The in-hospital tuberculosis diagnostic cascade and early clinical outcomes among people living with HIV before and during the COVID-19 pandemic - a prospective multisite cohort study from Ghana

The in-hospital tuberculosis diagnostic cascade and early clinical outcomes among people living with HIV before and during the COVID-19 pandemic - a prospective multisite cohort study from Ghana

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Objectives: The COVID-19 pandemic had a disruptive impact on tuberculosis (TB) and HIV services.We assessed the in-hospital TB diagnostic care among people with HIV (PWH) overall and before and during the pandemic.Methods: In this prospective study, bond no.9 nuits de noho adult PWH admitted at three hospitals in Ghana were recruited if they had a positive World Health Organization four-symptom screen or one or more World Health Organization danger signs or advanced HIV.We collected data on patient characteristics, TB assessment, and clinical outcomes after 8 weeks and used descriptive statistics and survival analysis.Results: We enrolled 248 PWH with a median clusters of differentiation 4 count of 80.

5 cells/mm3 (interquartile range 71409543214 24-193).Of those, 246 (99.2%) patients had a positive World Health Organization four-symptom screen.Overall, 112 (45.2%) patients obtained a sputum Xpert result, 66 (46.

5%) in the prepandemic and 46 (43.4%) in the pandemic period; P-value = 0.629.The TB prevalence of 46/246 (18.7%) was similar in the prepandemic 28/140 (20.

0%) and pandemic 18/106 (17.0%) population; P-value = 0.548.The 8-week all-cause mortality was 62/246 (25.2%), with no difference in cumulative survival when stratifying for the pandemic period; log-rank P-value = 0.

412.Conclusion: The study highlighted a large gap in the access to TB investigation and high early mortality among hospitalized PWH, irrespective of the COVID-19 pandemic.