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Tuberculosis, COVID-19 and hospital admission: Consensus on pros and cons based on a review of the evidence

The scientific debate on the criteria guiding hospitalization of tuberculosis (TB) and COVID-19 patients is ongoing. The aim of this review is to present the available evidence on admission for TB and TB/COVID-19 patients and discuss the criteria guiding hospitalization. Furthermore, recommendations...

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Published in:Pulmonology 2021-05, Vol.27 (3), p.248-256
Main Authors: Migliori, Giovanni Battista, Visca, Dina, van den Boom, Martin, Tiberi, Simon, Silva, Denise Rossato, Centis, Rosella, D’Ambrosio, Lia, Thomas, Tania, Pontali, Emanuele, Saderi, Laura, Schaaf, H. Simon, Sotgiu, Giovanni
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description The scientific debate on the criteria guiding hospitalization of tuberculosis (TB) and COVID-19 patients is ongoing. The aim of this review is to present the available evidence on admission for TB and TB/COVID-19 patients and discuss the criteria guiding hospitalization. Furthermore, recommendations are made as derived from recently published World Health Organization documents, based on Global Tuberculosis Network (GTN) expert opinion. The core published documents and guidelines on the topic have been reviewed. The proportion of new TB cases admitted to hospital ranges between 50% and 100% while for multidrug-resistant (MDR) TB patients it ranges between 85 and 100% globally. For TB patients with COVID-19 the proportion of cases admitted is 58%, probably reflecting different scenarios related to the diagnosis of COVID-19 before, after or at the same time of the active TB episode. The hospital length of stay for drug-susceptible TB ranges from 20 to 60 days in most of countries, ranging from a mean of 10 days (USA) to around 90 days in the Russian Federation. Hospitalization is longer for MDR-TB (50–180 days). The most frequently stated reasons for recommending hospital admission include: severe TB, infection control concerns, co-morbidities and drug adverse events which cannot be managed at out-patient level. The review also provides suggestions on hospital requirements for safe admissions as well as patient discharge criteria, while underlining the relevance of patient-centred care through community/home-based care.
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subjects Consensus
Costs
COVID-19
COVID-19 - complications
COVID-19 - therapy
Discharge
Hospital admission
Hospitalization - statistics & numerical data
Hospitalization criteria
Humans
Infection control and prevention
Length of stay
Length of Stay - statistics & numerical data
Practice Guidelines as Topic
SARS-CoV-2
The pulmonology TB series 2021. Edited by Raquel Duarte and Giovanni Battista Migliori
Tuberculosis - complications
Tuberculosis - therapy
title Tuberculosis, COVID-19 and hospital admission: Consensus on pros and cons based on a review of the evidence
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