Cohort study of the mortality among patients in New York City with tuberculosis and COVID-19, March 2020 to June 2022

Both tuberculosis (TB) and COVID-19 can affect the respiratory system, and early findings suggest co-occurrence of these infectious diseases can result in elevated mortality. A retrospective cohort of patients who were diagnosed with TB and COVID-19 concurrently (within 120 days) between March 2020 and June 2022 in New York City (NYC) was identified. This cohort was compared with a cohort of patients diagnosed with TB-alone during the same period in terms of demographic information, clinical characteristics, and mortality. Cox proportional hazards regression was used to compare mortality between patient cohorts. One hundred and six patients with concurrent TB/COVID-19 were identified and compared with 902 patients with TB-alone. These two cohorts of patients were largely demographically and clinically similar. However, mortality was higher among patients with concurrent TB/COVID-19 in comparison to patients with TB-alone, even after controlling for age and sex (hazard ratio 2.62, 95% Confidence Interval 1.66–4.13). Nearly one in three (22/70, 31%) patients with concurrent TB/COVID-19 aged 45 and above died during the study period. These results suggest that TB patients with concurrent COVID-19 were at high risk for mortality. It is important that, as a high-risk group, patients with TB are prioritized for resources to quickly diagnose and treat COVID-19, and provided with tools and information to protect themselves from COVID-19

Regeneration of Activated Carbon Fiber by the Electro-Fenton Process

An electro-Fenton (EF) based technology using activated carbon (AC) fiber as cathode and BDD as anode has been investigated for both regeneration of AC and mineralization of organic pollutants. The large specific surface area and low intraparticle diffusion resistance of AC tissue resulted in high maximum adsorption capacity of phenol (PH) (3.7 mmol g^–1) and fast adsorption kinetics. Spent AC tissue was subsequently used as the cathode during the EF process. After 6 h of treatment at 300 mA, 70% of PH was removed from the AC surface. The effectiveness of the process is ascribed to (i) direct oxidation of adsorbed PH by generated hydroxyl radicals, (ii) continuous shift of adsorption equilibrium due to oxidation of organic compounds in the bulk, and (iii) local pH change leading to electrostatic repulsive interactions. Moreover, 91% of PH removed from AC was completely mineralized, thus avoiding adsorption of degradation byproducts and accumulation of toxic compounds such as benzoquinone. Morphological and chemical characteristics of AC were not affected due to the effect of cathodic polarization protection. AC tissue was successfully reused during 10 cycles of adsorption/regeneration with regeneration efficiency ranging from 65 to 78%, in accordance with the amount of PH removed from the AC surface

Timeline of diagnoses for non-concurrent TB/COVID-19 patients diagnosed with TB between 3/1/2020 and 6/30/2022 (n = 133).

The dates when patients were diagnosed with TB are shown by blue points and the dates when patients were diagnosed with COVID-19 are shown by yellow points. The line between points represents the time between diagnosis of the two diseases. The line is the color of the first diagnosis. Deaths are shown as red points. Nine deaths occurred among these patients; however, one death occurred after 6/30/2022, but before that patient completed treatment for TB, and is thus not visible here. Five deaths occurred during a COVID-19 wave in late 2021. Four of these deaths occurred in a hospital, and COVID-19 was not noted in their death certificates. The fifth person who died was diagnosed with COVID-19 soon after their death. (TIF)</p

Comparison of concurrent TB/COVID-19 patients who died versus those who survived.

Comparison of concurrent TB/COVID-19 patients who died versus those who survived.</p

Comparison of patients diagnosed with TB in NYC in 2016–2018 (pre-pandemic TB) versus those diagnosed with TB in NYC between 3/1/2020 and 6/30/2022 (TB-alone group).

Comparison of patients diagnosed with TB in NYC in 2016–2018 (pre-pandemic TB) versus those diagnosed with TB in NYC between 3/1/2020 and 6/30/2022 (TB-alone group).</p

Timeline of diagnoses for TB/COVID-19 patients diagnosed with TB between 3/1/2020 and 6/30/2022 (n = 106).

The dates when patients were diagnosed with TB are shown by blue points and the dates when patients were diagnosed with COVID-19 are shown by yellow points. The line between points represents the time interval between diagnosis of the two diseases. The line is the color of the first diagnosis; thus, in cases where COVID-19 was diagnosed first, the line is yellow, and in cases where TB was diagnosed first, the line is blue. Deaths are shown as red points. Only patients with concurrent TB/COVID-19 are shown (n = 106). Patients with non-concurrent TB/COVID-19 are shown in S1 Fig (n = 133). Twenty-three deaths occurred in the concurrent cohort and nine deaths occurred in the non-concurrent cohort.</p

Full results of Cox proportional hazards regression analyses.

Full results of Cox proportional hazards regression analyses.</p

Comparison between patients diagnosed with TB-alone between 3/1/2020 and 6/30/2022 and patients with concurrent TB/COVID-19 in terms of clinical and demographic variables.

Comparison between patients diagnosed with TB-alone between 3/1/2020 and 6/30/2022 and patients with concurrent TB/COVID-19 in terms of clinical and demographic variables.</p

Comparison of patients diagnosed with TB in NYC between 3/1/2020 and 6/30/2022 and not diagnosed with COVID-19 during that period (TB-alone group), versus patients diagnosed with both TB and COVID-19 during this period, but where the TB and COVID-19 diagnoses were over 120 days apart (non-concurrent).

Comparison of patients diagnosed with TB in NYC between 3/1/2020 and 6/30/2022 and not diagnosed with COVID-19 during that period (TB-alone group), versus patients diagnosed with both TB and COVID-19 during this period, but where the TB and COVID-19 diagnoses were over 120 days apart (non-concurrent).</p

Comparison between patients diagnosed with TB-alone between 3/1/2020 and 6/30/2022 and patients with concurrent TB/COVID-19 in terms of outcomes.

Comparison between patients diagnosed with TB-alone between 3/1/2020 and 6/30/2022 and patients with concurrent TB/COVID-19 in terms of outcomes.</p