Tuberculosis, COVID-19 and hospital admission: Consensus on pros and cons based on a review of the evidence

Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS. Tradate, Italy.
Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy / Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Tradate. Varese-Como, Italy.
World Health Organization Regional Office for Europe. Copenhagen, Denmark.
Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK / Division of Infection, Royal London Hospital, Barts Health NHS Trust, London, UK.
Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Porto Alegre, RS, Brasil.
Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS. Tradate, Italy.
Public Health Consulting Group. Lugano, Switzerland.
Division of Infectious Diseases and International Health, University of Virginia. Charlottesville, VA, Virginia, USA.
Department of Infectious Diseases, Galliera Hospital. Genova, Italy.
Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.
Division of Infectious Diseases and International Health., University of Virginia, Charlottesville, VA, Virginia, USA.
Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Inovações em Terapias, Ensino e Bioprodutos. Rio de Janeiro, RJ, Brasil.
Ver em Notas

Abstract

CostsThe aim of this review is to present the available evidence on admission for TB and TB/COVID-19 patients and discuss the criteria guiding hospitalization. Furthermore, recommendationsare made as derived from recently published World Health Organization documents, based onGlobal Tuberculosis Network (GTN) expert opinion.The core published documents and guidelines on the topic have been reviewed.The proportion of new TB cases admitted to hospital ranges between 50% and 100% while formultidrug-resistant (MDR) TB patients it ranges between 85 and 100% globally. For TB patientswith COVID-19 the proportion of cases admitted is 58%, probably reflecting different scenar-ios related to the diagnosis of COVID-19 before, after or at the same time of the active TBepisode. The hospital length of stay for drug-susceptible TB ranges from 20 to 60 days in mostof countries, ranging from a mean of 10 days (USA) to around 90 days in the Russian Federation.Hospitalization is longer for MDR-TB (50---180 days).The most frequently stated reasons for recommending hospital admission include: severe TB,infection control concerns, co-morbidities and drug adverse events which cannot be managedat out-patient level. The review also provides suggestions on hospital requirements for safeadmissions as well as patient discharge criteria, while underlining the relevance of patient-centred care through community/home-based care.

Keywords in Portuguese

Internação hospitalar
Descarga
Controle e prevenção de infecções
Tempo de permanência
Critérios de internação
COVID-19
Tuberculose

Keywords

Hospital admission
Discharge
Hospitalization criteria
Infection control and prevention
Length of stay
Costs
COVID-19
TB

Publisher

Elsevier

Citation

MIGLIORI, GIovanni Battista et al. Tuberculosis, COVID-19 and hospital admission: Consensus on pros and cons based on a review of the evidence. Pulmonology, v. 27, p. 248-256, 2021.

DOI

10.1016/j.pulmoe.2020.12.016

ISSN

2531-0437

Notes

Autores: Giovanni Battista Migliori a,∗, Dina Visca b,c, Martin van den Boomd, Simon Tiberi e,f ,Denise Rossato Silvag, Rosella Centis a, Lia D’Ambrosio h, Tania Thomas i,Emanuele Pontalij , Laura Saderi k, H. Simon Schaafl, Giovanni Sotgiuk,contributing members of the Global Tuberculosis Network1; - Instituições: a Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy b Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy c Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Tradate, Varese-Como, Italy d World Health Organization Regional Office for Europe, Copenhagen, Denmark e Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK f Division of Infection, Royal London Hospital, Barts Health NHS Trust, London, UK g Faculdade de Medicina, Universidade Federal do Rio Grande do Sul --- UFRGS, Porto Alegre, Brazil h Public Health Consulting Group, Lugano, Switzerland i Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, Virginia, USA j Department of Infectious Diseases, Galliera Hospital, Genova, Italy k Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy l Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa

Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/49226

Type

Copyright

Open access

Collections

Share

Statistics

Metadata

Author

Affilliation