Impact of COVID-19 pandemic on Tubercolar Infection treatment in Italy: a multicentric retrospective analysis

Introduction: This study aims to assess the impact of COVID-19 pandemic on Tuberculosis Infection (TBI) treatment in Italy between 2019 and 2023. Methods: This multi-centric observational retrospective study analyzed TBI treatment data from 7 Italian TB centers (2019-2023), including patient origin, clinical indications, and outcomes. Completion (CR) and loss to follow-up (LR) rates were calculated yearly. Results: We included 7,830 patients (CR 75%, LR 10%). In 2019, 1,714 received treatment (CR 73%, LR 11%, see image 1), mainly TB-case contacts (38%) and homeless individuals (25%). In 2020, treatments were 1,034 (CR 77%, LR 9%), primary indication remained TB-case contacts (40%), refugees decreased (22%). In 2021, 1,551 treatments (CR 78%, LR 11%), with TB-case contacts declining (28%). Similarly, in 2022, 1,506 treatments (CR 76%, LR 11%) with TB-case contacts declining (23%). In 2023, 2,025 treatments (CR 75%, LR 10%), 47% refugees/homeless, 21% TB-case contacts. PA1764_80904_0_Figure1_638755875138010000 Conclusions: In 2020 TBI treatments dropped to 1,034 (-40%), mainly among homeless individuals (-48%), reflecting COVID-19 pandemic’s impact. Treatment numbers slowly increased, surpassing pre-pandemic levels in 2023 (+15% vs. 2019). However, TB-case contacts remained lower (38% in 2019 vs. 21% in 2023), despite increased TB notifications in 2021. Therapy completion rates remained stable (~75%), demonstrating effective case-holding processes.