ENT Service during the COVID-19 pandemic: a cross-sectional study in 572 patients.
Short title : Healthcare delivery during the pandemic
Keywords : Covid-19, SARS-CoV-2, Healthcare delivery, Surgery, Emergency
KEYPOINTS
  1. Lockdown measures have drastically restricted freedom of movement and outlawed public gatherings in order to protect health services.
  2. However, health services may have been impacted by these measures, in particular in otolaryngology. Our goal was to prospectively evaluate ENT coverage in real life under lockdown rules.
  3. The Coronavirus crisis resulted in a severe disruption of the ENT service, including outpatient, inpatient and surgical activities.
  4. The comparison with last year’s activity raised concerns about the quality of the care provided.
  5. If the goal of avoiding crowds of people has been achieved, patients may not have received the care they deserve and special attention should be paid to non-Covid patients.
ABSTRACT
Objective : To provide objective data on the impact of COVID-19 crisis on our ENT practice.
Design : Cross-sectional study.
Setting : Tertiary referral hospital (1038 inpatients beds).
Participants : 572 consecutive patients presenting to the ENT clinic and ENT operating theatre from March 16, 2020 to May 3, 2020 were prospectively included.
Main outcome measures : Demographic and clinical data, admission time, paraclinic testing, management, outcome and follow’up were recorded. Retrospective search for comparison to past year over the same period of time was carried out.
Results : Coronavirus crisis and the strict lockdown rules led to a severe disruption of the ENT service. A drop in overall activity of 91.1% was observed. Mortality rates increased from 0.82% to 4.55%. While some patients in real need may not have been able to be seen, others presented without ground. More than a quarter of admissions (n=157, 27.6%) resulted in no specific ENT treatment. Patient selection improved when patients had a recent ENT history (OR=2.39 [1.50-3.81], p=0.0003) or were referred by a physician (OR=5.30 [3.69-7.61], p<0.0001).
Conclusions : Our data suggested impaired healthcare of all ENT patients. Special attention should be paid to non-Covid otolaryngology patients.
INTRODUCTION
In December 2019, a new coronavirus was isolated from a cluster of pneumonia in Wuhan.1 The World Health Organization subsequently named this new entity as Coronavirus disease 2019 and declared pandemic status on March 11, 2020.2 Many European countries have imposed lockdowns to combat the spread of the SARS-CoV2, to curb infection and death rates and protect health services. In Belgium, the lockdown has been declared on March 13 at midnight and was gradually relieved from May 4, 2020. These measures have generated profound changes in our ENT practice, restricting our activity to what deemed necessary and emergencies. The purpose of this study was to provide objective data on the impact of COVID-19 crisis on our ENT practice over the lockdown period.
MATERIALS AND METHODS