Tuberculosis Diagnostic Delays and Treatment Outcomes among Patients with COVID-19, California, USA, 2020
Emily Han
1, Scott A. Nabity
1 , Shom Dasgupta-Tsinikas, Ramon E. Guevara, Marisa Moore, Ankita Kadakia, Hannah Henry, Martin Cilnis, Sonal Buhain, Amit Chitnis, Melony Chakrabarty, Ann Ky, Quy Nguyen, Julie Low, Seema Jain, Julie Higashi, Pennan M. Barry, and Jennifer Flood
Author affiliations: California Department of Public Health, Richmond, California, USA (E. Han, S.A. Nabity, H. Henry, M. Cilnis, S. Jain, P.M. Barry, J. Flood); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S.A. Nabity, M. Moore); Los Angeles County Department of Public Health, Los Angeles, California, USA (S. Dasgupta-Tsinikas, R.E. Guevara, J. Higashi); San Diego County Health and Human Services Agency, San Diego, California, USA (M. Moore, A. Kadakia); Alameda County Public Health Department, San Leandro, California, USA (S. Buhain, A. Chitnis); Sacramento County Health Services, Sacramento, California, USA (M. Chakrabarty); Santa Clara County Public Health Department, San Jose, California, USA (A. Ky); Orange County Health Care Agency, Santa Ana, California, USA (Q. Nguyen, J. Low)
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Figure 2
Figure 2. Timeline of 8 patients included in a study of TB diagnostic delays and treatment outcomes among patients with COVID-19, California, USA, 2020. Symptom onset is the date the first symptoms compatible with either TB or COVID-19 was identified. Symptom onset for patient 6 was in June 2019. Patient 7 was hospitalized for reasons unrelated to TB or COVID-19, and the TB diagnostic work-up was prompted by incidental findings on chest imaging. The healthcare visit of a missed opportunity to diagnose TB in a person with TB risk factors was a visit where >1 symptom or chest imaging finding was known. Yellow shading captures the number of days between the first missed opportunity and the first specimen collection for a TB diagnosis. Elevated COVID-19 incidence in California was considered >15 cases/100,000 population (7-day average rate). TB, tuberculosis.
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