Tuberculosis Co-Infection Is Common in Patients Requiring Hospitalization for COVID-19 in Belarus: Mixed-Methods Study

Int J Environ Res Public Health. 2022 Apr 5;19(7):4370. doi: 10.3390/ijerph19074370.

Abstract

A significant drop in tuberculosis (TB) case-finding has been widely reported during the period of the COVID-19 pandemic. To address a decrease in TB notification, Belarus introduced laboratory TB testing in patients with the laboratory-confirmed coronavirus disease 2019 (COVID-19). We conducted a secondary analysis of health records among 844 patients with laboratory-confirmed COVID-19 diagnosis who were admitted to repurposed departments at TB hospitals and who were tested by Xpert MTB/RIF (Cepheid Inc., Sunnyvale, CA, USA) in five Belarus regions between April and October 2021. Quantitative analysis followed by 13 individual interviews with health managers, physicians, and nurses participating in the intervention. Most patients were male (64%) and mean age was 43.5 ± 16 years. One in twenty (n = 47, 5.6%) patients were co-infected with active pulmonary TB, and over one-third of them (n = 18) had rifampicin resistance. In-hospital mortality was comparable in patients with and without TB co-infection (2.1% and 2.3% respectively, p > 0.99). Laboratory TB testing among patients with COVID-19 at repurposed departments of TB hospitals is feasible in Belarus and may improve TB case-finding.

Keywords: COVID-19; Eastern Europe; Xpert MTB/RIF; case-finding; operational research; rifampicin resistance; tuberculosis.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Antibiotics, Antitubercular* / therapeutic use
  • COVID-19 Testing
  • COVID-19* / epidemiology
  • Coinfection* / drug therapy
  • Coinfection* / epidemiology
  • Hospitalization
  • Humans
  • Latent Tuberculosis* / drug therapy
  • Male
  • Middle Aged
  • Mycobacterium tuberculosis*
  • Pandemics
  • Republic of Belarus / epidemiology
  • Rifampin
  • Sensitivity and Specificity
  • Tuberculosis* / diagnosis
  • Tuberculosis* / drug therapy
  • Tuberculosis* / epidemiology

Substances

  • Antibiotics, Antitubercular
  • Rifampin