Table. Characteristics of Persons Diagnosed With Tuberculosis (TB) and COVID-19 Within 120 Days vs Persons With TB Before COVID-19 Pandemic in Californiaa.
| Characteristic | TB and COVID-19 | TB before pandemic | P value | ||
|---|---|---|---|---|---|
| No./total No. | % (95% CI) | No./total No. | % (95% CI) | ||
| Participants, No. | 91 | NA | 6280 | NA | NA |
| Age, median (IQR), y | 91/91 | 58.0 (41.0-73.0) | 6280/6280 | 56.0 (35.0-70.0) | .16 |
| Sex | |||||
| Female | 39/91 | 42.9 (32.5-53.7) | 2441/6280 | 38.9 (37.7-40.1) | .44 |
| Male | 52/91 | 57.1 (46.3-67.5) | 3839/6280 | 61.1 (59.9-62.3) | |
| Race and/or ethnicity | |||||
| Asian or Pacific Islander | 28/91 | 30.8 (21.5-41.3) | 3323/6279 | 52.9 (51.7-54.2) | <.001 |
| Black | 4/91 | 4.4 (1.2-10.9) | 288/6279 | 4.6 (4.1-5.1) | |
| Hispanic or Latino | 55/91 | 60.4 (49.6-70.5) | 2285/6279 | 36.4 (35.2-37.6) | |
| White | 4/91 | 4.4 (1.2-10.9) | 372/6279 | 5.9 (5.4-6.5) | |
| Otherb | 0 | 0 | 11/6279 | 0.2 (0.1-0.3) | |
| Not born in US | 81/91 | 89.0 (80.7-94.6) | 5158/6268 | 82.3 (81.3-83.2) | .09 |
| Years in US before TB diagnosis, median (IQR) | 76/81 | 23.1 (15.2-31.5) | 4914/5158 | 19.7 (7.2-32.3) | .03 |
| Healthy Places Index score quartile | |||||
| 1 (least advantaged) | 40/89 | 44.9 (34.4-55.9) | 1984/6027 | 32.9 (31.7-34.1) | .003 |
| 2 | 29/89 | 32.6 (23.0-43.3) | 1569/6027 | 26.0 (24.9-27.2) | |
| 3 | 15/89 | 16.9 (9.8-26.3) | 1378/6027 | 22.9 (21.8-24.0) | |
| 4 (most advantaged) | 5/89 | 5.6 (1.9-12.6) | 1096/6027 | 18.2 (17.2-19.2) | |
| Previous TB disease | 1/90 | 1.1 (0.0-6.0) | 323/6276 | 5.1 (4.6-5.7) | .09 |
| Site of TB disease | |||||
| Pulmonary only | 65/91 | 71.4 (61.0-80.4) | 4357/6278 | 69.4 (68.2-70.5) | .88 |
| Nonpulmonary only | 16/91 | 17.6 (10.4-27.0) | 1129/6278 | 18.0 (17.0-19.0) | |
| Pulmonary and nonpulmonary | 10/91 | 11.0 (5.4-19.3) | 792/6278 | 12.6 (11.8-13.5) | |
| Positive sputum smear test result for pulmonary TBc | 45/71 | 63.4 (51.1-74.5) | 2515/4870 | 51.6 (50.2-53.1) | .05 |
| Cavitary pulmonary diseased | 33/74 | 44.6 (33.0-56.6) | 1709/5133 | 33.3 (32.0-34.6) | .04 |
| Disseminated TB diseasee | 13/91 | 14.3 (7.8-23.2) | 977/6280 | 15.6 (14.7-16.5) | .74 |
| Any initial isoniazid or rifampicin resistance | 4/60 | 6.7 (1.9-16.2) | 543/5136 | 10.6 (9.7-11.5) | .33 |
| Medical risk factors | |||||
| Diabetes | 42/91 | 46.2 (35.6-56.9) | 1734/6280 | 27.6 (26.5-28.7) | <.001 |
| HIV | 4/82 | 4.9 (1.3-12.0) | 197/5576 | 3.5 (3.1-4.1) | .54 |
| End-stage kidney disease | 5/91 | 5.5 (1.8-12.4) | 250/6280 | 4.0 (3.5-4.5) | .41 |
| Other immunocompromised conditionf | 7/91 | 7.7 (3.2-15.2) | 471/6280 | 7.5 (6.9-8.2) | .94 |
| Two or more medical risk factors | 7/91 | 7.7 (3.2-15.2) | 245/6280 | 3.9 (3.4-4.4) | .09 |
| Occupation | |||||
| Health care worker | 5/82 | 6.1 (2.0-13.7) | 246/6162 | 4.0 (3.5-4.5) | .57 |
| Correctional facility employee | 0 | 1/6162 | 0 (0-0.1) | ||
| Migrant or seasonal worker | 2/82 | 2.4 (0.3-8.5) | 125/6162 | 2.0 (1.7-2.4) | |
| Other occupation | 21/82 | 25.6 (16.7-36.4) | 2075/6162 | 33.7 (32.5-34.9) | |
| Not employed | 54/82 | 65.9 (54.6-76.0) | 3715/6162 | 60.3 (59.1-61.5) | |
| Social and behavioral characteristics | |||||
| Homeless | 2/89 | 2.2 (0.3-7.9) | 325/6256 | 5.2 (4.7-5.8) | .33 |
| Correctional facility resident | 2/91 | 2.2 (0.3-7.7) | 158/6274 | 2.5 (2.1-2.9) | >.99 |
| Long-term care facility resident | 5/91 | 5.5 (1.8-12.4) | 148/6271 | 2.4 (2.0-2.8) | .07 |
| Substance misuseg | 7/87 | 8.0 (3.3-15.9) | 650/6138 | 10.6 (9.8-11.4) | .44 |
| Deaths stratified by interval between TB and COVID-19 diagnosesh | |||||
| Within 120 d | 15/91 | 16.5 (9.5-25.7) | 631/5545 | 11.4 (10.6-12.2) | .13 |
| Within 90 d | 13/69 | 18.8 (10.4-30.1) | NA | NA | .05 |
| Within 60 d | 10/51 | 19.6 (9.8-33.1) | NA | NA | .07 |
| Within 30 d | 8/34 | 23.5 (10.8-41.2) | NA | NA | .05 |
| Dead at TB diagnosis | 2/91 | 2.2 (0.3-7.7) | 119/6280 | 1.9 (1.6-2.3) | .69 |
Abbreviation: NA, not applicable.
Statistical comparisons were made using χ2 or Fisher exact tests for categorical data and the Wilcoxon 2-sample test for continuous data. The TB diagnosis date was defined as the earliest of report date, treatment start date, or specimen collection date during which a positive result on a culture or nucleic acid amplification analysis was recorded. The COVID-19 diagnosis date was defined as the earliest laboratory specimen collection date with a positive test result. Persons with TB/COVID-19 were those successively diagnosed with TB and COVID-19 within 120 days for whom at least one of the diseases was diagnosed in 2020. Persons with TB before the pandemic included those diagnosed with TB between January 1, 2017, and December 31, 2019. In general, 174 TB cases were diagnosed per month during this period. From September 3, 2019, to December 31, 2020, approximately 147 TB cases were diagnosed per month. Unknown and missing values were excluded from all subcategories.
Includes American Indian or Alaska Native (2 of 6279 persons [0.03%]) and multiple races or ethnicities (9 of 6279 persons [0.1%]).
Denominator does not sum to total number with pulmonary TB because not all persons with pulmonary TB received a sputum smear test for acid-fast bacilli.
Cavity identified on chest radiography or computed tomography among persons with pulmonary TB when imaging was performed.
Meningeal, miliary, positive result on acid-fast bacilli blood culture, or both pulmonary and extrapulmonary TB.
Includes persons receiving immunosuppressive therapies (eg, tumor necrosis factor α antagonist or high-dose steroid medications) and persons with medical conditions, such as hematological cancer.
Any illicit injectable or noninjectable drug use or excess alcohol consumption within the 12 months before TB diagnosis.
Statistical comparison was made between all prepandemic TB deaths (631 of 5545 persons [11.4%]) and TB/COVID-19 deaths within each interval between diagnoses.