| Sumario: | Objective: To analyze the impact of the COVID-19 pandemic on tuberculosis treatment actions in Primary Health Care in the city of São Paulo. Methods: A quantitative, cross-sectional study was conducted in 80 health units distributed proportionally across regional health coordination offices of São Paulo. Participants were 80 health professionals working in tuberculosis control. Data collection was performed over a four-month period between 2022 and 2023. The Bonferroni post hoc test was used to compare the mean changes in treatment actions. The minimum measure of statistical significance adopted was p < 0.05. The Jamovi statistical program, version 2.3.28, was used in data analysis. Results: Changes in the request for sputum culture and collection of medication were reported in 2020 (21.2% and 47.4%), 2021 (21.2% and 39.5%) and 2022 (11.2% and 15.8%). Most units performed directly observed treatment of people with tuberculosis during the COVID-19 pandemic (91.3%), presenting a high level of change in 2020 (38.4%), a moderate level of change in 2021 (28.7%) and a low level of change in 2022 (8.2%). When evaluating the association of year, type of unit, regional health coordination office, change in the work process and increase in the workload, the association was only found for year and type of unit. Conclusion: This study showed that tuberculosis treatment actions in Primary Health Care in the city of São Paulo were impacted by the COVID-19 pandemic, although to a lesser extent than expected.
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