Publication date: Jul 15, 2026
The COVID-19 pandemic disrupted tuberculosis (TB) services worldwide, primarily affecting diagnosis and treatment initiation. However, the impact of the post-pandemic period on TB treatment outcomes remains poorly understood. We aimed to evaluate changes in TB treatment outcomes during and after the COVID-19 pandemic and to determine whether these changes occurred independently of delays in treatment initiation. We conducted a retrospective cohort study including adult patients diagnosed with TB at a tertiary referral hospital in Mexico between 2020 and 2025. Patients were categorized into COVID (2020-2022) and post-COVID (2023-2025) periods. The primary outcome was unfavorable treatment outcome (death, loss to follow-up, or treatment failure). Time from diagnosis to treatment initiation was assessed, and clinically relevant delay was defined using multiple thresholds. Multivariable logistic regression and Cox proportional hazards models were used to evaluate associations between period and outcomes, adjusting for age, sex, HIV status, undernutrition, and TB characteristics. Sensitivity analyses included exclusion of patients with HIV and socially vulnerable populations. A total of 1,299 patients were included. The proportion of unfavorable outcomes increased from 27. 1% in the COVID period to 34. 4% in the post-COVID period (p
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| Concepts | Keywords |
|---|---|
| COVID-19 | |
| Health systems | |
| Mexico | |
| Risk factors | |
| Treatment outcomes | |
| Tuberculosis |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | tuberculosis |
| pathway | KEGG | Tuberculosis |
| disease | MESH | COVID-19 pandemic |
| disease | MESH | death |
| disease | MESH | undernutrition |
| disease | MESH | included |
| disease | MESH | Infectious Diseases |
| disease | MESH | Dis |
| pathway | REACTOME | Reproduction |
| drug | DRUGBANK | Coenzyme M |
| disease | MESH | HRs |
| drug | DRUGBANK | Methionine |