Impact of the COVID19 pandemic on patterns of respiratory, thoracic oncology and thoracic surgery outpatient care

Abstract

<b>Introduction:</b> The COVID-19 pandemic has dramatically changed how outpatient care is delivered in health care practices. <b>Aim:</b> To provide an insight into the impact of COVID19 pandemic on outpatient care in a tertiary respiratory centre. <b>Materials/Methods:</b> Retrospective review of outpatient records and electronic databases during the pandemic (03/2020-12/2020) and comparison with previous year (03/2019-12/2019). <b>Results:</b> During the pandemic 15,897 outpatient visits were recorded versus 33,895 in 2019 (53% decrease) with a mean age 64.7 (age range 22-82 years). The biggest decrease in outpatient visits during the pandemic was noted in interstitial lung disease(ILD) clinics (-75%) and general respiratory outpatients (-72%) which are mainly self referrals/primary care referrals for persistent respiratory symptoms not subsiding with first line of treatment. Thoracic oncology outpatients visits decreased by 62% during the pandemic, COPD by 59%, asthma by 56%, OSA by 52%. Thoracic surgery outpatients was amongst the least affected outpatient pathways with a 30% reduction of outpatient visits. The monthly breakdown of visits was inversely proportional to the national pandemic curve and the intermittent state lockdowns. <b>Conclusions:</b> The pandemic and intermitted lockdowns changed the threshold for general respiratory referrals with more people remaining under the community care. The most immunocompromised groups of patients (ILD, thoracic oncology patients) did not seek outpatient care preferring to either transfer their care to other centres or remaining under community care until progression.