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

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.

Impact on tuberculosis diagnostic during COVID-19 pandemic in a tertiary care hospital

“…3 , 9 As Jinsoo Min et al suggested, this could be due to reassignment of health staff in an overstretched health services during COVID-19, reduced patients referrals and social coughing becoming an stigma. 10 In Italy during the first 3 months of lockdown Francesco Di Gennaro et al described similar findings. 11 However, data regarding Australia reflects a slight increase of TB notifications during this period.…”

Trends in incidences of newly notified tuberculosis in Jeju Province, Korea, 2017-2021

“…Second, notification of tuberculosis cases was delayed during the first pandemic. 7,8 However, the delay lasted 6 days, which did not significantly affect annual fluctuations.…”

Analysis of compound health impacts of heatwave and COVID-19 in Korea from May to September in 2020

“…The Korean government operated public health emergency level 4 on February 23, 2020 and prioritized most emergency units and hospital rooms for COVID-19 patients. During the first five months of the pandemic, restrictions on tuberculosis treatment were reported in Korea since many pulmonologists had been put on the frontlines 39 . Women, urban dwellers, and individuals without chronic diseases experience delays in health screening and non-urgent medical visits 40 .…”