Impact of Prior COVID-19 on the Demographics & Exposure Pattern of Tuberculosis Patients: A Cross-Sectional Study

Abstract

Introduction: Tuberculosis (TB) remains a major global public health concern. Although TB mortality had been declining until 2019, it reversed during 2020–2021, as highlighted in the Global Tuberculosis Report 2022, largely due to disruptions caused by the COVID-19 pandemic. While COVID-19 has affected TB control programs worldwide, limited data exist on its impact on the demographic and exposure profiles of TB patients, especially in endemic regions.

Aim & Objective: To assess the impact of prior COVID-19 infection on the demographics and exposure patterns of TB patients.

Materials & Methods: This hospital-based cross-sectional study included 482 adult TB patients at a tertiary care center (January 2025–January 2026). Data on age, sex, previous TB history, TB contact, prior COVID-19 infection, vaccination status, steroid use, and hospitalization were collected. Statistical analysis included descriptive statistics, Chi-square/Fisher’s exact test, and binary logistic regression to identify predictors of previous TB history and TB contact.

Results: The mean age was 36.3 ± 15.98 years, with most patients aged 18–27 years (34.0%). Females constituted 63.3% of cases. Previous TB history was present in 54.4%, and 57.9% reported TB contact. Prior COVID-19 infection was documented in 57.3% of patients. A significant association was observed between TB contact and previous TB history (p < 0.001). Logistic regression showed that TB contact increased the odds of previous TB by approximately fourfold (OR = 4.04, 95% CI: 2.75–5.92).

Conclusion: COVID-19 related factors showed no significant association with TB history or contact. Traditional risk factors, particularly TB contact and prior TB, remain key determinants, emphasizing the need to strengthen core TB control strategies.