Impact of COVID-19 pandemic and country of origin on tuberculosis treatment outcome in Greece

<b>Background:</b> Tuberculosis (TB) remains an actual cause of morbidity and mortality in Greece. <b>Aims/Objectives:</b> The aim of this study was to assess TB treatment outcome (based on the new WHO definitions) according to date of diagnosis (before or during the COVID-19 pandemic) and country of origin. Positive outcome was defined as cure and completion of treatment and negative outcome as lost to follow up, failure and not evaluated. Death was assessed separately. <b>Methods:</b> Patients registered at the Department of Pulmonary Medicine, Aristotle University of Thessaloniki, Greece, during the period 2018-2021, were retrospectively studied. <b>Results:</b> 102 patients (45 before and 57 during the pandemic) of mean age 44.8 ± 21.8 years were included. 15 were women and 87 men. 45 were Greeks, 12 of other European and 45 of non-European origin. Before the pandemic (2018 and 2019), 32 patients (62.5%) had positive outcome, 15 (29.4%) negative and 4 (7.8%) died, whereas in 2020 and 2021, positive outcome was noted in 28 (54.9%), negative in 20 (39.2%) and 3 patients (5.9%) died (p=0.66). Greeks have a positive outcome rate of 66.7%, Europeans 83.3%, while non-Europeans 44.4%. Negative outcome rate was 17.8% for Greek, 16.7% for European and 55.6% for non-European patients (p&lt;0.001). Greek patients had the highest mortality rate (15.6%), with both other groups having 0 deaths. <b>Conclusion:</b> The COVID pandemic did not affect treatment outcomes significantly, as some members of staff worked exclusively on TB. Country of origin significantly affected outcome with patients of non-European origin presenting with the highest negative outcome rate. This observation can be attributed to the lack of social and/or familial support.