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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 |
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creator | 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 |
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. |
doi_str_mv | 10.1016/j.pulmoe.2020.12.016 |
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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.</description><identifier>ISSN: 2531-0437</identifier><identifier>ISSN: 2531-0429</identifier><identifier>EISSN: 2531-0437</identifier><identifier>DOI: 10.1016/j.pulmoe.2020.12.016</identifier><identifier>PMID: 33547028</identifier><language>eng</language><publisher>Spain: Elsevier España, S.L.U</publisher><subject>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</subject><ispartof>Pulmonology, 2021-05, Vol.27 (3), p.248-256</ispartof><rights>2021 Sociedade Portuguesa de Pneumologia</rights><rights>Copyright © 2021 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.</rights><rights>2021 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. 2021 Sociedade Portuguesa de Pneumologia</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c463t-a2cc1f6b6166352f0177a679b1828210fa2c82bf40a4cc17c88a834cf0f50f5a3</citedby><cites>FETCH-LOGICAL-c463t-a2cc1f6b6166352f0177a679b1828210fa2c82bf40a4cc17c88a834cf0f50f5a3</cites><orcidid>0000-0002-7000-5777 ; 0000-0003-2298-1623 ; 0000-0002-1085-0442 ; 0000-0002-3929-6369 ; 0000-0001-5755-4133 ; 0000-0002-2597-574X ; 0000-0002-6417-6668 ; 0000-0002-8551-3598 ; 0000-0002-5131-9367 ; 0000-0003-0230-2734</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S2531043721000362$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,3549,27924,27925,45780</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33547028$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Migliori, Giovanni Battista</creatorcontrib><creatorcontrib>Visca, Dina</creatorcontrib><creatorcontrib>van den Boom, Martin</creatorcontrib><creatorcontrib>Tiberi, Simon</creatorcontrib><creatorcontrib>Silva, Denise Rossato</creatorcontrib><creatorcontrib>Centis, Rosella</creatorcontrib><creatorcontrib>D’Ambrosio, Lia</creatorcontrib><creatorcontrib>Thomas, Tania</creatorcontrib><creatorcontrib>Pontali, Emanuele</creatorcontrib><creatorcontrib>Saderi, Laura</creatorcontrib><creatorcontrib>Schaaf, H. Simon</creatorcontrib><creatorcontrib>Sotgiu, Giovanni</creatorcontrib><creatorcontrib>contributing members of the Global Tuberculosis Network</creatorcontrib><title>Tuberculosis, COVID-19 and hospital admission: Consensus on pros and cons based on a review of the evidence</title><title>Pulmonology</title><addtitle>Pulmonology</addtitle><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.</description><subject>Consensus</subject><subject>Costs</subject><subject>COVID-19</subject><subject>COVID-19 - complications</subject><subject>COVID-19 - therapy</subject><subject>Discharge</subject><subject>Hospital admission</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Hospitalization criteria</subject><subject>Humans</subject><subject>Infection control and prevention</subject><subject>Length of stay</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Practice Guidelines as Topic</subject><subject>SARS-CoV-2</subject><subject>The pulmonology TB series 2021. Edited by Raquel Duarte and Giovanni Battista Migliori</subject><subject>Tuberculosis - complications</subject><subject>Tuberculosis - therapy</subject><issn>2531-0437</issn><issn>2531-0429</issn><issn>2531-0437</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9UdFuFCEUJY1N27T9g8bw6IOzcoGZYX0wMWvVJk36Un0lDHNxWWdhhJk2_n1Zt631xYQEOJx7LvccQi6ALYBB826zGOdhG3HBGS8QXxTwgJzwWkDFpGhfvTgfk_OcN4wVJuNCwRE5FqKWLePqhPy8nTtMdh5i9vktXd18v_pUwZKa0NN1zKOfzEBNv_U5-xje01UMGUOeM42BjinmP0xbUNqZjP0ONjThncd7Gh2d1kjLpcdg8YwcOjNkPH_cT8m3z5e3q6_V9c2Xq9XH68rKRkyV4daCa7oGmkbU3DFoW9O0yw4UVxyYKwTFOyeZkYXZWqWMEtI65uqyjDglH_a649xtsbcYpmQGPSa_Nem3jsbrf1-CX-sf8U63SgqQyyLw5lEgxV8z5kmX-S0OgwkY56y5VC3UHGooVLmn2uJFTuie2wDTu6j0Ru-j0ruoNHBdwFL2-uUXn4uegvk7AxajiplJZ-t3JvY-oZ10H_3_OzwAgqqnSw</recordid><startdate>20210501</startdate><enddate>20210501</enddate><creator>Migliori, Giovanni Battista</creator><creator>Visca, Dina</creator><creator>van den Boom, Martin</creator><creator>Tiberi, Simon</creator><creator>Silva, Denise Rossato</creator><creator>Centis, Rosella</creator><creator>D’Ambrosio, Lia</creator><creator>Thomas, Tania</creator><creator>Pontali, Emanuele</creator><creator>Saderi, Laura</creator><creator>Schaaf, H. 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Published by Elsevier España, S.L.U</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-7000-5777</orcidid><orcidid>https://orcid.org/0000-0003-2298-1623</orcidid><orcidid>https://orcid.org/0000-0002-1085-0442</orcidid><orcidid>https://orcid.org/0000-0002-3929-6369</orcidid><orcidid>https://orcid.org/0000-0001-5755-4133</orcidid><orcidid>https://orcid.org/0000-0002-2597-574X</orcidid><orcidid>https://orcid.org/0000-0002-6417-6668</orcidid><orcidid>https://orcid.org/0000-0002-8551-3598</orcidid><orcidid>https://orcid.org/0000-0002-5131-9367</orcidid><orcidid>https://orcid.org/0000-0003-0230-2734</orcidid></search><sort><creationdate>20210501</creationdate><title>Tuberculosis, COVID-19 and hospital admission: Consensus on pros and cons based on a review of the evidence</title><author>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. 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Simon</au><au>Sotgiu, Giovanni</au><aucorp>contributing members of the Global Tuberculosis Network</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Tuberculosis, COVID-19 and hospital admission: Consensus on pros and cons based on a review of the evidence</atitle><jtitle>Pulmonology</jtitle><addtitle>Pulmonology</addtitle><date>2021-05-01</date><risdate>2021</risdate><volume>27</volume><issue>3</issue><spage>248</spage><epage>256</epage><pages>248-256</pages><issn>2531-0437</issn><issn>2531-0429</issn><eissn>2531-0437</eissn><abstract>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.</abstract><cop>Spain</cop><pub>Elsevier España, S.L.U</pub><pmid>33547028</pmid><doi>10.1016/j.pulmoe.2020.12.016</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-7000-5777</orcidid><orcidid>https://orcid.org/0000-0003-2298-1623</orcidid><orcidid>https://orcid.org/0000-0002-1085-0442</orcidid><orcidid>https://orcid.org/0000-0002-3929-6369</orcidid><orcidid>https://orcid.org/0000-0001-5755-4133</orcidid><orcidid>https://orcid.org/0000-0002-2597-574X</orcidid><orcidid>https://orcid.org/0000-0002-6417-6668</orcidid><orcidid>https://orcid.org/0000-0002-8551-3598</orcidid><orcidid>https://orcid.org/0000-0002-5131-9367</orcidid><orcidid>https://orcid.org/0000-0003-0230-2734</orcidid><oa>free_for_read</oa></addata></record> |
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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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