Sociodemographic Characteristics, Comorbidities, and Mortality Among Persons Diagnosed With Tuberculosis and COVID-19 in Close Succession in California, 2020

Nabity, Scott A; Han, Emily; Lowenthal, Phil; Henry, H. Balfour; Okoye, Nnenna; Chakrabarty, Melony; Chitnis, Amit S.; Kadakia, Ankita; Villarino, Elsa; Low, Julie; Higashi, Julie; Barry, Pennan M.; Jain, Seema; Flood, Jennifer

doi:10.1001/jamanetworkopen.2021.36853

Cited by 14 publications

(16 citation statements)

References 9 publications

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“…The difference between the frequency of death among patients with concurrent TB/COVID-19 and TB-alone could not be explained by differences in demographic or clinical characteristics between these groups. Our results are aligned with findings of elevated mortality risk among patients with TB/COVID-19 in California, Asia and South Africa [5][6][7][8]10], and support statements of concern about outcomes for patients with both TB and COVID-19 [2].…”

Section: Discussionsupporting

confidence: 86%

“…An early multinational study found that while the mortality rate was high among patients with both TB and COVID-19, this could have been the result of older age and other comorbidities in the study population [3,4]. In California, researchers found differences in terms of diabetes prevalence and ethnicity between patients with concurrent TB/COVID-19 and a comparison group of patients who had active TB prior to the COVID-19 pandemic [10]. Surprisingly, the TB-alone and concurrent TB/COVID-19 patient cohorts in NYC were similar to each other in terms of a range of demographic and clinical variables.…”

Section: Comparing Characteristics Of Tb/covid-19 Versus Tb-alone Pat...mentioning

confidence: 99%

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Cohort study of the mortality among patients in New York City with tuberculosis and COVID-19, March 2020 to June 2022

Easton

Salerno

Trieu

et al. 2023

PLOS Glob Public Health

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Both tuberculosis (TB) and COVID-19 can affect the respiratory system, and early findings suggest co-occurrence of these infectious diseases can result in elevated mortality. A retrospective cohort of patients who were diagnosed with TB and COVID-19 concurrently (within 120 days) between March 2020 and June 2022 in New York City (NYC) was identified. This cohort was compared with a cohort of patients diagnosed with TB-alone during the same period in terms of demographic information, clinical characteristics, and mortality. Cox proportional hazards regression was used to compare mortality between patient cohorts. One hundred and six patients with concurrent TB/COVID-19 were identified and compared with 902 patients with TB-alone. These two cohorts of patients were largely demographically and clinically similar. However, mortality was higher among patients with concurrent TB/COVID-19 in comparison to patients with TB-alone, even after controlling for age and sex (hazard ratio 2.62, 95% Confidence Interval 1.66–4.13). Nearly one in three (22/70, 31%) patients with concurrent TB/COVID-19 aged 45 and above died during the study period. These results suggest that TB patients with concurrent COVID-19 were at high risk for mortality. It is important that, as a high-risk group, patients with TB are prioritized for resources to quickly diagnose and treat COVID-19, and provided with tools and information to protect themselves from COVID-19.

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Section: Discussionsupporting

confidence: 86%

Section: Comparing Characteristics Of Tb/covid-19 Versus Tb-alone Pat...mentioning

confidence: 99%

Cohort study of the mortality among patients in New York City with tuberculosis and COVID-19, March 2020 to June 2022

Easton

Salerno

Trieu

et al. 2023

PLOS Glob Public Health

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“…After testing criteria changed, the prevalence rate increased to approximately 0.06% until 9 June 2020 [ 17 ]. The second study, led by Nabity in 2021, identified 6371 co-infected patients among all California residents between September 3, 2019, and December 31, 2020, resulting in a prevalence rate of approximately 0.02% [ 18 ]. The S3 Table provides detailed information on these two studies.…”

Section: Resultsmentioning

confidence: 99%

“…A notable contribution to the field is a large-scale study led by Nabity in 2021, which provided an updated prevalence rate estimate of approximately 0.02% in California, USA [ 18 ]. In contrast, an earlier study conducted in West Cape Province, South Africa in early 2020 reported a prevalence rate of 0.06%.…”

Section: Discussionmentioning

confidence: 99%

Systematic review and meta-analysis of Tuberculosis and COVID-19 Co-infection: Prevalence, fatality, and treatment considerations

Wang,

Cao,

Liu

et al. 2024

PLoS Negl Trop Dis

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Background Tuberculosis (TB) and COVID-19 co-infection poses a significant global health challenge with increased fatality rates and adverse outcomes. However, the existing evidence on the epidemiology and treatment of TB-COVID co-infection remains limited. Methods This updated systematic review aimed to investigate the prevalence, fatality rates, and treatment outcomes of TB-COVID co-infection. A comprehensive search across six electronic databases spanning November 1, 2019, to January 24, 2023, was conducted. The Joanna Briggs Institute Critical Appraisal Checklist assessed risk of bias of included studies, and meta-analysis estimated co-infection fatality rates and relative risk. Results From 5,095 studies screened, 17 were included. TB-COVID co-infection prevalence was reported in 38 countries or regions, spanning both high and low TB prevalence areas. Prevalence estimates were approximately 0.06% in West Cape Province, South Africa, and 0.02% in California, USA. Treatment approaches for TB-COVID co-infection displayed minimal evolution since 2021. Converging findings from diverse studies underscored increased hospitalization risks, extended recovery periods, and accelerated mortality compared to single COVID-19 cases. The pooled fatality rate among co-infected patients was 7.1% (95%CI: 4.0% ~ 10.8%), slightly lower than previous estimates. In-hospital co-infected patients faced a mean fatality rate of 11.4% (95%CI: 5.6% ~ 18.8%). The pooled relative risk of in-hospital fatality was 0.8 (95% CI, 0.18–3.68) for TB-COVID patients versus single COVID patients. Conclusion TB-COVID co-infection is increasingly prevalent worldwide, with fatality rates gradually declining but remaining higher than COVID-19 alone. This underscores the urgency of continued research to understand and address the challenges posed by TB-COVID co-infection.

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“…The well-documented inequalities in preexisting health conditions, such as diabetes or cardiovascular disease, have been named as core explanatory pathways in adult populations. 16 , 18 , 29 , 30 The risk of a severe clinical course of COVID-19 has been shown to also increase in children if chronic conditions, such as obesity or type 1 diabetes, are present. 31 , 32 At the same time, there is evidence that at least some predisposing diseases (eg, obesity or asthma) may occur more often in children from socioeconomically deprived families.…”

Section: Introductionmentioning

confidence: 99%

Association of Household Deprivation, Comorbidities, and COVID-19 Hospitalization in Children in Germany, January 2020 to July 2021

et al. 2022

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ImportanceAdults in disadvantaged socioeconomic positions have elevated risks of a severe course of COVID-19, but it is unclear whether this holds true for children.ObjectiveTo investigate whether young people from disadvantaged households have a higher risk of COVID-19 hospitalization and whether differences were associated with comorbidities that predispose children to severe courses.Design, Setting, and ParticipantsThis population-based cohort study included all children and adolescents (aged 0-18 years) who were enrolled in a statutory health insurance carrier in Germany during the observation period of January 1, 2020, to July 13, 2021. Logistic regressions were calculated to compare children from households with and without an indication of poverty. Age, sex, days under observation, nationality, and comorbidities (eg, obesity, diabetes) were controlled for to account for explanatory factors.ExposuresDisadvantage on the household level was assessed by the employment status of the insurance holder (ie, employed, long- or short-term unemployed, low-wage employment, economically inactive). Socioeconomic characteristics of the area of residence were also assessed.Main Outcomes and MeasuresDaily hospital diagnoses of COVID-19 (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes U07.1 and U07.2) were recorded. Comorbidities were assessed using inpatient and outpatient diagnoses contained in the insurance records.ResultsA total of 688 075 children and adolescents were included, with a mean (SD) age of 8.3 (5.8) years and 333 489 (48.4%) female participants. COVID-19 hospital diagnosis was a rare event (1637 participants [0.2%]). Children whose parents were long-term unemployed were 1.36 (95% CI, 1.22-1.51) times more likely than those with employed parents to be hospitalized. Elevated odds were also found for children whose parents had low-wage employment (odds ratio, 1.29; 95% CI, 1.05-1.58). Those living in low-income areas had 3.02 (95% CI, 1.73-5.28) times higher odds of hospitalization than those in less deprived areas. Comorbidities were associated with hospitalization, but their adjustment did not change main estimates for deprivation.Conclusions and RelevanceIn this cohort study, children who had parents who were unemployed and those who lived in low-income areas were at higher risk of COVID-19 hospitalization. This finding suggests that attention must be paid to children with SARS-CoV-2 from vulnerable families and closer monitoring should be considered. A number of explanatory factors, including comorbidities, were taken into account, but their analysis yielded no clear picture about underlying processes.

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Sociodemographic Characteristics, Comorbidities, and Mortality Among Persons Diagnosed With Tuberculosis and COVID-19 in Close Succession in California, 2020

Cited by 14 publications

References 9 publications

Cohort study of the mortality among patients in New York City with tuberculosis and COVID-19, March 2020 to June 2022

Cohort study of the mortality among patients in New York City with tuberculosis and COVID-19, March 2020 to June 2022

Systematic review and meta-analysis of Tuberculosis and COVID-19 Co-infection: Prevalence, fatality, and treatment considerations

Association of Household Deprivation, Comorbidities, and COVID-19 Hospitalization in Children in Germany, January 2020 to July 2021

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