Utjecaj pandemije COVID-19 na rad patologije i citologije u Kliničkom bolničkom centru Rijeka

Danijela Vrdoljak Mozetič, Anita Savić Vuković, Manuela Avirović, Irena Seili Bekafigo, Dora Fučkar Čupić, Ksenija Jurinović, Gordana Đorđević, Senija Eminović, Nives Jonjić

Cilj istraživanja: Cilj istraživanja je bio utvrditi utjecaj pandemije COVID-19 na sveukupni rad patohistološkog i citološkog laboratorija u KBC-u Rijeka kao i na dijagnostiku nekih od najčešćih malignih bolesti. Metode: Retrospektivno su iz računalne baze podataka izvučeni i međusobno uspoređeni brojevi patohistoloških i citoloških nalaza, novodijagnosticiranih malignoma dojke, pluća, debelog crijeva, endometrija i prostate te molekularnih testova za analizu mutacije EGFR i HPV-infekcije za razdoblje od 1. ožujka do 30. rujna 2019. (prije pandemije) te od 1. ožujka do 30. rujna 2020. (za vrijeme pandemije COVID-19). Rezultati: Ukupni broj izvršenih pretraga bio je statistički značajno manji za vrijeme pandemije COVID-19 u 2020. u odnosu na isto razdoblje 2019. (p<0,000), patohistološke dijagnostike za 24%, neginekoloških citoloških nalaza za 20%, ginekoloških za 13% te papa testova za 11% manje. Za vrijeme COVID-19 u odnosu na isto razdoblje prije pandemije broj novodijagnosticiranih malignih tumora značajno je smanjen za maligne novotvorine debelog crijeva (–25%, p<0,0001). Smanjenje novih slučajeva karcinoma dojke (–3%) i karcinoma prostate (–4%) bilo je manje izraženo, dok je povećanje evidentirano za karcinome pluća (+2%) i endometrija (+53%). Broj HPV-testova značajno je pao za vrijeme pandemije COVID-19, za 40% (p<0,0001). Zaključci: Ovim radom smo potvrdili očekivano značajno smanjenje opsega rada tijekom prvog vala pandemije COVID-19 u 2020., i to od 11% do 40%, iako broj bolesnica/ka s novodijagnosticiranim karcinomima, osim s karcinomom debelog crijeva, nije značajno pao. Važno bi bilo formirati zajednički nacionalni registar koji bi prikupio ne samo dijagnostičke, već i terapijske postupke, posebno onkoloških bolesnica/ka, čime bi se dobio objektivniji uvid u probleme zdravstvenog sustava za vrijeme pandemije. Ovi podatci mogu poslužiti promišljanju mjera i strategije za što adekvatnije zbrinjavanje ne samo oboljelih od COVID-19, već i ostalih.

Aim: To determine the impact of the COVID-19 pandemic on the overall practice of the histopathological and cytological laboratory at the University Hospital Centre Rijeka, and on the diagnosis of the most common cancers. Methods: The numbers of histopathological and cytological reports, newly diagnosed cancers of breast, lung, colon, endometrium, and prostate, molecular tests for EGFR mutations and HPV were extracted. Two periods, from March 1 to September 30 in 2019 and 2020 were analysed and compared, as the periods before and during the COVID-19 pandemic. Results: The total number of reports was statistically significantly lower during
the COVID-19 pandemic in 2020, compared to the same period in 2019 (p<0.000), histopathology by 24%, non-gynecological cytology by 20%, gynecological cytology by 13%, and Pap tests by 11%. During COVID-19 compared to the same period in 2019 the number of newly diagnosed malignant tumors was significantly reduced for colon cancers (–25%, p <0.0001). The decrease in the new cases of breast (–3%) and prostate cancer (–4%) was less pronounced while the increase was recorded for lung (+ 2%) and endometrial cancer (+ 53%). The number of HPV tests dropped significantly during the COVID-19 pandemic, by 40% (p <0.0001). Conclusions: This study confirmed the expected significant reduction in workload during the first wave of the COVID-19 pandemic in 2020, from 11% to 40%, although the number of patients with newly diagnosed cancers, except for colon, did not fall significantly. It would be important to form a joint national registry that would collect diagnostic and also therapeutic procedures, especially for oncology patients, in order to gain a more objective insight into the problems of the health system during pandemics. These data can be used to consider measures
and strategies for the most adequate care, not only for COVID-19 but also for all other patients.