AUTHOR=Deng Huan , Liu Yishan , Lv Fan , Li Xiaofeng , Qi Mingyan , Bo Yajing , Qiu Sikai , He Xinyuan , Ji Fanpu , Zeng Qing-Lei , Gao Ning TITLE=Sex disparities of the effect of the COVID-19 pandemic on mortality among patients living with tuberculosis in the United States JOURNAL=Frontiers in Public Health VOLUME=12 YEAR=2024 URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1413604 DOI=10.3389/fpubh.2024.1413604 ISSN=2296-2565 ABSTRACT=Background

We aimed to determine the trend of TB-related deaths during the COVID-19 pandemic.

Methods

TB-related mortality data of decedents aged ≥25 years from 2006 to 2021 were analyzed. Excess deaths were estimated by determining the difference between observed and projected mortality rates during the pandemic.

Results

A total of 18,628 TB-related deaths were documented from 2006 to 2021. TB-related age-standardized mortality rates (ASMRs) were 0.51 in 2020 and 0.52 in 2021, corresponding to an excess mortality of 10.22 and 9.19%, respectively. Female patients with TB demonstrated a higher relative increase in mortality (26.33 vs. 2.17% in 2020; 21.48 vs. 3.23% in 2021) when compared to male. Female aged 45–64 years old showed a surge in mortality, with an annual percent change (APC) of −2.2% pre-pandemic to 22.8% (95% CI: −1.7 to 68.7%) during the pandemic, corresponding to excess mortalities of 62.165 and 99.16% in 2020 and 2021, respectively; these excess mortality rates were higher than those observed in the overall female population ages 45–64 years in 2020 (17.53%) and 2021 (33.79%).

Conclusion

The steady decline in TB-related mortality in the United States has been reversed by COVID-19. Female with TB were disproportionately affected by the pandemic.