# Upstaging of Tuberculosis in the Post-COVID-19 Era: A Case Series

## TL;DR

The paper discusses how the COVID-19 pandemic worsened tuberculosis in India, especially highlighting advanced genital TB cases that could have been treated earlier.

## Contribution

The paper presents a case series of advanced genital TB cases to emphasize the need for early detection and improved TB services post-COVID-19.

## Key findings

- The pandemic disrupted TB services in India, leading to increased TB-related deaths.
- Genital TB often goes undetected due to asymptomatic presentation and is frequently diagnosed incidentally in young women.
- Early detection and restoration of TB services are critical to reversing the pandemic's impact on TB.

## Abstract

The COVID-19 pandemic has significantly impacted the global health system as well as the social and economic impact on tuberculosis (TB) treatment and diagnostic services. A high volume of patients diagnosed and treated for TB were impacted by the pandemic restrictions, particularly reduced access to TB services provided by the National Tuberculosis Elimination Programme in India; this in turn increased the number of deaths due to TB. The Indian healthcare system has been struggling with the eradication of TB, and this additional worldwide health crisis caused by SARS-CoV-2 has put the Indian healthcare system under severe stress. Both COVID-19 and TB are infectious diseases that primarily affect the lungs and have similar symptoms such as cough, fever, and difficulty breathing. The need of the hour is to take proper actions to mitigate and reverse these impacts urgently. The immediate priority is to aggressively step up the provision of essential TB services so that the levels of TB case detection and treatment return to at least pre-COVID-19 levels. The diagnosis of genital TB especially needs a high index of suspicion, as most of the cases are asymptomatic and diagnosed by chance in young women being evaluated for fertility. Here, we present a series of advanced genital TB cases that required intensive care and could have been detected and treated at an early stage.