Impact of COVID-19 pandemic and country of origin on TB treatment outcome in Greece

INTRODUCTION Tuberculosis (TB) remains a cause of morbidity and mortality in Greece. The aim of this study was to assess TB treatment outcome (based on the new WHO definitions) according to date of diagnosis (before or during the COVID-19 pandemic) and country of origin. Positive outcome was defined as cure and completion of treatment, and negative outcome as lost to follow-up, failure or not evaluated. Death was assessed separately. METHODS Patients registered at the Department of Pulmonary Medicine, Aristotle University of Thessaloniki, Greece, during the period 2018-2021, were retrospectively studied. RESULTS A total of 102 patients (51 before and 51 during the pandemic), with mean age 44.8 +/- 21.9 years, were included; 15 were women and 87 men, 45 were Greeks, 12 other Europeans, and 45 non-Europeans. Before the pandemic, 32 patients (62.8%) had positive outcome, 15 (29.4%) negative, and 4 (7.8%) died. During the pandemic, positive outcome was noted in 28 (54.9%), negative in 20 (39.2%), and 3 patients (5.9%) died (p=0.66). Greeks had a positive outcome rate of 66.7%, other Europeans 83.3%, and non-Europeans 44.4%. Negative outcome rate among patients was: 17.8% for Greeks, 16.7% for other Europeans, and 55.6% for non-Europeans (p<0.001). Greeks had the highest mortality rate (15.6%), with both other groups having zero deaths. CONCLUSIONS The pandemic did not affect significantly treatment outcomes, as members of staff worked exclusively on TB. Country of origin significantly affected outcome, with non-European patients having the highest negative outcome rate. This observation can be attributed to the lack of social and/or familial support.