Increased Healthcare Delays in Tuberculosis Patients During the First Wave of COVID-19 Pandemic in Korea: A Nationwide Cross-Sectional Study

J Korean Med Sci. 2022 Jan 17;37(3):e20. doi: 10.3346/jkms.2022.37.e20.

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic caused disruptions to healthcare systems, consequently endangering tuberculosis (TB) control. We investigated delays in TB treatment among notified patients during the first wave of the COVID-19 pandemic in Korea.

Methods: We systemically collected and analyzed data from the Korea TB cohort database from January to May 2020. Groups were categorized as 'before-pandemic' and 'during-pandemic' based on TB notification period. Presentation delay was defined as the period between initial onset of symptoms and the first hospital visit, and healthcare delay as the period between the first hospital visit and anti-TB treatment initiation. A multivariate logistic regression analysis was performed to evaluate factors associated with delays in TB treatment.

Results: Proportion of presentation delay > 14 days was not significantly different between two groups (48.3% vs. 43.7%, P = 0.067); however, proportion of healthcare delay > 5 days was significantly higher in the during-pandemic group (48.6% vs. 42.3%, P = 0.012). In multivariate analysis, the during-pandemic group was significantly associated with healthcare delay > 5 days (adjusted odds ratio = 0.884, 95% confidence interval = 0.715-1.094).

Conclusion: The COVID-19 pandemic was associated with healthcare delay of > 5 days in Korea. Public health interventions are necessary to minimize the pandemic's impact on the national TB control project.

Keywords: Anti-Tuberculosis Treatment; COVID-19; Diagnosis; Healthcare; SARS-CoV-2; Tuberculosis.

MeSH terms

  • COVID-19 / epidemiology*
  • COVID-19 / therapy
  • Cross-Sectional Studies
  • Delayed Diagnosis / statistics & numerical data*
  • Delivery of Health Care / statistics & numerical data
  • Humans
  • Pandemics
  • Republic of Korea / epidemiology
  • SARS-CoV-2
  • Time-to-Treatment / statistics & numerical data*
  • Tuberculosis, Pulmonary / diagnosis
  • Tuberculosis, Pulmonary / therapy*