Tuberculosis during the COVID-19 Pandemic: Retrospective Analysis in a Tertiary Hospital in Portugal

Introduction: Tuberculosis (TB) remains a major public health challenge despite being a preventable and curable infectious disease. Early diagnosis and access to treatment are essential to tackle its transmission and mortality. The COVID-19 pandemic led to worldwide healthcare service disruptions and an underrecognized impact on the global fight against TB. Objective: To describe the clinical and epidemiological characteristics of TB patients diagnosed during the COVID-19 pandemic period. Methods: We conducted a retrospective observational study at a tertiary hospital center in Porto, Portugal, reviewing all patients admitted and diagnosed with TB between January 2020 and December 2022. Demographic data, clinical manifestations, immunosuppression status, microbiological and radiological findings, treatment and outcomes were analysed. Results: A total of 72 patients were diagnosed with TB during the study period. Most were male with a median age of 54 years. More than one-third were immunosuppressed. The median interval from symptom onset to diagnosis was 60 days. Pulmonary TB with sputum-smear positivity and cavitary lesions accounted for the majority of cases. Treatment was initiated in all but one patient. Overall, most patients (88.9%) achieved successful outcomes. Conclusion: During the COVID-19 pandemic, significant delays in TB diagnosis led to a substantial proportion of patients presenting with advanced pulmonary disease. These findings underscore the constraints felt during an unprecedented health crisis and the need for resilient TB programs capable of maintaining diagnostic and treatment services. Further research is warranted to quantify the long-term effects of the pandemic on TB control efforts.