Tuberculosis (TB) is caused by a bacterium called Mycobacterium tuberculosis.  TB remains a significant global health problem. The UK has one of the highest rates of TB in Europe, with almost 5000 new cases notified in 2019. Within the UK, Birmingham and the West Midlands are particular hotspots for TB, with over 300 cases of active disease and approximately 10 times that of new latent infections diagnosed each year.

Birmingham and the West Midlands have experienced particularly high rates of COVID-19 during the pandemic and there is increasing evidence that individuals of Black, Asian and minority ethnicities (BAME) experience the most significant morbidity and highest mortality rates due to COVID-19. These groups also experience the highest burdens of TB, both in the UK and overseas.

Epidemiological data suggests that current and previous tuberculosis (TB) increase the risk of COVID-19 mortality and severe disease. There is also evidence of immunopathogenic overlap between the two infections with in vitro studies finding that SARS-CoV-2 infection is increased in human macrophages cultured in the inflammatory milieu of TB-infected macrophages.

This dataset would enable a deeper analysis of demography and clinical outcomes associated with COVID-19 in patients with concurrent TB.

PIONEER geography: the West Midlands (WM) has a population of 5.9 million & includes a diverse ethnic & socio-economic mix.

EHR. UHB is one of the largest NHS Trusts in England, providing direct acute services & specialist care across four hospital sites, with 2.2 million patient episodes per year, 2750 beds & an expanded 250 ITU bed capacity during COVID. UHB runs a fully electronic healthcare record (EHR) (PICS Birmingham Systems), a shared primary & secondary care record (Your Care Connected) & a patient portal “My Health”.

Scope: All hospitalised patients admitted to UHB during the COVID-19 pandemic, curated to focus on Mycobacterium tuberculosis and SARS-CoV-2. Longitudinal & individually linked, so that the preceding & subsequent health journey can be mapped & healthcare utilisation prior to & after admission understood. The dataset includes highly granular patient demographics & co-morbidities taken from ICD-10 & SNOMED-CT codes. Serial, structured data pertaining to acute care process (A&E, triage, IP, ITU admissions), presenting complaint, DNAR teal, all physiology readings (AVPU scale, Covid CFS, blood pressure, respiratory rate, oxygen saturations and others), all blood results, imaging reports, all prescribed & administered treatments, all outcomes.

Available supplementary data: Matched controls ambulance, OMOP data, synthetic data.

Available supplementary support: Analytics, Model build, validation & refinement A.I. Data partner support for ETL (extract, transform & load) process, Clinical expertise, Patient & end-user access, Purchaser access, Regulatory requirements, Data-driven trials, “fast screen” services.