, p = 0.005), and with diabetes (5% vs. 8%, p = 0.017). There was no difference in the proportion of HIV (8% in both periods). Unfavorable outcomes increased from 11 to 20% during the pandemic (aRR = 1.83; 95% CI: 1.44–2.31). Case fatality rose from 6 to 9% (p = 0.038). Risk factors for unfavorable TB treatment outcomes among all participants were being male (aRR = 1.44, 95%CI = 1.12–1.85), having HIV (aRR = 2.72, 95%CI = 1.99–3.72), having alcohol use disorder (aRR = 2.58, 95%CI = 1.83–3.62) and experiencing homelessness (aRR = 2.94, 95%CI = 1.80–4.80). Protective factors were being 18–39 years old (aRR = 0.33, 95%CI = 0.24–0.44) and 40–59 years old (aRR = 0.56, 95%CI = 0.41–0.75) compared to 60 years old and up.ConclusionCOVID-19 pandemic was associated with unfavorable treatment outcomes for people newly diagnosed with drug-sensitive TB in Almaty, Kazakhstan. People with fewer comorbidities were at increased risk. Results point to the need to maintain continuity of care for persons on TB treatment, especially those at higher risk for poor outcomes during periods of healthcare service disruption.

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Section: Discussionmentioning

confidence: 99%

COVID-19 pandemic and other factors associated with unfavorable tuberculosis treatment outcomes—Almaty, Kazakhstan, 2018–2021

Gabdullina,

Maes,

Horth

et al. 2023

Front. Public Health

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“…All these need to be factored in for a comprehensive worldwide TB control plan. In this special IJID World TB Day issue to commemorate World TB Day, we present nine reports covering several of these aspects: impacts of COVID-19 on the diagnosis of TB, MDR-TB, and on mortality [15] ; characterization of immune inflammation of TB-COVID-19 coinfection [16] ; the impact of COVID-19 on increasing non-communicable diseases, such as diabetes [17] ; updated drug-resistant tuberculosis treatment regimens [18] ; need of new formulations of TB drugs, especially for MDR-TB, for children [19] ; importance of the engagement of those affected by TB in the clinical trials [20] ; new proposed strategies to design new TB vaccines, such as the mRNA technology [21] ; characterization of the TB vaccine-induced immunity in newborns [22] ; the necessity to have genomic and geospatial epidemiology of Mtb at a local level, as reported in Oman [23] ; and the urgent need to have programmatic management of TB preventive treatment (PMTPT) [24] .…”

mentioning

confidence: 99%

World Tuberculosis Day 2023 theme “Yes! We Can End TB!”

Goletti¹,

Al-Abri²,

Migliori³

et al. 2023

International Journal of Infectious Diseases

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Interaction between type 2 diabetes and past COVID-19 on active tuberculosis

Calles-Cabanillas,

Aguillón-Durán,

Ayala

et al. 2024

BMC Infect Dis

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Background The global setback in tuberculosis (TB) prevalence and mortality in the post-COVID-19 era has been partially attributed to pandemic-related disruptions in healthcare systems. The additional biological contribution of COVID-19 to TB is less clear. The goal of this study was to determine if there is an association between COVID-19 in the past 18 months and a new TB episode, and the role played by type 2 diabetes mellitus (DM) comorbidity in this relationship. Methods A cross-sectional study was conducted among 112 new active TB patients and 373 non-TB controls, identified between June 2020 and November 2021 in communities along the Mexican border with Texas. Past COVID-19 was based on self-report or positive serology. Bivariable/multivariable analysis were used to evaluate the odds of new TB in hosts with past COVID-19 and/or DM status. Results The odds of new TB were higher among past COVID-19 cases vs. controls, but only significant among DM patients (aOR 2.3). The odds of TB in people with DM was 2.7-fold higher among participants without past COVID-19 and increased to 7.9-fold among those with past COVID-19. Conclusion DM interacts with past COVID-19 synergistically to magnify the risk of TB. Latent TB screening and prophylactic treatment, if positive, is recommended in past COVID-19 persons with DM. Future studies are warranted with a longitudinal design and larger sample size to confirm our findings. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-024-10244-z.

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COVID-19, the escalation of diabetes mellitus and the repercussions on tuberculosis

Cited by 3 publications

References 35 publications

COVID-19 pandemic and other factors associated with unfavorable tuberculosis treatment outcomes—Almaty, Kazakhstan, 2018–2021

COVID-19 pandemic and other factors associated with unfavorable tuberculosis treatment outcomes—Almaty, Kazakhstan, 2018–2021

World Tuberculosis Day 2023 theme “Yes! We Can End TB!”

Interaction between type 2 diabetes and past COVID-19 on active tuberculosis

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