Impact of COVID-19 Coinfection on Management of Tuberculosis Patients Registered at DOTS Center in a Tertiary Care Hospital

Abstract

Introduction: This study was conducted to determine the impact of coronavirus disease 2019 (COVID-19) and the ensuing lockdown on tuberculosis (TB) management undergoing treatment under the National Tuberculosis Elimination Program (NTEP) and vice-versa. Aims: To study (1) the occurrence of COVID-19 and its severity among patients suffering from TB and (2) the impact of a pandemic on TB management under NTEP. Materials and methods: A retrospective observational study was conducted in patients registered at Directly observed therapy short-course (DOTS) center from 1st April 2020 to 31st July 2021 at ESIC Medical College and Hospital, Faridabad, Haryana, India, using a semi-structured predesigned questionnaire administered telephonically. Results: Out of 387 TB patients registered at the DOTS center, 191 participated in the study. The occurrence of COVID-19 in patients with TB was 10 (5.2%), of which five (50%) were symptomatic; four (40%) had pulmonary TB, and six (60%) had extrapulmonary TB. Nine (90%) patients had mild and one (10%) moderately severe disease requiring hospitalization. Amongst 191 patients, 29 (15.2%) missed anti-TB treatment (ATT); 15 (51.7%) could not access the DOTS center due to restrictions, and seven (24.1%) due to personal reasons, eight (27.5%) forgot to take medication, and one (0.34%) migrated elsewhere. Conclusions: The occurrence of COVID-19 in patients with TB was found to be 5.2% in this study. The severity of COVID-19 was mostly mild and the mortality rate in patients with a coinfection of TB and COVID-19 was 10%. The COVID-19 pandemic had a negative impact on TB management under NTEP due to the imposed lockdown. The limitation of this study was the small sample size.