ВЛИЯНИЕ ПАНДЕМИИ COVID-19 НА ХИРУРГИЮ ЩИТОВИДНОЙ ЖЕЛЕЗЫ: РЕТРОСПЕКТИВНОЕ ИССЛЕДОВАНИЕ

Abstract

Introduction. The COVID-19 pandemic has affected the pathomorphism of many diseases due to the pathophysiological impact of the infectious process and its drug therapy, and sometimes due to changes in the organization of medical care. During the pandemic, the number of patients with thyroid nodules has increased. Aim. To analyze the impact of the COVID-19 pandemic in Crimea on the surgical aspects of thyroid diseases. Material and methods. A study was made of the impact of the COVID-19 pandemic in Crimea on the surgical aspects of thyroid diseases. Statistical work was carried out with the data of the conclusions of cytological and pathomorphological diagnostics in 1244 patients during the period before, during and after the pandemic. A detailed analysis of cytology according to Bethesda was performed with the calculation of the percentage of conclusions of classes I-VI, morphological data of histological studies with a detailed assessment of malignant neoplasms. Results and discussion. After the start of the epidemic, at the preoperative stage of diagnosing thyroid nodules, an increase in the percentage of nodes with signs of cancer was noted compared to the period of 2019. During the pandemic, a reversible increase in the number of operations for toxic goiter and an irreversible increase in the proportion of malignant tumors were established; an increase in the incidence of B-cell adenomas; the prevalence after the pandemic of more differentiated forms of cancer with a low-risk prognosis, as well as tumors at earlier stages. Such dynamics is probably associated with a complex of factors: antigenic mimicry of the virus, its tropism for thyrocytes, stress and immunosuppression, paradoxically more timely seeking surgical care. Conclusion. The pandemic is characterized by an increase in the number of patients with primary manifestations of thyroid diseases, an increase in the number of toxic goiters and adenomas against the background of gland hyperfunction, a change in the incidence of papillary cancer - an increase in the number of patients, but the identification of prognostically more favorable forms.