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Outbreaks of COVID-19 in a tuberculosis treatment sanatorium on the Thailand-Myanmar border: a retrospective cohort analysis..

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Title: Outbreaks of COVID-19 in a tuberculosis treatment sanatorium on the Thailand-Myanmar border: a retrospective cohort analysis..
Authors: Ko Aung, Htet Ko1, Swe, Lei Lei1, Saito, Makoto1,2, Lesseps, Sophie3, Janurian, Naw1, Pa Tun, Win Pa1, Maung, Banyar Maung1, Than, Aung1, Watthanaworawit, Wanitda1, Kaewphanderm, Napaporn1, Gornsawun, Gornpan1, Phyo, Aung Pyae1 aungpyaephyo@shoklo-unit.com, Nosten, François1,4
Source: Wellcome Open Research. 2023, p1-27. 27p.
Subject Terms: *Disease outbreaks, COVID-19, Tuberculosis treatment, Disease progression, Disease remission
Abstract: Background Tuberculosis (TB) is a chronic condition, with overlapping symptoms to those of coronavirus disease 2019 (COVID-19). There has been inconsistent evidence on whether TB is a predisposing factor for developing severe COVID-19. The aim of this report is to explore whether TB influences the severity of COVID-19. Methods COVID-19 cases at two TB sanatoria on the Thailand-Myanmar border were reviewed. Demographic, clinical and laboratory data including TB treatment and co-morbidities, were analyzed. Characteristics and COVID-19 clinical outcomes were compared between two groups of patients: TB and those without TB (the caretakers and the medical personnel). Multivariable ordered logistic regression was conducted to compare the risk of severe COVID-19 between the two groups. Results Between September 2021 and March 2022, 161 COVID-19 cases were diagnosed. Over half of the COVID-19 patients were infected with TB (n= 104, 64.6%), and the rest were not (n=57, 35.4%). The median (interquartile range) age was 48 (33.5-57.0) and 27 (23-33) years in the TB and in the non-TB COVID-19 patients, respectively. Before COVID19 infection, 67.1% (106/158) of patients had received at least one dose of COVID-19 vaccine. The median cycle threshold value at diagnosis was not different between TB (18.5, IQR 16.1-32.3) and nonTB patients (18.8, 15.1-30.0). Fever, gastrointestinal symptoms and ageusia were more common in non-TB patients. Six patients (3.8%, 6/156) all from the TB group became severe of which five (3.2%, 5/156) required oxygen therapy. One TB patient died (1/104, 0.96%) of lung cancer. After adjustment for potential confounders, the final clinical severity was not different between the two groups (adjusted odds ratio 1.40, 95% confidence interval 0.16–12.39). Conclusions TB was not associated with severe outcomes in the two TB sanatoria. The high uptake of COVID-19 vaccination and active screening could have impacted on disease progression and prevented unfavorable outcomes. [ABSTRACT FROM AUTHOR]
Copyright of Wellcome Open Research is the property of Wellcome Trust and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Outbreaks of COVID-19 in a tuberculosis treatment sanatorium on the Thailand-Myanmar border: a retrospective cohort analysis..
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  Data: <searchLink fieldCode="AR" term="%22Ko+Aung%2C+Htet+Ko%22">Ko Aung, Htet Ko</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Swe%2C+Lei+Lei%22">Swe, Lei Lei</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Saito%2C+Makoto%22">Saito, Makoto</searchLink><relatesTo>1,2</relatesTo><br /><searchLink fieldCode="AR" term="%22Lesseps%2C+Sophie%22">Lesseps, Sophie</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Janurian%2C+Naw%22">Janurian, Naw</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Pa+Tun%2C+Win+Pa%22">Pa Tun, Win Pa</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Maung%2C+Banyar+Maung%22">Maung, Banyar Maung</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Than%2C+Aung%22">Than, Aung</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Watthanaworawit%2C+Wanitda%22">Watthanaworawit, Wanitda</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Kaewphanderm%2C+Napaporn%22">Kaewphanderm, Napaporn</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Gornsawun%2C+Gornpan%22">Gornsawun, Gornpan</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Phyo%2C+Aung+Pyae%22">Phyo, Aung Pyae</searchLink><relatesTo>1</relatesTo><i> aungpyaephyo@shoklo-unit.com</i><br /><searchLink fieldCode="AR" term="%22Nosten%2C+François%22">Nosten, François</searchLink><relatesTo>1,4</relatesTo>
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  Data: <searchLink fieldCode="JN" term="%22Wellcome+Open+Research%22">Wellcome Open Research</searchLink>. 2023, p1-27. 27p.
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  Data: *<searchLink fieldCode="DE" term="%22Disease+outbreaks%22">Disease outbreaks</searchLink><br /><searchLink fieldCode="DE" term="%22COVID-19%22">COVID-19</searchLink><br /><searchLink fieldCode="DE" term="%22Tuberculosis+treatment%22">Tuberculosis treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+progression%22">Disease progression</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+remission%22">Disease remission</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background Tuberculosis (TB) is a chronic condition, with overlapping symptoms to those of coronavirus disease 2019 (COVID-19). There has been inconsistent evidence on whether TB is a predisposing factor for developing severe COVID-19. The aim of this report is to explore whether TB influences the severity of COVID-19. Methods COVID-19 cases at two TB sanatoria on the Thailand-Myanmar border were reviewed. Demographic, clinical and laboratory data including TB treatment and co-morbidities, were analyzed. Characteristics and COVID-19 clinical outcomes were compared between two groups of patients: TB and those without TB (the caretakers and the medical personnel). Multivariable ordered logistic regression was conducted to compare the risk of severe COVID-19 between the two groups. Results Between September 2021 and March 2022, 161 COVID-19 cases were diagnosed. Over half of the COVID-19 patients were infected with TB (n= 104, 64.6%), and the rest were not (n=57, 35.4%). The median (interquartile range) age was 48 (33.5-57.0) and 27 (23-33) years in the TB and in the non-TB COVID-19 patients, respectively. Before COVID19 infection, 67.1% (106/158) of patients had received at least one dose of COVID-19 vaccine. The median cycle threshold value at diagnosis was not different between TB (18.5, IQR 16.1-32.3) and nonTB patients (18.8, 15.1-30.0). Fever, gastrointestinal symptoms and ageusia were more common in non-TB patients. Six patients (3.8%, 6/156) all from the TB group became severe of which five (3.2%, 5/156) required oxygen therapy. One TB patient died (1/104, 0.96%) of lung cancer. After adjustment for potential confounders, the final clinical severity was not different between the two groups (adjusted odds ratio 1.40, 95% confidence interval 0.16–12.39). Conclusions TB was not associated with severe outcomes in the two TB sanatoria. The high uptake of COVID-19 vaccination and active screening could have impacted on disease progression and prevented unfavorable outcomes. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Wellcome Open Research is the property of Wellcome Trust and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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