An Analysis of The Trend of Incidences and Fatality of Pulmonary Tuberculosis in East Java from 2015-2020: A Lesson From COVID-19

Background: Pulmonary tuberculosis is still a public health problem, and surveillance data analysis has not been done much. Recently a global pandemic of COVID-19 has the potential in disturbing TB elimination programs and treatment. This study aims to comprehensively analyse the incidence rate (IR) and Case Fatality Rate (CFR) of pulmonary tuberculosis in East Java from 2015–2020 and during COVID-19 and the strategies for optimizing tuberculosis disease control. Methodology: The study analyzed annual surveillance data using an analytical descriptive design. The Variables were analyzed with Spearman correlation with a level of evidence of 95% (p<0.05). Results: The prevalence of pulmonary tuberculosis in East Java fluctuated from 2015–2020. In 2020 and during the COVID-19 pandemic, the number of cases and morbidity rates increased. Statistic results confirm the presence of a significant correlation between the values of Incidence rate (IR) and Case Fatality rate (CFR) (p = 0.032), IR and Treatment Success Rate (TSR) (p = 0.020), and CFR and TSR (p = 0.002). Population density is not correlated with the number of new cases (p = 0.667). Treatment rates have increased to 51%;cure and treatment rates have decreased to 76% and 89%, respectively, and there was a 4% increase in mortality during COVID-19. Conclusions: COVID-19 has tremendously affected the treatment of pulmonary TB cases in East Java, Indonesia by increasing the incidence rate and decreasing the fatality rate. The pandemic promotes fear in the community to check their medical status and improve the quality of their health in East Java. © The Authors retain the copyrights of this article, with first publication rights granted to Medsci Publications.

Stool Xpert MTB/RIF as a possible diagnostic alternative to sputum in Africa: a systematic review and meta-analysis.

Introduction: Worldwide, COVID-19 pandemic lead to a large fall in the number of newly reported TB cases. In sub-Saharan Africa, microbiological diagnosis of TB is generally based on smear microscopy and Xpert MTB/RIF on sputum samples, but good quality sputum samples are often difficult to obtain, leading clinicians to rely on more invasive procedures for diagnosis. Aim of this study was to investigate pooled sensitivity and specificity of Xpert MTB/RIF on stool samples compared to respiratory microbiological reference standards in African countries. Methods: Four investigators independently searched PubMed, SCOPUS, and Web of Science until 12th October 2022, then screened titles and abstracts of all potentially eligible articles. The authors applied the eligibility criteria, considered the full texts. All the studies reported the data regarding true positive (TP), true negative (TN), false positive (FP) and false negative (FN). Risk of bias and applicability concerns were assessed with the Quadas-2 tool. Results: overall, among 130 papers initially screened, we evaluated 47 works, finally including 13 papers for a total of 2,352 participants, mainly children. The mean percentage of females was 49.6%, whilst the mean percentage of patients reporting HIV was 27.7%. Pooled sensitivity for Xpert MTB/RIF assay for detecting pulmonary tuberculosis was 68.2% (95%CI: 61.1-74.7%) even if characterized by a high heterogeneity (I2=53.7%). Specificity was almost 100% (99%, 95%CI: 97-100%; I2 = 45.7%). When divided for reference standard, in the six studies using sputum and nasogastric aspirate the accuracy was optimal (AUC = 0.99, SE = 0.02), whilst in the studies using only sputum for tuberculosis detection the AUC was 0.85 (with a SE = 0.16). The most common source of bias was exclusion of enrolled patients in the analysis. Conclusions: Our study confirms that, in Africa, stool Xpert MTB/RIF may be a useful rule-in test for children above and below 5 years of age under evaluation for pulmonary tuberculosis. Sensitivity increased substantially when using both sputum and nasogastric aspirate as reference samples.

Distribution of clinical forms of newly detected pulmonary tuberculosis among adult population of the Sakha Republic (Yakutia) during the pandemic of novel coronavirus infection

The article analyzes the epidemic situation of tuberculosis and the clinical structure of newly diagnosed pulmonary tuberculosis among the adult population, both in general on the territory of the Republic of Sakha (Yakutia) and with the allocation of the Arctic zone during the period of restrictive measures organized to combat the pandemic of a new coronavirus infection COVID- 19. During the period of strengthening anti-epidemic and sanitary measures, there was a significant decrease in the main epidemic indicators for tuberculosis, but at the same time, the situation with the timely detection of tuberculosis among the population worsened. The proportion of newly diagnosed adult patients with destructive forms of pulmonary tuberculosis and bacterial excretion increased when self-referencing to medical organizations. A statistically significant correlation was found between the indicators of the volume and quality of preventive examinations of the population for tuberculosis and the aggravated clinical structure of newly diagnosed patients with tuberculosis.

Epidemiology and factors associated with Extra-pulmonary tuberculosis in a Low-prevalence area.

Background: Tuberculosis is a global public health problem. Extra-pulmonary tuberculosis accounts for an increasing proportion of cases worldwide, although information about epidemiological, clinical, or microbiological factors is lacking. Methods: We conducted a retrospective observational study of tuberculosis cases diagnosed between 2016 and 2021, classified into Pulmonary and Extra-pulmonary tuberculosis. Univariable and multivariable logistic regression models were used to investigate risk factors of Extra-pulmonary tuberculosis. Results: 20.9% of overall cases were classified as Extra-pulmonary tuberculosis, with a rising trend from 22.6% in 2016 to 27.9% in 2021. Lymphatic tuberculosis accounted for 50.6% of cases, followed by pleural tuberculosis (24.1%). 55.4% of cases belonged to foreign-born patients. Microbiological culture tested positive in 92.8% of Extra-pulmonary cases. Logistic regression analysis showed that women were more predisposed to develop Extra-pulmonary tuberculosis (aOR 2.46, 95% CI 1.45-4.20) as well as elderly patients (aged ≥ 65 years) (aOR 2.47, 95% CI 1.19-5.13) and persons with previous history of tuberculosis (4.99, 95% CI 1.40-17.82). Conclusions: Extra-pulmonary Tuberculosis have increased within our study period. A profound decline occurred in 2021 tuberculosis cases, probably due to COVID-19. Women, elderly population, and persons with previous history of tuberculosis are at higher risk of developing Extra-pulmonary tuberculosis in our setting.

COVID-19 and pulmonary Tubercuiosis coinfection: three case reports from Iran

Tubercuiosis is still a significant problem worldwide. Until the COVID-19 pandemic, tuberculosis was the leading cause of mortality from a single infectious agent. Pulmonary Tubercuiosis patients are more tending to be co-infected with COVID-19 notably when they have a history of exposure. There are some case reports relating to pulmonary TB and COVID-19 coinfection but the information about TB and COVID-19 was still little. We report three coinfected patients. Case one and two were both middle-aged Iranian mans with history of opium addiction, case one presented with dyspnea and weakness and case two presented with progressive weakness. Case three was a healthy young man with history of progressive dyspnea, productive cough and hemoptysis. Case one and case three were improved. In conclusion, COVID-19 is still an important issue and can coexist with other lung infections such as Pulmonary Tubercuiosis, so we should be aware of the advancement of the Tubercuiosis epidemic after the COVID-19 pandemic.Copyright © 2023 Tuberculosis Association of India

UMOYA: a prospective longitudinal cohort study to evaluate novel diagnostic tools and to assess long-term impact on lung health in South African children with presumptive pulmonary TB-a study protocol.

BACKGROUND: Despite a high paediatric tuberculosis (TB) burden globally, sensitive and specific diagnostic tools are lacking. In addition, no data exist on the impact of pulmonary TB on long-term child lung health in low- and middle-income countries. The prospective observational UMOYA study aims (1) to build a state-of-the-art clinical, radiological, and biological repository of well-characterised children with presumptive pulmonary TB as a platform for future studies to explore new emerging diagnostic tools and biomarkers for early diagnosis and treatment response; and (2) to investigate the short and long-term impact of pulmonary TB on lung health and quality of life in children. METHODS: We will recruit up to 600 children (0-13 years) with presumptive pulmonary TB and 100 healthy controls. Recruitment started in November 2017 and is expected to continue until May 2023. Sputum and non-sputum-based samples are collected at enrolment and during follow-up in TB cases and symptomatic controls. TB treatment is started by routine care services. Intensive follow-up for 6 months will allow for TB cases to retrospectively be classified according to international consensus clinical case definitions for TB. Long-term follow-up, including imaging, comprehensive assessment of lung function and quality of life questionnaires, are done yearly up to 4 years after recruitment. DISCUSSION: The UMOYA study will provide a unique platform to evaluate new emerging diagnostic tools and biomarkers for early diagnosis and treatment response and to investigate long-term outcomes of pulmonary TB and other respiratory events on lung health in children.

Strategy for covid-19 vaccination for patients with tuberculosis during the covid-19 pandemic.

The pandemic of COVID-19 is still rampaging all over the world, so it is urgent to popularize vaccination. Meanwhile, pulmonary tuberculosis is one of the chronic infectious diseases with a high incidence in China. Since these diseases all occur in lung tissue, patients with TB and COVID-19 co-infection show more serious conditions and poorer treatment effects. However, we have limited knowledge about the protective efficacy, immunogenicity and safety of COVID-19 vaccine in patients with TB at present, with a lack of corresponding evidence-based medicine as well. Therefore, this paper reviews the pathogenesis and epidemiology of TB, discusses the immune status of patients with TB and summarizes the existing proposals for vaccination of patients with TB at home and abroad. Furthermore, we analyze the existing clinical trials in TB patients and other special populations, and finally discuss the strategy of vaccination for patients with TB during the COVID-19 pandemic and the necessity of clinical research on COVID-19 vaccines with target population of TB patients.Copyright © 2022, Publication Centre of Anhui Medical University. All rights reserved.

The safety and immunogenicity of inactivated COVID-19 vaccine in old pulmonary tuberculosis patients.

The immunogenicity and safety of vaccines against coronavirus disease 2019 (COVID-19) remain unknown in patients with a history of pulmonary tuberculosis (OPTB). Therefore, the safety and effectiveness of inactivated vaccines against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) were assessed in patients with a history of PTB. The study cohort included 106 healthy controls and 93 adult patients with OPTB who received a two-dose vaccination. The study period was 21 to 105 days. Concentrations of antibodies (Abs) against receptor-binding domain (RBD) IgG and SARS-CoV-2 neutralizing Abs (NAbs) were measured, in addition to the frequencies of SARS-CoV-2-specific B and a portion T cells. The incidence of adverse events was similar between the OPTB patients and healthy controls. No severe adverse events occurred. Concentrations of Abs against RBD-IgG and CoV-2 neutralizing Abs in addition to the frequencies of RBD-specific memory B cells proportions were lower in OPTB patients than the healthy controls (all, p < 0.05), while the frequencies of cytotoxic T-lymphocyte-associated protein 4 (CTLA-4+) cells were higher (p = 0.023). There was no obvious correlation between age and blood concentrations of Abs against RBD-IgG and CoV-2 neutralizing Abs, while immune responses were similar in the fibrosis and calcification groups. The period of time following full-course vaccination and lymphocyte counts were associated to anti-RBD-IgG responses. Inactivated COVID-19 vaccinations were well tolerated in OPTB patients, although immunogenicity was limited in this population. This study has been registered at ClinicalTrials.gov (NCT05043246).

Stroke in a child with pulmonary tuberculosis and pleural effusion-An important clue for the diagnosis of disseminated central nervous system tuberculosis.

Central nervous system tuberculosis (CNS-TB) is one of the most devastating and life-threatening conditions having high mortality and morbidity. Here, we report a 12-year-old child with pulmonary tuberculosis and pleural effusion presenting with ischemic stroke as an important manifestation of central nervous system tuberculosis.

Strategy for covid-19 vaccination for patients with tuberculosis during the covid-19 pandemic.

The pandemic of COVID-19 is still rampaging all over the world, so it is urgent to popularize vaccination. Meanwhile, pulmonary tuberculosis is one of the chronic infectious diseases with a high incidence in China. Since these diseases all occur in lung tissue, patients with TB and COVID-19 co-infection show more serious conditions and poorer treatment effects. However, we have limited knowledge about the protective efficacy, immunogenicity and safety of COVID-19 vaccine in patients with TB at present, with a lack of corresponding evidence-based medicine as well. Therefore, this paper reviews the pathogenesis and epidemiology of TB, discusses the immune status of patients with TB and summarizes the existing proposals for vaccination of patients with TB at home and abroad. Furthermore, we analyze the existing clinical trials in TB patients and other special populations, and finally discuss the strategy of vaccination for patients with TB during the COVID-19 pandemic and the necessity of clinical research on COVID-19 vaccines with target population of TB patients. Copyright © 2022, Publication Centre of Anhui Medical University. All rights reserved.

Covid 19: Risk factors and development of pulmonary TB in household contacts, Lima, Peru.

Objective: is to determine the risk factors associated with developing tuberculosis in household contacts of patients with pulmonary tuberculosis in the epidemiological context of the Covid 19 pandemic. Methods: It is descriptive, analytical and cross-sectional, the population of index cases with tuberculosis is 53, and a sample of 59 household contacts of a health center of the Ministry of Health, in Lima, in the months of September and October 2021, two pre-established surveys were applied, one applied in the index case, and another to household contacts; for the association of risk factors, the Mantel and Haenszel Chi-square test was used. Results: in the sociodemographic risk, shared housing, with a significance of 0.000; family support, with a significance of 0.006, considered P values < 0.05. Clinical factor, 27.5 % (11) of the index cases have type 2 diabetes mellitus, and 7.5 % (3) have malnutrition, and 7.5 % have alcoholism, 5 % have HIV/AIDS, arterial hypertension, and lack of application of isoniazid preventive therapy (IPT) are associated with a significance level of 0.001, (P < 0.05). Environmental risk, home lighting, hygiene and ventilation are associated with a significance level of 0.017, 0.002 and 0.011 respectively, with P < 0.05. index cases, more than 28 % were infected, 69.8 % were vaccinated; in contacts more than 13 % were infected, and vaccinated more than 47. Conclusion: shared housing, family support, associated diseases, lack of implementation of isoniazid preventive therapy (PTZ), home lighting, hygiene and ventilation were the most relevant associated with the development of tuberculosis. Tuberculosis is a global health crisis, attention should focus on controlling tuberculosis in areas where it continues to develop. Given that migration factors are a prevalent condition in the Americas, the focus must address health risk factors to improve health outcomes and care for TB patients in Peru.

Strategy for covid-19 vaccination for patients with tuberculosis during the covid-19 pandemic

The pandemic of COVID-19 is still rampaging all over the world, so it is urgent to popularize vaccination. Meanwhile, pulmonary tuberculosis is one of the chronic infectious diseases with a high incidence in China. Since these diseases all occur in lung tissue, patients with TB and COVID-19 co-infection show more serious conditions and poorer treatment effects. However, we have limited knowledge about the protective efficacy, immunogenicity and safety of COVID-19 vaccine in patients with TB at present, with a lack of corresponding evidence-based medicine as well. Therefore, this paper reviews the pathogenesis and epidemiology of TB, discusses the immune status of patients with TB and summarizes the existing proposals for vaccination of patients with TB at home and abroad. Furthermore, we analyze the existing clinical trials in TB patients and other special populations, and finally discuss the strategy of vaccination for patients with TB during the COVID-19 pandemic and the necessity of clinical research on COVID-19 vaccines with target population of TB patients. Copyright © 2022, Publication Centre of Anhui Medical University. All rights reserved.

Sleep quality and influencing factors and correlation with T-lymphocyte subpopulation counts in patients with pulmonary tuberculosis: a cross-sectional study.

BACKGROUND: Patients diagnosed with pulmonary tuberculosis (TB) have poor sleep quality due to multiple factors. We aimed to assess the sleep status and related factors of TB patients in Shenzhen, China. METHODS: A questionnaire survey was conducted on 461 TB patients hospitalized at Shenzhen Third People's Hospital from March 2021 to January 2022, and sleep quality was assessed using the Pittsburgh sleep quality index (PSQI). RESULTS: A total of 459 valid questionnaires were collected, and 238 of the 459 TB patients had general or poor sleep quality (PSQI > 5). Patients' gender, marriage, nutritional screening score, family atmosphere, fear of discrimination, fear of interactions, and the impact of the disease on their work life had significant effects on sleep quality (P < 0.05); PSQI scores of TB patients were negatively correlated with lymphocyte counts (r = - 0.296, P < 0.01), T-lymphocyte counts (r = - 0.293, P < 0.01), helper T lymphocyte counts (r = - 0.283, P < 0.01), killer T lymphocyte counts (r = - 0.182, P < 0.05), and were positively correlated with depression scores (r = 0.424, P < 0.01). Multivariable logistic regression analysis showed that male (OR = 1.64,95% CI 1.11-2.42, P < 0.05), unmarried (OR = 1.57, 95% CI 1.02-2.42, P < 0.05), NRS score grade 3(OR = 5.35, 95% CI 2.08-15.73, P < 0.01), general family atmosphere (OR = 2.23, 95% CI 1.07-4.93, P < 0.05), and the disease affecting work (OR = 1.66, 95% CI 1.11-2.50, P < 0.05) were factors influencing poor sleep quality. CONCLUSION: Most TB patients had varying degrees of sleep disturbance, which may be affected by their gender, marriage, family atmosphere, nutritional status, the effect of the disease on work life, and, depression, as well as lower absolute T-lymphocyte subpopulation counts. Appropriate interventions should be implemented to improve their sleep quality, when treating or caring for such patients.

A low risk of nosocomial transmission of subclinical tuberculosis to neonates in a postpartum care center under COVID-19 control measures.

We report the results of investigating and managing a tuberculosis (TB) exposure in apostpartum care center. Among the contacts exposed to a nursing assistant with subclinical TB,5 of 44 neonates (11.4%) had positive tuberculin skin tests (TSTs) at 3 months of age, and all theTST-positive neonates received the Bacille Calmette-Guérin vaccination. Seven of 28 healthcareworkers (25.0%) and 1 of 3 household contacts (33.3%) were positive in the initial or repeatedinterferon-gamma release assay. None of the contacts developed TB disease during the studyperiod. Annual TB examinations of healthcare personnel at a postpartum care center under theTuberculosis Prevention Act in South Korea enabled the early detection of subclinical TB, whichreduced the risk of transmission to neonates under strict coronavirus disease 2019 preventionmeasures.

3- to 24-month Follow-up on COVID-19 with Pulmonary Tuberculosis Survivors after Discharge: Results from a Prospective, Multicenter Study.

Objective: Coronavirus disease 2019 (COVID-19) and tuberculosis (TB) are major public health and social issues worldwide. The long-term follow-up of COVID-19 with pulmonary TB (PTB) survivors after discharge is unclear. This study aimed to comprehensively describe clinical outcomes, including sequela and recurrence at 3, 12, and 24 months after discharge, among COVID-19 with PTB survivors. Methods: From January 22, 2020 to May 6, 2022, with a follow-up by August 26, 2022, a prospective, multicenter follow-up study was conducted on COVID-19 with PTB survivors after discharge in 13 hospitals from four provinces in China. Clinical outcomes, including sequela, recurrence of COVID-19, and PTB survivors, were collected via telephone and face-to-face interviews at 3, 12, and 24 months after discharge. Results: Thirty-two COVID-19 with PTB survivors were included. The median age was 52 (45, 59) years, and 23 (71.9%) were men. Among them, nearly two-thirds (62.5%) of the survivors were moderate, three (9.4%) were severe, and more than half (59.4%) had at least one comorbidity (PTB excluded). The proportion of COVID-19 survivors with at least one sequela symptom decreased from 40.6% at 3 months to 15.8% at 24 months, with anxiety having a higher proportion over a follow-up. Cough and amnesia recovered at the 12-month follow-up, while anxiety, fatigue, and trouble sleeping remained after 24 months. Additionally, one (3.1%) case presented two recurrences of PTB and no re-positive COVID-19 during the follow-up period. Conclusion: The proportion of long symptoms in COVID-19 with PTB survivors decreased over time, while nearly one in six still experience persistent symptoms with a higher proportion of anxiety. The recurrence of PTB and the psychological support of COVID-19 with PTB after discharge require more attention.

Assessment of Timeliness of Tuberculosis Detection among Foreign Citizens in Novosibirsk Oblast

The objective: assessment of timeliness and efficiency of organization of TB diagnostics among foreign citizens in Novosibirsk Oblast during the COVID-19 pandemic and related restrictive measures. Subjects and Methods. A retrospective descriptive cohort study was conducted, it included foreign citizens above 18 years old diagnosed with tuberculosis and detected in 2018-2021. Totally 348 patients were enrolled in the study: 192 patients detected in 2018-2019 and 156 patients detected in 2020-2021. Results. In the short-term assessment, the COVID-19 pandemic did not have a significant impact on the organization of detection of tuberculosis in foreign citizens in Novosibirsk Oblast, although there is a significant increase in the number of untimely detected patients with destruction. Nevertheless, the currently existing procedure for diagnostics of tuberculosis among foreign citizens requires significant improvement. Thus, coverage with preventive examinations concerns mainly legal labor migrants, while illegally working foreign citizens remain uncovered by screening for tuberculosis. When diagnosing tuberculosis, the minimum required laboratory tests are used which do not allow verifying the diagnosis bacteriologically and assessing drug susceptibility. © 2022 New Terra Publishing House. All rights reserved.

Fortuitous discovery of pulmonary tuberculosis in an asymptomatic, SARS-CoV-2 positive, Moroccan patient

The COVID-19 pandemic has created worldwide change in screening, management, and deadlines for the treatment of tuberculosis, among other latent diseases. Safe access to health-care structures, drug interactions, and ongoing changes in treatment guidelines are the main challenges. The first published cohort of 45 patients with both tuberculosis and SARS-CoV-2 infection presented three different scenarios regarding the timing of these diagnoses, both diagnoses being made within the same week in only nine of these patients. Thus far, tuberculosis has not been shown to influence the pathophysiology of SARS-CoV-2 infection. The association between these two diseases may be incidental. Tuberculosis remains the leading lethal infection worldwide. 2In patients with preexisting pulmonary tuberculosis and COVID-19, management priorities, drug interactions, and optimal frequency of clinical, biological, and radiological check-ups require clarification. We here report an asymptomatic young patient who had both COVID-19 and pulmonary tuberculosis, raising challenging questions regarding diagnostic tools, treatment, and follow-up.

Diagnostic and treatment outcomes of patients with pulmonary tuberculosis in the first year of COVID-19 pandemic.

Background: The COVID-19 pandemic has put a significant strain on human life and health care systems, however, little is known about its impact on tuberculosis (TB) patients. Aims: To assess the impact of COVID-19 pandemic on pulmonary tuberculosis (PTB) diagnosis, treatment and patient outcomes, using the WHO definitions. Methods: A cross-sectional study was conducted in Malatya region, Turkey (population 800 000). Data on regional PTB test numbers, case notification rates and PTB patients' clinical characteristics and treatment outcomes were collected. Data from the first pandemic year (2020) were compared to data from the previous 3 years (2017-2019). The attitudes and experiences of patients were analysed. Results: Despite a non-significant 22% decrease in annual PTB case notifications (P = 0.317), the number of TB tests performed (P = 0.001) and PTB patients evaluated (P = 0.001) decreased significantly during the pandemic year compared with the previous 3 years. The proportion of patients with high (3/4+) sputum acid-fast bacilli grades (P = 0.001), TB relapse (P = 0.022) and treatment failure (P = 0.018) increased significantly. The median 64.5-day treatment delay detected in 2017-2019 increased significantly to 113.5 days in 2020 (P = 0.001), due primarily to patients' reluctance to visit a health care facility. Conclusion: In addition to the problems with case detection, this study shows notable deterioration in several indicators related to the severity, contagiousness and poor outcomes of TB, which had already been suppressed for decades.

Utility and Limits of Lung Ultrasound in Childhood Pulmonary Tuberculosis: Lessons from a Case Series and Literature Review.

Childhood pulmonary tuberculosis (PTB) diagnosis is often a challenge that requires a combination of history, clinical, radiological, immunological and microbiological findings. Radiological diagnosis is based today on the use of chest X-ray and chest CT that, in addition to being radio-invasive tools for children, are often not available in countries with low-resources. A non-invasive, easily usable and reproducible, low-cost diagnostic tool as LUS would therefore be useful to use to support the diagnosis of childhood PTB. Data on the use of LUS for the diagnosis and follow-up of childhood PTB are limited and in some respects contradictory. To help better define the potential role of LUS we have described the pros and cons of lung ultrasound method through a brief review of the studies in the literature and reporting some case series in which we describe clinical, laboratory, radiological results as well as detailed lung ultrasound findings of four children/adolescents with PTB.

Data Classification Model for COVID-19 Pandemic

A significant worldwide pandemic disease that has shut the whole world's economy and put the health care services personnel into anxiety is COronaVIrus Disease 2019 (COVID-19). It is difficult to model as it shared closely related characteristics/symptoms with other pneumonia diseases like SARS, MERS, ARDS, and Pulmonary Tuberculosis (PTB). Health practitioners use images (CT scan, Chest X-Ray (CXR)), timely occurrences (daily), audio (Cough), text (clinical and laboratory data) to detect, predict and treat patients with this disease. But machine learning has been proven by researchers when it can effectively and precisely detect, predict, classify, recommend treatment. This chapter discusses and implements a data classification task for early diagnosis and prognosis of the COVID-19 pandemic using CXR image. Classification is a supervised learning task that uses labeled data to assign items to different classes. The indicators that define a good classification task and assess classification models' performance are Receiver Operating Characteristic (ROC), Precision-Recall Curve (PRC), Recall, F1-Score Precision.