Impact of COVID-19 pandemic, and the mediating role of hospital caseload and severity on mortality of hospitalised tuberculosis patients in Thailand.

IF 4.6 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Global Health Research and Policy Pub Date : 2025-08-25 DOI:10.1186/s41256-025-00437-7

Nyi Nyi Zayar, Rassamee Chotipanvithayakul, Alan Frederick Geater, Kyaw Ko Ko Htet, Chumpol Ngamphiw, Virasakdi Chongsuvivatwong

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引用次数: 0

Abstract

Background: The COVID-19 hospital caseload indicates the quality of hospital care, as resources were redirected to address the surge in COVID-19 cases. The study aimed to evaluate the impact of COVID-19 hospital caseload on hospital tuberculosis (TB) case fatality rate (CFR) mediated by the TB caseload and severity of patients.

Methods: A retrospective analysis of TB patients' hospital admission data in Thailand extracted from the Thai Health Information Portal database between January 2017 and September 2022. Charlson Comorbidity Index (CCI) was used to determine the severity of hospitalised TB patients. An interrupted time series analysis, lag time analysis and serial mediation analysis were done.

Results: During COVID-19 pandemic, there was a 12.9% decrease in monthly hospital TB caseload, and a 14.1% increase in monthly TB hospital CFR compared to the counterfactual scenario had there been no COVID-19. COVID-19 hospital caseload had a strong negative correlation with TB hospital caseload (r = - 0.60, p-value = < 0.001), but a strong positive correlation with TB hospital CFR (r = 0.74, p-value = < 0.001) during the same month. An increase in average CCI score of 0.1 was associated with an increase of 2.3 deaths per 100 TB admissions. After adjusting the TB caseload and CCI of TB patients admitted to the hospital, no association was found between COVID-19 hospital caseload and the hospital CFR of TB patients.

Conclusions: The increase in TB hospital CFR during COVID-19 pandemic was likely driven by a higher proportion of severe cases being admitted, rather than a decline in hospitals' quality of care.

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COVID-19大流行对泰国住院结核病患者死亡率的影响，以及医院病例量和严重程度的中介作用

背景：COVID-19医院病例量表明医院护理质量，因为资源被重新定向用于应对COVID-19病例激增。本研究旨在评估COVID-19医院病例量对TB病例量和患者严重程度介导的医院结核病病死率（CFR）的影响。方法：回顾性分析2017年1月至2022年9月泰国卫生信息门户数据库中提取的泰国结核病患者入院数据。Charlson共病指数（CCI）用于确定住院结核病患者的严重程度。进行了中断时间序列分析、滞后时间分析和序列中介分析。结果：在2019冠状病毒病大流行期间，与未发生COVID-19的情况相比，每月医院结核病病例数减少12.9%，每月结核病医院CFR增加14.1%。COVID-19医院病例量与结核病医院病例量呈强负相关（r = - 0.60， p值=）结论：COVID-19大流行期间结核病医院CFR的增加可能是由于入院重症病例比例较高，而不是医院护理质量下降所致。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Global Health Research and Policy Social Sciences-Health (social science)

CiteScore

12.00

自引率

1.10%

发文量

审稿时长

5 weeks

期刊介绍： Global Health Research and Policy, an open-access, multidisciplinary journal, publishes research on various aspects of global health, addressing topics like health equity, health systems and policy, social determinants of health, disease burden, population health, and other urgent global health issues. It serves as a forum for high-quality research focused on regional and global health improvement, emphasizing solutions for health equity.