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Volume 29, Number 10—October 2023
Research

Characteristics of and Deaths among 333 Persons with Tuberculosis and COVID-19 in Cross-Sectional Sample from 25 Jurisdictions, United States

Scott A. NabityComments to Author , Suzanne M. Marks, Neela D. Goswami, Shona R. Smith, Evan Timme, Sandy F. Price, Lon Gross, Julie L. Self, Katelynne Gardner Toren, Masahiro Narita, Donna H. Wegener, Shu-Hua Wang, and for the National Tuberculosis Controllers Association/CDC TB-COVID-19 Collaboration1
Author affiliations: California Department of Public Health, Richmond, California, USA (S.A. Nabity); Centers for Disease Control and Prevention, Atlanta, USA (S.A. Nabity, S.M. Marks, N.D. Goswami, S.F. Price, L. Gross, J.L. Self); Michigan Department of Health and Human Services, Lansing, Michigan, USA (S.R. Smith); Arizona Department of Health Services, Phoenix, Arizona, USA (E. Timme); Public Health–Seattle & King County, Seattle, Washington, USA (K. Gardner Toren, M. Narita); University of Washington, Seattle (M. Narita); National Tuberculosis Controllers Association, Atlanta (D.H. Wegener); The Ohio State University College of Medicine, Columbus, Ohio, USA (S.-H. Wang)

Main Article

Table 1

Characteristics of 333 persons from 25 US jurisdictions who were diagnosed with TB–COVID-19 in 2020 and persons with TB only diagnosed in 2017‒2019 or in 2020*

Characteristic 2020 TB–COVID-19 2020 TB only
 2017‒2019 TB only
Value p value Value p value
Total no.
 333
4,433
18,898
Median age at TB diagnosis, y (IQR) 55 (35‒69) 51 (32‒66) 0.0834 50 (32‒66) 0.0564
0‒4 <5 104 (2.3) 0.0373 435 (2.3) 0.0389
5‒14 6 (1.8) 92 (2.1) 0.7345 360 (1.9) 0.8914
15‒24 33 (9.9) 440 (9.9) 0.9927 1,778 (9.4) 0.7561
25‒44 82 (24.6) 1,220 (27.5) 0.2527 5,525 (29.2) 0.0720
45‒64 106 (31.8) 1,341 (30.2) 0.5450 5,700 (30.2) 0.5105
65‒74 53 (15.9) 630 (14.2) 0.3920 2,469 (13.1) 0.1266
75‒85 39 (11.7) 416 (9.4) 0.1634 1,842 (9.8) 0.2316
>85
 12 (3.6)
190 (4.3)
 0.5511
807 (4.3)
 0.5503
Sex
M 204 (61.3) 2,707 (61.1) 0.9435 11,602 (61.4) 0.9601
F
 129 (38.7)
1,726 (38.9)
7,296 (38.6)
Race/ethnicity
Missing/unknown 2 13 61
White 26 (7.8) 445 (10.1) 0.1939 1,993 (10.6) 0.1094
Black 49 (14.8) 787 (17.8) 0.1666 3,201 (17.0) 0.2926
Asian 101 (30.5) 1,691 (38.3) 0.0051 7,047 (37.4) 0.0101
Hispanic 146 (44.1) 1,433 (32.4)† <0.0001 6,278 (33.3)‡ <0.0001
NHOPI 5 (1.5) 25 (0.6) 0.0363 128 (0.7) 0.0710
American Indian/Alaska Native <5 13 (0.3) 0.0072 99 (0.5) 0.0921
Multiple
 0
26 (0.6)
91 (0.5)
Non–US-born 264 (79.3) 3,195 (72.3) 0.0059 13,645 (72.2) 0.0045
Missing/Unknown
 0
15
12
Years in United States, non–US born
 17 (7‒27)
12 (3‒28)
 0.0031
12 (2‒26)‡
 0.0005
Long-term care facility resident at time of TB diagnosis§ 15 (4.6) 68 (1.6)† <0.0001 341 (1.9)‡ 0.0004
Missing/unknown
 10
207
822
Correctional facility resident at time of TB diagnosis¶ 11 (3.4) 137 (3.3) 0.8876 694 (3.8) 0.6739
Missing/unknown
 9
218
864
Homeless within year before TB diagnosis§ 12 (3.7) 179 (4.2) 0.6549 826 (4.6) 0.4638
Missing/unknown
 11
217
891
Excessive alcohol within year before TB diagnosis§ 24 (7.6) 366 (8.8) 0.4692 1,488 (8.3) 0.6349
Missing/unknown
 17
267
1,055
Drug use within year before TB diagnosis¶ 14 (4.4) 322 (7.7) 0.0332 1,384 (7.8) 0.0293
Missing/Unknown
 18
262
1,029
Employed§ 123 (74.5) 1,623 (66.6) 0.0346 7,604 (67.5) 0.0540
Missing/unknown
 49
365
504
Healthcare worker§ 15 (5.2) 144 (3.5) 0.1007 631 (3.4) 0.0538
Missing/unknown
 47
365
504
Previous episode of TB 11 (3.4) 215 (4.9) 0.2135 872 (4.6) 0.2753
Missing/unknown
 6
32
110
Site of TB disease
Missing/unknown 0 0 5
Pulmonary only 223 (67.0) 2,997 (67.6) 0.8100 12,950 (68.5) 0.5391
Extrapulmonary only 69 (20.7) 874 (19.7) 0.6571 3,749 (19.8) 0.6907
Both
 41 (12.3)
562 (12.7)
 0.8467
2,194 (11.6)
 0.6930
HIV-positive at TB diagnosis 14 (4.7) 186 (4.8) 0.9740 811 (4.9) 0.9011
Missing/unknown
 37
535
2,302
Other immunocompromising condition#
 27 (8.1)
285 (6.4)
 0.2323
998 (5.3)
 0.0228
Diabetes
 122 (36.6)
1,044 (23.6)†
 <0.0001
4,138 (21.9)‡
 <0.0001
End-stage renal disease
 21 (6.3)
155 (3.5)
 0.0087
544 (2.9)‡
 0.0002
AFB sputum smear positive 155 (53.3) 1795 (46.9) 0.0373 7354 (45.2) 0.0061
Missing/unknown
 42
609
2,623
Sputum Mycobacterium tuberculosis complex culture–positive 206 (71.8) 2,566 (67.9) 0.1782 11,077 (69.6) 0.4360
Missing/unknown
 46
657
3,003
NAAT-positive 210 (82.4) 2,458 (74.1) 0.0034 9,648 (72.5) 0.0004
Missing/unknown
 78
1,115
5,583
Cavity on chest imaging** 119 (41.6) 1,395 (36.6) 0.0935 5,777 (35.6) 0.0350
Missing/unknown
 47
626
2,663
Disseminated TB†† 60 (18.0) 717 (16.2) 0.3797 2,763 (14.6) 0.0925

*Values are no. (%) except as indicated. Percentages were calculated after subtracting missing and unknown responses. AFB, acid-fast bacilli; IQR, interquartile range; NAAT, nucleic acid amplification test; NHOPI, Native Hawaiian and other Pacific Islander; TB, tuberculosis; TB–COVID-19, diagnosed with both TB and COVID-19 within 180 days. †Statistically significant comparison between persons with TB–COVID-19 and 2020 TB-only with Bonferroni correction (critical value 0.0017). ‡Statistically significant comparison between persons with TB–COVID-19 and 2017‒2019 TB-only with Bonferroni correction (critical value 0.0017). §Among persons >15 years of age. ¶Among persons >15 years of age. Includes injecting and noninjecting drugs. #Non-HIV immunocompromising condition attributable to medical conditions, such as hematologic or reticuloendothelial malignancies (e.g., leukemia, Hodgkin’s lymphoma, carcinoma of the head or neck), or immunosuppressive therapy, such as prolonged use of high-dose adrenocorticosteriods (e.g., prednisone), but not including immunocompromising condition related to HIV infection. **Among persons with pulmonary TB having chest radiograph, chest computed tomography, or both. ††Defined as both pulmonary and extrapulmonary sites of disease, positive blood culture for Mycobacterium tuberculosis complex, meningitis, or miliary pattern on imaging.

Main Article

1Group members are listed at the end of this article.

Page created: August 08, 2023
Page updated: September 20, 2023
Page reviewed: September 20, 2023
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