Clinical and laboratory characteristics of pulmonary tuberculosis in the context of the COVID-19 pandemic in the Republic of Moldova and Ukraine

Abstract

The studyaimed to analyze the main clinical and laboratory characteristics of tuberculosis and their impact on case management and outcomes before, during, and after the COVID-19 pandemic in the Republic of Moldova (RM) and Ukraine (UA). A prospective case-controlstudy was conducted between 2018 and 2023, including two cohorts: Moldovan (MD) comprised 1617 and Ukrainian (UA) 896 patients divided into three groups: 1st group corresponding to the pre-COVID-19 period (2018–2019), 2nd group (n=451) corresponding to the COVID-19 period (2020–2021), and 3rd group-post pandemic period (2022–2023). Primary healthcare providers played a central role in TB case detection and clinical assessment of the majority of TB cases in both countries, which were clinically symptomaticwith TB-related presentations, whereas active screening made a limited contribution. The COVID-19 period impacted the case-management, determining a marked increase in laboratory-diagnosed TB, a higher rate of late-detected cases, and lower outcomes, particularly in drug-resistant TB. The results highlighted the importance of strengthening primary care-based case detection, expanding active screening, and sustaining progress in TB control while adapting to region-specific needs.