Pulmonary tuberculosis control: does COVID-19 have any effect?

<bold>Background:</bold> There’s a critical need for evidence on possible links between COVID-19 and Pulmonary tuberculosis (PTB) control. Eventual negative impacts of the pandemic urge to be precociously recognized and addressed to mitigate its present and future consequences. <bold>Aims:</bold> To assess COVID-19 possible effects on PTB control. <bold>Methods:</bold> This is a retrospective study of patients followed in a Portuguese TB outpatient centre between March-December 2019 (pre-pandemic [PP]) and in the same period of 2020 (pandemic [PD]). Demographic and clinical features, time from the onset of the first symptom until diagnosis (SD) and from diagnosis to treatment initiation (DT) were compared. Index patients with positive respiratory samples smear or culture and all contacts screened by index case were included. Cohabitation, contact sphere, and screening results were also considered. <bold>Results:</bold> Among 40 index patients with PTB in 2019 PP and 27 in 2020 PD, SD median[IQR] time was 43 [15.5-75] vs 34 [18-77] days (p=0.980) respectively; DT median time was 0 [0-1] vs 1 [0-2] days (p=0.014). A median of 7 [3.5-12.5] vs 8 [4-14] (p=0.505) contacts were screened by index case, with a median positivity rate of 8 [0-14] vs 20 [7-45]% (p=0.007). Among positive contacts, 21.2% vs 38.9% (p=0.024) were household-type. Latent TB infection was diagnosis in 87.9% vs 93.1% positive contacts and TB disease was found in 12.1% vs 6.9% (p=0.298). <bold>Conclusions:</bold> COVID-19 pandemic seems to have had an impact in: decreased new cases of PTB; slight delay in treatment initiation; increased screening rate of positive contacts and household transmission.