Journal of Mazandaran University of Medical Sciences (Jul 2024)
Investigating the Characteristics and Clinical Outcomes of Children with Tuberculosis Admitted to Buali Hospital of Sari Before and After the COVID-19 Pandemic
Abstract
Background and purpose: Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis and about 2 billion people are infected with tuberculosis. Every year, millions of children are exposed to Mycobacterium tuberculosis, and tuberculosis is still one of the main infectious causes of death among children in the world. Considering the importance of tuberculosis in children and the lack of information about the effects of the COVID-19 pandemic on it, this study aimed to investigate the characteristics and clinical outcomes of children with tuberculosis admitted to Buali Hospital of Sari before and after the COVID-19 pandemic. Materials and methods: In this descriptive-cross-sectional study, all children with tuberculosis who were admitted to Buali Hospital between 2014 to 2019 were divided into two groups before and after COVID-19 (Before: from June 2014 to the end of 2019; After: from the end of 2019 to June 2023). Demographic information, type of disease, contact history, underlying disease, clinical symptoms, laboratory tests, radiological findings, medications, duration of hospitalization, and clinical outcome of the patients were recorded. The data was statistically analyzed with SPSS software version 22. Results: In the present study, 15 children were hospitalized before the COVID-19 pandemic and 17 people after it. There were 19 girls (59.37%) and 13 boys (40.63%) with an average age of 6.60±4.24 years. The median duration of hospitalization after the COVID-19 pandemic was significantly longer (4 days vs. 5 days; P=0.019). 22 patients (68.75%) had active tuberculosis and the remaining cases were asymptomatic and diagnosed with latent tuberculosis (P=0.811). Pulmonary involvement was observed in 17 patients (53.12%) and extrapulmonary involvement was observed in 5 patients (46.87%) (P=0.323). 19 patients (59.37%) were new cases and other cases were disease recurrences (P=0.571). History of contact with TB patients was positive in 19 patients (59.37%). The skin tuberculin test of the patients was positive in 24 patients (75%), and the gastric aspirate examination of none of the patients was positive before COVID-19, but 4 patients (33.33%) were positive after COVID-19 (P=0.245). IGRA test was positive in 1 patient (3.12%) before COVID-19 and in 2 patients (6.25%) after the pandemic (P=1.000). The most common clinical symptom was cough (68.75%), followed by fever (43.75%), vomiting and weight loss (32.25%), rhinorrhea and anorexia (28.12%) and night sweats (15.62%). Three patients (17.5%) needed intensive care unit admission after the pandemic. The laboratory markers did not have a statistically significant difference between the two groups, and ESR was high in 66.67% of the patients before the pandemic and 81.2% after it. Disturbance in the laboratory tests including electrolytes and liver and kidney function tests was not observed in both groups. All patients recovered and no deaths were reported. Conclusion: Comparing the results showed a significant increase in the duration of hospitalization after the pandemic. Although some studies have reported a more severe form of tuberculosis after the COVID-19 pandemic, finding the association between the changes in the clinical manifestations of TB and its type before and after COVID-19 and generalizing the results requires multicenter studies with higher sample sizes.
