ORIGINAL RESEARCH article
Front. Med.
Sec. Pulmonary Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1582726
From Pandemic to Endemic: Assessing the Impact of COVID-19 History and Socio-Demographic Factors on Quality of Life in Tuberculosis Patients
Provisionally accepted- 1Doctoral School, University of Medicine and Pharmacy of Craiova, Craiova, Romania
- 2Department of Pulmonology, Faculty of Medicine, Titu Maiorescu University, Craiova, Romania
- 3University of Medicine and Pharmacy of Craiova, Craiova, Romania
- 4Pneumology, Carol Davila University of Medicine and Pharmacy, Bucharest, Bucharest, Romania
- 5Oral-Dental Prevention, University of Medicine and Pharmacy of Craiova, Craiova, Dolj, Romania
- 6Radiology, University of Medicine and Pharmacy of Craiova, Craiova, Dolj, Romania
- 7Pneumology, University of Medicine and Pharmacy of Craiova, Craiova, Dolj, Romania
- 8Internal Medicine, Filantropia Hospital, Craiova, Romania
- 9Victor Babes Infectious Diseases and Pneumology Hospital, Craiova, Romania
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Background: Tuberculosis (TB) and COVID-19 are major global health concerns, and their interaction, particularly regarding socio-demographic factors, remains insufficiently explored. This study assessed the impact of prior confirmed COVID -19, alongside age, education, smoking, gender, and marital status, on TB relapse risk and quality of life (QOL) among TB patients in South-Western Romania. Methods: A cross-sectional analysis was performed on 763 bacteriologically confirmed TB patients enrolled between October 2022 and January 2025. Participants provided socio-demographic and clinical information and completed the WHOQOL-BREF questionnaire. Binary logistic regression was used to identify predictors of TB relapse, while structural equation modelling (SEM) assessed factors influencing QOL.Results: Patients with a confirmed history of COVID-19 exhibited a twofold increase in TB relapse risk (OR=2.08, p=0.003). Age was a strong predictor, with individuals aged 36-60 years and those >60 years showing over fivefold (OR=5.08, p<0.001) and nearly fourfold (OR=3.96, p=0.004) increases in relapse risk, respectively. Smoking further increased relapse odds by 76% (OR=1.77, p=0.009). Conversely, secondary and tertiary education significantly reduced relapse risk (OR=0.48, p=0.002; OR=0.46, p=0.006). SEM revealed that COVID-19 history had a pronounced negative impact on QOL (β=-0.51, p<0.001), while marital status (β≈0.09, p=0.022) and education (β≈0.18, p<0.001) were positively associated with QOL.COVID-19, advanced age, and smoking significantly elevate TB relapse risk and detrimentally affect QOL, whereas higher education appears protective. Integrated interventions addressing COVID-19 prevention, smoking cessation, and socio-economic support are essential to improve TB outcomes and patient quality of life.
Keywords: Tuberculosis, COVID-19, Quality of Life, TB relapse, Socio-demographic(SD) factors Space Before: 0 pt Formatted: Left, Space Before: 0 pt Formatted: Space Before: 0 pt Formatted: Centered, Space Before: pt Formatted: Centered, Space Before: pt Formatted: Space Before: 0 pt Formatted: Left
Received: 24 Feb 2025; Accepted: 04 Jun 2025.
Copyright: © 2025 Mitroi, BĂLTEANU, Zlatian, Toma, Catana, Mirea, Camen, Biciusca and CIOBOATA. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Ovidiu Zlatian, University of Medicine and Pharmacy of Craiova, Craiova, Romania
Claudia Lucia Toma, Pneumology, Carol Davila University of Medicine and Pharmacy, Bucharest, 020022, Bucharest, Romania
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