Late Breaking Abstract - Impact of the SARS-CoV-2 pandemic on incidence and phenotype of tuberculosis in a UK hotspot

<bold>Introduction:</bold> The SARS-CoV-2 pandemic and response measures have significantly impacted healthcare delivery including tuberculosis (TB) services. <bold>Aims:</bold> To compare the incidence and phenotype of TB and latent TB infection rates in contacts between pre-pandemic (January 2019 – March 2020) and pandemic periods (April 2020 – March 2021) in Leicester, UK. <bold>Methods:</bold> Retrospective cohort study including all notified TB cases and contacts (January 2019 – March 2021). <bold>Results:</bold> 388 incident TB cases (179 pulmonary) were notified during the analysis period. Overall, the mean monthly number of TB cases was lower in the pandemic period (13.8 vs 14.9). For pulmonary TB (see table), patients were significantly younger, with an 88% increase in the proportion having smear positive disease. Median time to diagnosis after symptoms onset was 3 weeks lower during the pandemic, and driven by accelerated diagnosis in symptomatic patients presenting to hospital. There was a mean reduction of 1.1 and 0.5 contacts screened per smear negative and positive index case respectively, however a higher proportion screened with QuantiFERON-TB Gold Plus had latent TB infection (33% vs. 28%). <bold>Conclusion:</bold> Our data suggest the pandemic has disproportionately impacted presentation in older persons and smear negative pulmonary TB. As pandemic restrictions are eased, increased vigilance will be needed to prospectively sustain effective TB control. <fig><object-id>erj;58/suppl_65/OA1608/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>