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Scharf C, Mongardini FM, Fisone F, Briatico G, Brancaccio G, Chirico F, Tolone S, Docimo L, Gambardella C, Lucido F, Parisi S, Moscarella E, Argenziano G, Iovino F. Impact of the COVID pandemic on melanoma thickness and ulceration: a meta-analysis. Int J Dermatol 2024. [PMID: 39095953 DOI: 10.1111/ijd.17401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 07/04/2024] [Accepted: 07/10/2024] [Indexed: 08/04/2024]
Abstract
The global healthcare sector faced immense challenges due to the COVID-19 pandemic. Oncologists noted reduced cancer screening, which impacted melanoma diagnosis and treatment, leading to concerns about delayed care and poorer outcomes. This review analyzes how the pandemic influenced melanoma ulceration risk and Breslow thickness index through a meta-analysis of published studies. Following PRISMA guidelines, we conducted a systematic review of literature from January 2021 to December 2022 on cutaneous melanoma before and during the COVID-19 pandemic. Upon screening 1854 manuscripts, the review led to 13 studies meeting inclusion standards. The quality assessment followed MINORS and Newcastle-Ottawa Scale criteria. Regarding ulceration, post-COVID ulceration surpassed pre-COVID levels significantly, with a risk ratio of 1.31 and an estimated odds ratio of 1.41, indicating a 44% rise post-COVID. As for Breslow thickness, studies show a rising trend in the Breslow index post-COVID, but less significantly, with an effect size of 0.08 regarding the meta-analysis model (P = 0.02) with a pre-COVID mean Breslow of 1.56 mm and post-COVID of 1.84 mm. This meta-analysis concluded that post-COVID ulceration rates significantly surpassed pre-COVID levels. Considering that ulcerated melanomas usually undergo sentinel lymph node biopsy and are more likely to benefit from adjuvant therapies, this indicates important implications, as many patients might have missed the opportunity to start therapy appropriately, regardless of their Breslow thickness status.
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Affiliation(s)
- Camila Scharf
- Dermatology Unit, University of Campania L. Vanvitelli, Naples, Italy
| | - Federico M Mongardini
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Francesca Fisone
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giulia Briatico
- Dermatology Unit, University of Campania L. Vanvitelli, Naples, Italy
| | | | - Fabrizio Chirico
- Maxillofacial Surgery Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Salvatore Tolone
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Ludovico Docimo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Claudio Gambardella
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Francesco Lucido
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Simona Parisi
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Elvira Moscarella
- Dermatology Unit, University of Campania L. Vanvitelli, Naples, Italy
| | | | - Francesco Iovino
- Department of Translational Medicine Science, School of Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
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Díaz-Calvillo P, Muñoz-Barba D, Ureña-Paniego C, Maul LV, Cerminara S, Kostner L, Martínez López A, Arias-Santiago S. Effects of COVID-19 Pandemic on the Diagnosis of Melanoma and Keratinocyte Carcinomas: a Systematic Review and Meta-analysis. Acta Derm Venereol 2024; 104:adv19460. [PMID: 38483083 PMCID: PMC10953710 DOI: 10.2340/actadv.v104.19460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 02/22/2024] [Indexed: 03/22/2024] Open
Abstract
Since December 2019, the COVID-19 pandemic has profoundly affected healthcare. The real effects of the COVID-19 pandemic on skin cancer are still unclear, more than 3 years later. This study aims to summarise the pandemic's impact on skin cancer diagnosis and outcome. A systematic review and meta-analysis was conducted, selecting studies comparing skin cancer diagnosis and prognosis post-pandemic with pre-pandemic data. A total of 27 papers were reviewed including 102,263 melanomas and 271,483 keratinocyte carcinomas. During the initial pandemic months (January-July 2020), melanoma surgeries dropped by 29.7% and keratinocyte carcinomas surgeries by 50.8%. Early pandemic tumours exhibited greater thickness and stage. In a long-term period beyond the initial months, melanoma surgeries decreased by 9.3%, keratinocyte carcinomas by 16.6%. No significant differences were observed in the Breslow thickness of melanomas after the start of the pandemic (mean difference 0.06, 95% confidence interval -0.46, 0.58). Melanomas operated on post-pandemic onset had an increased risk of ulceration (odds ratio 1.35, 95% confidence interval 1.22-1.50). Keratinocyte carcinomas showed increased thickness and worsened stage post-pandemic. However, studies included were mostly retrospective and cross-sectional, reporting diverse data. This review indicates that the pandemic likely caused delays in skin cancer diagnosis and treatment, potentially impacting patient outcomes.
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Affiliation(s)
- Pablo Díaz-Calvillo
- Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Daniel Muñoz-Barba
- Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Clara Ureña-Paniego
- Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Lara Valeska Maul
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
| | - Sara Cerminara
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
| | - Lisa Kostner
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland.
| | - Antonio Martínez López
- Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.
| | - Salvador Arias-Santiago
- Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Department of Dermatology, University of Granada, Granada, Spain
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3
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Díaz-Calvillo P, Sánchez-Díaz M, Rodríguez-Pozo JÁ, Martínez-Ruiz V, Martínez-López A, Arias-Santiago S. Impact of COVID-19 Pandemic on Cutaneous Squamous Cell Carcinoma: A Single-Centre Study of Epidemiologic, Clinic and Histopathological Factors. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:T224-T230. [PMID: 38185206 DOI: 10.1016/j.ad.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/12/2023] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic may have adversely affected the early diagnosis of skin cancer. OBJECTIVE To compare epidemiological, clinical and histopathological characteristics in patients undergoing cutaneous squamous cell carcinoma (SCC) surgery before and after the beginning of the pandemic. MATERIAL & METHODS We conducted a cross-sectional study including two case series: (1) patients operated on for SCC in the year after the first state of alarm in Spain (15 March 2020), and (2) patients with SCC operated on in the previous year. Epidemiological, clinical and histopathological variables, tumour stage and risk grade were collected. RESULTS 248 patients were included (127 undergoing surgery before the pandemic and 121 after the pandemic). After the beginning of the pandemic, the percentage of high-risk SCC significantly increased from 35.3% to 46.2% (p=0.011). However, no significant differences were found in thickness, perineural invasion or metastases. CONCLUSIONS Although there has not been a significant reduction in the number of SCC operated on after the pandemic, there has been a significant increase in high-risk SCC. All this could lead to an increase in skin cancer mortality in the future.
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Affiliation(s)
- P Díaz-Calvillo
- Servicio de Dermatología, Hospital Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria (IBS), Granada, Spain
| | - M Sánchez-Díaz
- Servicio de Dermatología, Hospital Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria (IBS), Granada, Spain
| | - J Á Rodríguez-Pozo
- Servicio de Dermatología, Hospital Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria (IBS), Granada, Spain
| | - V Martínez-Ruiz
- Instituto de Investigación Biosanitaria (IBS), Granada, Spain; Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Granada, Granada, Spain
| | - A Martínez-López
- Servicio de Dermatología, Hospital Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria (IBS), Granada, Spain.
| | - S Arias-Santiago
- Servicio de Dermatología, Hospital Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria (IBS), Granada, Spain; Departamento de Medicina, Facultad de Medicina, Universidad de Granada, Granada, Spain
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4
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Díaz-Calvillo P, Sánchez-Díaz M, Rodríguez-Pozo JÁ, Martínez-Ruiz V, Martínez-López A, Arias-Santiago S. Impact of COVID-19 Pandemic on Cutaneous Squamous Cell Carcinoma: A Single-Centre Study of Epidemiologic, Clinic and Histopathological Factors. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:224-230. [PMID: 37858857 DOI: 10.1016/j.ad.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/10/2023] [Accepted: 10/12/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic may have adversely affected the early diagnosis of skin cancer. OBJECTIVE To compare epidemiological, clinical and histopathological characteristics in patients undergoing cutaneous squamous cell carcinoma (SCC) surgery before and after the beginning of the pandemic. MATERIAL & METHODS We conducted a cross-sectional study including two case series: (1) patients operated on for SCC in the year after the first state of alarm in Spain (15 March 2020), and (2) patients with SCC operated on in the previous year. Epidemiological, clinical and histopathological variables, tumour stage and risk grade were collected. RESULTS 248 patients were included (127 undergoing surgery before the pandemic and 121 after the pandemic). After the beginning of the pandemic, the percentage of high-risk SCC significantly increased from 35.3% to 46.2% (p=0.011). However, no significant differences were found in thickness, perineural invasion or metastases. CONCLUSIONS Although there has not been a significant reduction in the number of SCC operated on after the pandemic, there has been a significant increase in high-risk SCC. All this could lead to an increase in skin cancer mortality in the future.
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Affiliation(s)
- P Díaz-Calvillo
- Dermatology Unit, Virgen de las Nieves University Hospital, Granada, Spain; TECe19-Investigational and Translational Dermatology Research Group, Instituto de Investigación Biosanitaria (IBS), Granada, Spain
| | - M Sánchez-Díaz
- Dermatology Unit, Virgen de las Nieves University Hospital, Granada, Spain; TECe19-Investigational and Translational Dermatology Research Group, Instituto de Investigación Biosanitaria (IBS), Granada, Spain
| | - J Á Rodríguez-Pozo
- Dermatology Unit, Virgen de las Nieves University Hospital, Granada, Spain; TECe19-Investigational and Translational Dermatology Research Group, Instituto de Investigación Biosanitaria (IBS), Granada, Spain
| | - V Martínez-Ruiz
- TECe19-Investigational and Translational Dermatology Research Group, Instituto de Investigación Biosanitaria (IBS), Granada, Spain; Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, Granada, Spain
| | - A Martínez-López
- Dermatology Unit, Virgen de las Nieves University Hospital, Granada, Spain; TECe19-Investigational and Translational Dermatology Research Group, Instituto de Investigación Biosanitaria (IBS), Granada, Spain.
| | - S Arias-Santiago
- Dermatology Unit, Virgen de las Nieves University Hospital, Granada, Spain; TECe19-Investigational and Translational Dermatology Research Group, Instituto de Investigación Biosanitaria (IBS), Granada, Spain; Department of Dermatology, University of Granada, Granada, Spain
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Apostu AP, Vesa ȘC, Frățilă S, Iancu G, Bejinariu N, Muntean M, Șenilă SC, Baba OA, Secășan CP, Ungureanu L. The effects of the COVID-19 pandemic on the diagnosis and prognosis of melanoma 2 years after the pandemic in two Romanian counties. Front Med (Lausanne) 2024; 11:1328488. [PMID: 38323030 PMCID: PMC10844525 DOI: 10.3389/fmed.2024.1328488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/09/2024] [Indexed: 02/08/2024] Open
Abstract
Background The COVID-19 pandemic disrupted the healthcare system and negatively affected the diagnosis and management of melanoma worldwide. The purpose of this study is to investigate the long-term effects of the COVID-19 pandemic on the diagnosis and prognosis of melanoma. Materials and methods This retrospective cohort study included histopathologically confirmed melanoma cases from March 2019 to February 2023 in Cluj and Bihor counties. Data from the post-COVID-19 period (March 2021 to February 2023) were compared to the pre-COVID-19 period (March 2019 to February 2020) and the COVID-19 period (March 2020 to February 2021). Patient characteristics, monthly diagnostics, histological subtypes, and key histological features were analyzed using statistical tests. Results The number of melanoma cases diagnosed annually decreased by 31.37 and 23.75% in the first and second post-pandemic years, respectively, compared to pre-pandemic numbers. Diagnostic rates also decreased by 14.9 and 5.4% in the first and second post-pandemic years, respectively, compared to the pandemic period. Prognostic factors worsened in the post-pandemic period, with higher Breslow index and mitotic rate, and increased ulceration and thick melanomas compared to the pre-pandemic period. Conclusion The COVID-19 pandemic had a long-lasting impact on the diagnosis of melanoma in Romania, resulting in advanced stages and unfavorable prognostic factors. Larger global studies are needed to comprehensively understand the pandemic's long-term effects on the diagnosis of melanoma.
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Affiliation(s)
- Adina Patricia Apostu
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Clinical Hospital of Infectious Diseases, Cluj Napoca, Romania
| | - Ștefan Cristian Vesa
- Department of Pharmacology, Toxicology and Clinical Pharmacology, “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Simona Frățilă
- Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
- Clinical Emergency County Hospital, Oradea, Romania
| | - Gabriela Iancu
- Department of Dermatology, Faculty of Medicine, “Lucian Blaga” University of Sibiu, Sibiu, Romania
- Clinic of Dermatology, County Emergency Hospital Sibiu, Sibiu, Romania
| | - Nona Bejinariu
- Santomar Oncodiagnostic Laboratory, Cluj-Napoca, Romania
| | - Maximilian Muntean
- Department of Plastic and Reconstructive Surgery, “Prof Dr. I. Chiricuță” Institute of Oncology, Cluj-Napoca, Romania
| | - Simona C. Șenilă
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Department of Dermatology, Emergency County Hospital, Cluj-Napoca, Romania
| | | | | | - Loredana Ungureanu
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Department of Dermatology, Emergency County Hospital, Cluj-Napoca, Romania
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Toma AO, Prodan M, Reddyreddy AR, Seclaman E, Crainiceanu Z, Bloanca V, Bratosin F, Dumitru C, Pilut CN, Alambaram S, Vasamsetti NG, Decean L, Pricop M. The Epidemiology of Malignant Melanoma during the First Two Years of the COVID-19 Pandemic: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:305. [PMID: 36612627 PMCID: PMC9819675 DOI: 10.3390/ijerph20010305] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/16/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
It is hypothesized that the COVID-19 pandemic had a major impact on the epidemiology of malignant melanoma owing to diminished screening, diagnostic, and treatment capacities, resulting in a more advanced stage at initial presentation. The goal of this study is to undertake a systematic analysis of all epidemiological and clinical data on the trends and patient outcomes with malignant melanoma during the ongoing pandemic. Records were identified from PubMed, Cochrane, and Web of Science, selecting a total of 39 articles, narrative reviews, and editorial letters, following the PRISMA guidelines. The vast majority of the studies were published in Europe (28/39), and North America (7/39). A total of 99,860 patients were analyzed during 2020 and 2021 of the COVID-19 pandemic, and it was observed that malignant melanoma TNM staging increased significantly compared to the pre-pandemic period. Before the pandemic, 25.88% of patients had TNM stage II or above, compared to 36.25% during 2020-2021. During the COVID-19 pandemic, the malignant melanoma Breslow depth index grew from 1.59 mm before 2020 to 1.86 mm in 2020 and 2021. Patients decreased by 19.58% in 2020 and 2021 compared to pre-pandemic numbers. The patient-loss ratio indicated lower screening activity and patient addressability to dermatology and plastic surgery departments with skin cancer concerns during the COVID-19 pandemic. This systematic study shows that the identification and management of malignant melanoma during the COVID-19 pandemic faced major challenges which should alert medical systems to the high number of patients with advanced disease stages who may need emergency treatment and become incurable.
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Affiliation(s)
- Ana-Olivia Toma
- Department of Microbiology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Mihaela Prodan
- Department of Plastic Surgery, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Akash Reddy Reddyreddy
- School of General Medicine, Bhaskar Medical College, Amdapur Road 156-162, Hyderabad 500075, India
| | - Edward Seclaman
- Department of Biochemistry and Pharmacology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Center for Complex Networks Science, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Zorin Crainiceanu
- Department of Plastic Surgery, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Vlad Bloanca
- Department of Plastic Surgery, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Felix Bratosin
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Catalin Dumitru
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Ciprian Nicolae Pilut
- Kaloji Narayana Rao University of Health Sciences, Nizampura, Warangal, Telangana 506007, India
| | - Satish Alambaram
- School of General Medicine, Bhaskar Medical College, Amdapur Road 156-162, Hyderabad 500075, India
| | | | - Luminita Decean
- Faculty of General Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Strada Gheorghe Marinescu 38, 540139 Targu Mures, Romania
| | - Marius Pricop
- Discipline of Oral and Maxillo-Facial Surgery, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
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Seretis K, Bounas N, Gaitanis G, Bassukas I. A Meta-Analysis on the Impact of the COVID-19 Pandemic on Cutaneous Melanoma Diagnosis in Europe. Cancers (Basel) 2022; 14:cancers14246085. [PMID: 36551570 PMCID: PMC9776971 DOI: 10.3390/cancers14246085] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/05/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
The COVID-19 pandemic has been the epicenter of healthcare attention globally for the past two years, and large-scale adaptations in healthcare provision have been required. This study aimed to investigate the impact of the pandemic and the resulting lockdowns on cutaneous melanoma diagnosis and tumor burdens in Europe. A relevant literature search in electronic databases was conducted from inception to September 2022. The inclusion criteria were: controlled studies published in a peer-reviewed journal evaluating cutaneous melanoma in Europe and reporting data on melanoma characteristics from diagnoses. The quality of studies was evaluated using the Cochrane ROBINS-I tool for assessing bias in non-randomized studies. Meta-analysis was conducted utilizing a random effects model to synthesize the data. A total of 25 studies involving 32,231 patients were included in the data analysis models. Statistically significant increases in mean Breslow thickness (0.29 mm (0.03-0.55 mm)), ulceration rates (OR = 1.66 (1.29-2.13)), and resultant tumor staging were observed in the PostCovid group, with subgroup analysis revealing that lockdown-derived data were responsible for this trend. This meta-analysis reported on the impact of COVID-19 restrictions on melanoma diagnosis in Europe, emphasizing the higher tumor burden and disease progression state provoked by healthcare adaptations in the pandemic period.
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Affiliation(s)
- Konstantinos Seretis
- Department of Plastic Surgery, School of Health Sciences, University of Ioannina, 45100 Ioannina, Greece
- Correspondence: (K.S.); (I.B.); Tel.: +30-26-5109-9077 (K.S.); +30-26-5100-7425 (I.B.)
| | - Nikolaos Bounas
- Department of Plastic Surgery, School of Health Sciences, University of Ioannina, 45100 Ioannina, Greece
| | - Georgios Gaitanis
- Department of Skin and Venereal Diseases, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45100 Ioannina, Greece
| | - Ioannis Bassukas
- Department of Skin and Venereal Diseases, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45100 Ioannina, Greece
- Correspondence: (K.S.); (I.B.); Tel.: +30-26-5109-9077 (K.S.); +30-26-5100-7425 (I.B.)
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Ungureanu L, Apostu AP, Vesa ȘC, Cășeriu AE, Frățilă S, Iancu G, Bejinariu N, Munteanu M, Șenilă SC, Vasilovici A. Impact of the COVID-19 Pandemic on Melanoma Diagnosis in Romania-Data from Two University Centers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15129. [PMID: 36429847 PMCID: PMC9690697 DOI: 10.3390/ijerph192215129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 11/13/2022] [Accepted: 11/14/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic affected the healthcare system in our country and led non-COVID patients to postpone medical visits that were not urgent. The purpose of this study was to investigate the impact of the first year of the COVID-19 pandemic on the trends in melanoma diagnosis and to compare the pathological characteristics of melanoma patients before and during the pandemic. The number of primary cutaneous melanomas diagnosed each month between 1 March 2019 and 29 February 2020 (pre-COVID-19) and between 1 March 2020 and 28 February 2021 (COVID-19) in the North-Western Region of Romania (Cluj and Bihor counties) was determined. The pathological characteristics of melanomas diagnosed in the two intervals were compared. The number of melanoma diagnoses substantially decreased during the pandemic, with 66 (-19.3%) fewer cutaneous melanomas being diagnosed in the first year of the pandemic when compared with the previous year. The tumor thickness and mitotic rate were significantly higher in cases found during the COVID-19 pandemic. Our study suggests that COVID-19 has delayed diagnosis in patients with melanoma, leading to the detection of thicker melanomas that may increase morbidity and mortality. Further studies are needed to determine the consequences of this delay on outcomes.
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Affiliation(s)
- Loredana Ungureanu
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
- Department of Dermatology, Emergency County Hospital, 400006 Cluj-Napoca, Romania
| | - Adina Patricia Apostu
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Ștefan Cristian Vesa
- Department of Pharmacology, Toxicology and Clinical Pharmacology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania
| | - Alexandra Elena Cășeriu
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Simona Frățilă
- Faculty of Medicine and Pharmacy, University of Oradea, 410068 Oradea, Romania
- Clinical Emergency County Hospital, 410039 Oradea, Romania
| | - Gabriela Iancu
- Department of Dermatology, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 550169 Sibiu, Romania
- Clinic of Dermatology, County Emergency Hospital Sibiu, 550245 Sibiu, Romania
| | - Nona Bejinariu
- Santomar Oncodiagnostic Laboratory, 400350 Cluj-Napoca, Romania
| | - Maximilian Munteanu
- Department of Plastic and Reconstructive Surgery, “Prof Dr. I. Chiricuță” Institute of Oncology, 400015 Cluj-Napoca, Romania
| | - Simona C. Șenilă
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
- Department of Dermatology, Emergency County Hospital, 400006 Cluj-Napoca, Romania
| | - Alina Vasilovici
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
- Department of Dermatology, Emergency County Hospital, 400006 Cluj-Napoca, Romania
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