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
- Lockdown measures have drastically restricted freedom of movement and
outlawed public gatherings in order to protect health services.
- 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.
- The Coronavirus crisis resulted in a severe disruption of the ENT
service, including outpatient, inpatient and surgical activities.
- The comparison with last year’s activity raised concerns about the
quality of the care provided.
- 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