Pre-pandemic Period Research Articles

Self-Perceived Stress and the Personality of Mothers of Children with Central Auditory Processing Disorder, as Well as in Mothers of Typically Developing Children, Before and Late in the COVID-19 Pandemic.

This study aims to measure, at two time points, the relationship between self-perceived global stress and the personality traits of the mothers of children who have central auditory processing disorder (APD) and compare it with the results from mothers of typically developing (TD) children. The comparisons were made before the COVID-19 pandemic, as well as late in the pandemic. The level of stress was assessed using the Perceived Stress Scale (PSS-10), while the Short Big Five Markers (IPIP-BFM-20) were used to assess Big Five personality traits. The study used two independent samples: one evaluated before the COVID-19 pandemic and the other late in the pandemic. Each sample consisted of 108 mothers of children with APD and 79 mothers whose children did not have APD (TD children) as controls. The average global stress levels were similar in mothers of children with APD and in mothers of TD children, both before and in the late stage of the COVID-19 pandemic. During the late stage, both sets of mothers scored similarly on all personality dimensions, but significantly, mothers of TD children exhibited lower emotional stability compared to during the pre-pandemic period. In both groups, emotional stability predicted global stress level at both time points; however, during the pandemic, conscientiousness also became a predictor of global stress level but only in the group of mothers of TD children. Mothers of APD children might be more resistant to additional stressors. It would be prudent to watch mothers of APD and TD children for signs of needing psychological intervention.

The Advancement of Appendicitis in Children in the Pre-Pandemic and the Pandemic Year.

Background: The COVID-19 pandemic affected the health of millions of people, both directly through infection and indirectly through delayed diagnosis and treatment of non-COVID-19 illnesses. The aim of this study was to check the impact of the COVID-19 pandemic on the diagnosis and treatment of appendicitis in children. Methods: The study was carried out at the Department of Paediatric Surgery of the Marciniak Hospital (Wrocław, Poland) and covered two periods, the pre-pandemic one (P1, 01/03/2019-29/02/2020) and the pandemic one (P2, 01/03/2020-28/02/2021). Results: The number of admissions of patients with suspected appendicitis and observation-only patients decreased during the pandemic (400/289 and 226/160, respectively). Although the number of operated children was similar during both analyzed periods (P1: 174, P2: 160), the rate of surgical interventions was significantly higher during P2 (55.4%) than during P1 (43.5%) (χ2 test: p = 0.00272). The values of the variables quantifying disease progression and severity of inflammation, selected inflammation-related parameters detected by laboratory blood tests, latencies from the onset of symptoms to the admission and from the admission to the operation, and total duration of hospitalization did not differ significantly between the pre-pandemic and pandemic periods. Conclusions: These results show that the COVID-19 pandemic led to more rigorous and careful triage of pediatric patients suspected of acute appendicitis that did not have a negative impact on patient outcomes.

Effects of the COVID-19 pandemic on hospital admissions and inpatient mortality in Kenya: a retrospective cohort study

Background The impact of COVID-19 in Africa remains poorly described. We examined hospitalisation trends for all medical causes, clinician-diagnosed pneumonia admissions, and inpatient mortality in Kenya two years before and across the first six waves of the pandemic. Methods We conducted a hospital-based observational study of patients admitted to 13 public referral facilities in Kenya from January 2018 to December 2022. The pre-COVID-19 population included admissions before 1st March 2020. Time series models, adjusted for seasonality and hospital, compared observed and predicted trends. To estimate the impact of the COVID-19 pandemic, we calculated incidence rate ratios (IRR) from negative binomial mixed-effects models. Results 357,631 patients were admitted across the 13 sites (range 15,354 to 67,241 per hospital). 45,349 patients (42.1%) were admitted to the adult medical wards. On the paediatric ward, 163,608 individuals (47.4%) were aged under five years and 36,227 individuals (10.5%) were aged five years and older. In comparison to the pre-pandemic period, hospitalisations reduced for adults (IRR 0.75, 95% CI 0.69–0.82) and paediatric cases (IRR 0.69, 95% CI 0.64–0.75). In-hospital deaths also declined for adults (IRR 0.83, 95% CI 0.77–0.89) and children (IRR 0.85, 95% CI 0.77–0.94). Adult pneumonia admissions increased (IRR 1.59, 95% CI 1.36–1.85), while paediatric cases decreased overall, (IRR 0.78, 95% CI 0.51–1.20), but became elevated in late 2021 compared to the pre-pandemic period. Conclusions The COVID-19 pandemic did not cause a surge in hospitalisations in Kenya. However, pneumonia admissions among adults (but not children) increased significantly, with peaks aligning with the pandemic waves. These findings underscore the importance of syndromic inpatient surveillance in detecting and monitoring outbreaks.

Psychosocial and pandemic-related circumstances of suicide deaths in 2020: Evidence from the National Violent Death Reporting System.

To describe and explore variation in 'pandemic-related circumstances' among suicide decedents during the first year of the COVID-19 pandemic. We identified pandemic-related circumstances using decedents' text narratives in the 2020 National Violent Death Reporting System. We use time-series analysis to compare other psychosocial characteristics (e.g., mental health history, interpersonal difficulties, financial strain) of decedents pre-pandemic (2017/2018: n = 56,968 suicide and n = 7,551 undetermined deaths) to those in 2020 (n = 31,887 suicide and n = 4,100 undetermined). We characterize common themes in the narratives with pandemic-related circumstances using topic modeling, and explore variation in topics by age and other psychosocial circumstances. In 2020, n = 2,502 (6.98%) narratives described pandemic-related circumstances. Compared to other deaths in 2020 and to the pre-pandemic period, decedents with pandemic-related circumstances were older and more highly educated. Common themes of pandemic-related circumstances narratives included: concerns about shutdown restrictions, financial losses, and infection risk. Relative to decedents of the same age that did not have pandemic-related circumstances in 2020, those with pandemic-related circumstances were more likely to also have financial (e.g., for 25-44 years, 43% vs. 12%) and mental health (76% vs. 66%) psychosocial circumstances, but had similar or lower prevalence of substance abuse (47% vs. 49%) and interpersonal (40% vs. 42%) circumstances. While descriptive, these findings help contextualize suicide mortality during the acute phase of the COVID-19 pandemic and can inform mental health promotion efforts during similar public health emergencies.

Differences in the Rates of Diagnoses of Mental and Behavioral Disorders Due to Psychoactive Substance Use by Sex and Age during Pre-Pandemic and COVID-19 Pandemic Periods in Kazakhstan.

The COVID-19 pandemic had profound impacts worldwide on individuals with mental and behavioral disorders, including disorders due to psychoactive substance use. We investigated how the COVID-19 pandemic affected the trends in these disorders in the Republic of Kazakhstan. We researched and compared ICD-10 data on mental and behavioral disorders due to substance use in Kazakhstan that were diagnosed in 2018-2019 (pre-pandemic) versus 2020-2021 (the pandemic period). The data for the pandemic period were significantly different from those of the pre-pandemic in that (i) 'other stimulant-related disorders (F15)' and 'other psychoactive substance-related disorders (F19)' were increased in the younger age groups, (ii) the risk of 'opioid-related disorders (F11)' was decreased in the 30-year-old group in both males and females, and (iii) the risk of 'alcohol-related disorders (F10)' was increased in the 30-year-old group and decreased in the 20- and 50-year-old groups. In only the males, (iv) the risk of 'other psychoactive substance-related disorders (F19)' was increased in almost all of the age groups, and (v) the risk of 'cannabis-related disorders (F12)' was increased in the ≥50-year-olds. The pre-pandemic and pandemic periods thus involved changes due to COVID-19 in both males and females that were especially notable in males. These results indicate that further measures designed to prevent mental and behavioral disorders due to psychoactive substances are necessary at the primary, secondary, and tertiary levels, and personnel in medicine/nursing, the government, private organizations, and the public need to collaborate to devise such measures.

Respiratory pathogen analysis in pediatric inpatients unraveled the infection pattern of Mycoplasma pneumoniae post the COVID-19 pandemic.

To counteract the COVID-19 pandemic, nonpharmaceutical interventions (NPIs) were implemented globally, exerting a profound influence on a wide spectrum of infectious diseases, encompassing respiratory tract infections (RTIs). Subsequent to the easing of NPIs, China experienced a significant outbreak of Mycoplasma pneumoniae (MP). Over a decade from 2015 to 2024, our study scrutinized 12 common infectious diseases among pediatric children. Etiologically diagnostic data and clinical outcome metrics of children with RTIs, tested for 13 pathogens, were analyzed to evaluate changes during and after the pandemic compared to pre-pandemic periods, with a notable emphasis on age profile and coinfection patterns of MP. Among 57,471 hospitalized children, 23,178 were diagnosed with infectious diseases. Under NPIs, most respiratory infections declined compared to pre-pandemic levels, rebounding by 69.64% in 2023. While the infection rate of common respiratory pathogens decreased, cases of respiratory syncytial virus increased during the period of extensive NPI implementation. In 2023, pediatric intensive care unit durations for these pathogens increased, suggesting greater severity of illness compared to 2019. MP exhibited the highest infection rate (31.38% average), with a notable outbreak post-pandemic due to severity increase in <3 year olds and rise among older children. NPIs reduced MP coinfections and mitigated their severity, while exerting a significant influence on bacterial coinfections with MP over the span of 5 years, in contrast to their impact on viral pathogens. NPIs effectively curb transmission of respiratory infections by most pathogens, resulting in increased average age of MP infections and altered patterns of coinfection post-pandemic.

Kawasaki disease before and during the COVID-19 pandemic: a single-center comparative study in Switzerland.

Kawasaki disease is a rare systemic inflammatory syndrome that mainly affects children under five years of age and is the first cause of pediatric acquired cardiovascular disease. The pathogenesis is complex and a viral trigger is suspected, as well as genetic susceptibility. Multiple studies around the world have shown a decrease in the incidence of Kawasaki disease and have hypothesized that the different sanitary measures enforced in each country during the pandemic period could be responsible to a certain extent. The aim of this study is to evaluate the effects of the COVID-19 pandemic on the disease's incidence, defining characteristics, coronary artery outcomes and management in a tertiary center in Switzerland. This study is a retrospective analysis of children who have been diagnosed with Kawasaki disease that compares clinical, laboratory, SARS-CoV-2 exposure, and echocardiographic data as well as treatments before (January 1st 2017 to February 24th 2020) and during (February 25th 2020 to December 31st 2022) the COVID-19 pandemic in Switzerland. Statistical significance of differences in the compared parameters was assessed. Of the 90 patients included, 31 belonged to the first group and 59 belonged to the second group. There was a statistically significant (p < 0.05) increase in incidence during the pandemic period (5.91/100,000 children) of 88% compared to the pre-pandemic period (3.14/100,000 children). A lesser seasonal variation was observed during the pandemic. 30% of the patients in the pandemic group had an exposure to SARS-CoV-2. There was no other notable difference in demographic factors, clinical presentation, coronary outcome or administered treatment. To the best of our knowledge, this is the first prolonged European study comparing Kawasaki disease before and during the COVID-19 pandemic. There was a significant increase in incidence in Kawasaki disease during the COVID-19 pandemic. In contrast, studies done in Japan, South Korea and the USA have shown a decrease in incidence. Differences in methodologies, genetics, ethnicities, environments, microbiome-altering behaviors, sanitary measures and SARS-CoV-2 spread are factors that should be considered. Further studies analyzing the differences between countries with increased incidence of Kawasaki disease could help better understand the relevance of such factors and provide more insight into the etiologies of this particular disease.

COVID-19 pandemic and competitive authoritarian regimes: Human rights and democracy in the Philippines and Nicaragua

How do competitive authoritarian regimes in the Global South respond to the COVID-19 pandemic? How do these policy responses facilitate human rights deterioration in societies that are already facing democratic regression during the pre-pandemic period? Examining evidence from the Philippines and Nicaragua during the COVID-19 pandemic, this article demonstrates that competitive authoritarian regimes have reinforced the deterioration of democratic processes and disregard for their human rights commitments amidst the global pandemic. First, such regimes weaponize the legal system to consolidate the powers of the chief executive and their allies. Second, such regimes systematically disregard transparency and accountability when executing state leaders’ public actions and responsibilities. Third, such regimes increasingly empower military personnel and intensify state violence at the expense of science-based approaches to crisis policies, thereby embracing militarism as an overarching orientation.

COVID-19 and Mortality in the Spinal Cord Injury Population: Examining the Impact of Sex, Mental Health, and Injury Etiology.

The purpose of this study was to investigate the impact of the COVID-19 pandemic on mortality rates in a community-dwelling spinal cord injury (SCI) population in Ontario. Using health administrative databases, monthly mortality rates were evaluated pre-pandemic, during the pandemic, and post-pandemic from March 2014 to May 2024. Data were stratified by sex, injury etiology, and mental health status. Group differences were evaluated using t-tests. Autoregressive integrated moving average (ARIMA) models evaluated the pandemic's impact on mortality rates. A significant increase of 21.4% in mortality rates during the pandemic was found for the SCI cohort. With the exception of the traumatic group, all subgroups also experienced a significant increase in mortality rates (males: 13.9%, females: 31.9%, non-traumatic: 32.3%, mental health diagnoses: 19.6%, and mental health diagnoses: 29.4%). During the pandemic, females had a significantly higher mortality rate than males. The non-traumatic group had higher mortality rates than the traumatic group at all time periods. Individuals with mental health diagnoses had higher mortality rates than those without at the pre-pandemic and pandemic periods. The variation in mortality rates across groups highlights inequitable access to medical care in the SCI population, with further research and interventions needed.

Lifestyle, meal times, and sleep patterns changes in higher education professors during COVID-19: Association with non-communicable chronic diseases.

In response to the COVID-19 pandemic, educational institutions had to swiftly adapt and transition to remote teaching in order to maintain academic activities. However, these changes presented a number of challenges for professors, which could have negative effects on their health. To analyze the association between changes in dietary and sleep habits, physical activity level, and sedentary behavior with the development of non-communicable diseases (NCDs) among Brazilian higher education professors during the pandemic period. This is a cross-sectional and retrospective study conducted using an online form. Generalized linear models, adjusted for age, sex, and body mass index, were used to verify the difference between pre-pandemic and pandemic periods. Logistic regression models were used to predict the odds ratio (OR) for the development of NCDs according to physical activity time, sedentary behavior time, dietary and sleep patterns. A total of 936 professors residing across Brazil participated in the survey. The duration of sedentary behavior increased, sleep duration slightly decreased, and meal times shifted to earlier during the pandemic. A total of 22.9%of the participants reported the diagnosis of some NCDs during this period. Physical activity practice was associated with a lower risk of diseases during the pandemic, regardless of the intensity performed. On the other hand, late eating habits and excessive food consumption during the pandemic were associated with a higher risk. The results provide data that can help in the development of public policies that promote health actions to minimize the consequences associated with the pandemic period.

‘Retire, play petanque, take synthrom, travel, eat a blue pill and screw two old ladies’: Ageist language in Spain on Twitter

Ageist language discriminates against older people, infantilising, depersonalising and dehumanising them. Through a longitudinal study of tweets written in Spain between 2019 and 2023, this study investigates the evolution of ageism in the Spanish language. Using a mixed methodology based on Twitter public data mining, 27,971 tweets were analysed. Of these, 3555 tweets (19.31%) used ageist language. The analysis revealed a significant increase in ageist language after COVID-19, with the number of ageist tweets almost doubling compared to the pre-pandemic period. The results of the study suggest that ageist language on Twitter in Spain is mainly characterised by depersonalisation, portraying older people as a homogeneous and passive group. The study also highlights the double discrimination faced by older women on Twitter, where the language is not only ageist but also sexist, limiting their privacy and denying their rights in relation to their sexuality and physical appearance.

Trends of Diphtheria–Tetanus–Pertussis and Measles Vaccine Coverage Preceding and during the COVID-19 Pandemic: An Analysis of the WHO European Region from 2000 to 2022

Available data highlights the significant impact of the COVID-19 pandemic on global vaccination trends. Despite this, comprehensive evaluations of these changes at the European level are still scarce. This study examines coverage for diphtheria, tetanus, and pertussis (DTP) and measles-containing vaccines (MCV) in the WHO European Region from 2000 to 2022. Vaccination coverage data, defined as the percentage of surviving infants who received the first and third doses of DTP (DTP1 and DTP3) and the first and second doses of MCV (MCV1 and MCV2), were extracted from UNICEF databases. Joinpoint regression analysis was employed to identify joinpoints in the time series and to estimate Annual Percent Changes (APCs) and Average Annual Percent Changes (AAPCs) over predefined timeframes. The coverages for DTP1 and MCV1 exhibit a similar trend, overall characterized by four joinpoints, one of which is in 2019. In contrast, the coverage for DTP3 does not show a significant temporal trend and lacks joinpoints, while the vaccination coverage for MCV2 shows a steadily increasing trend, with three identified joinpoints. A comparative analysis with the pre-pandemic period reveals a significant increase in the number of countries characterized by a decreasing trend during the pandemic period for all considered vaccination coverages, as indicated by the negative AAPC values. These results highlight the effect of the pandemic on childhood vaccination coverage. Compared to a mere descriptive analysis, the temporal analysis of trends using joinpoint regression provides significant opportunities to identify variations in vaccination coverages and pinpoint areas for intervention in future vaccination strategies.

Post-pandemic consumption of outpatient antibiotics in Switzerland up to pre-pandemic levels, 2018–2023: An interrupted time series analysis

BackgroundThe COVID-19 pandemic has been a challenge for health-care systems and antibiotic stewards as uncertainty regarding treatment and bacterial coinfections raised concern. MethodsThis retrospective observational study examined the association of the pandemic on outpatient antibiotic sales and prescriptions in Switzerland using interrupted time series (ITS) analyses. Data from IQVIA™ and the Sentinella Network were used to analyze antibiotic consumption and prescription patterns over a 72-month period from January 2018 to December 2023, divided into pre-pandemic, pandemic, and post-pandemic periods. ResultsAntibiotic consumption decreased during the pandemic and returned to pre-pandemic levels in the post-pandemic period. A decrease in level was most pronounced in the French-speaking region (−2.82 defined daily doses per 1,000 inhabitants per day (DID) per month, 95 %CI [−4.34, −1.30], p < 0.001) and the Italian-speaking region (−2.80 DID per month, 95 %CI [−4.78, −0.82], p < 0.01), followed by the German-speaking region (−1.72 DID per month, 95 %CI [−2.71, −0.74], p < 0.01). Similarly, in the ITS, the relative change of model estimates in antibiotic prescriptions by GPs and pediatricians for upper respiratory tract infections, was of −36.0 % and −50.3 % resp. in the pandemic period and +10.1 % and −2.6 % in the post-pandemic period compared with the pre-pandemic period. ConclusionsA decrease of antibiotic prescriptions was observed in GPs and pediatricians during the COVID-19 pandemic, followed by a return to pre-pandemic levels. The patterns in antibiotic prescriptions aligned with the epidemiology of respiratory infections and demonstrated a pronounced association with the implementation and subsequent removal of non-pharmaceutical interventions.

Interhospital transfer among US veterans admitted to community and veterans affairs hospitals for acute myocardial infarction and ischemic stroke before and during the COVID-19 pandemic.

Veterans Health Administration (VHA) enrollees may use community hospitals for inpatient care and sometimes require transfer to larger community or VHA hospitals. Little is known about interhospital transfer patterns among veterans using community and VHA hospitals or how coronavirus disease 2019 (COVID-19) case surges affected transfer. Retrospective cohort study among veterans age 65+ admitted to community and VHA hospitals for acute myocardial infarction (AMI) or acute ischemic stroke (AIS) during 2018-2021. We examined associations between COVID-19 case density in regional hospital referral networks and the likelihood of transfer. A total of 8373 (23.6%) veterans with AMI and 4630 (13.1%) with AIS were transferred in the prepandemic period. Transfer was especially common for rural veterans (36% with AMI, 20% with AIS). Most transfers (88%) were between community hospitals and 6% from community to VHA. Among AMI patients, transfer was less likely among patients age >90 (relative to age 65-69), those with non-White race/ethnicity, and females. Transfer was more common among patients initially seen in rural hospitals (AMI, odds ratio [OR] = 2.73, 95% confidence interval [CI], 2.90-3.74; AIS, OR = 2.43; 95% CI, 2.24-2.65). During 2020-2021, transfer among AMI patients was less likely during COVID-19 case density surges affecting the admitting hospital's referral network (OR = 0.86; 95% CI, 0.78-0.96 for highest compared with lowest quartile of COVID-19 cases). Interhospital transfer was common for veterans with AMI and AIS, especially among rural veterans. Few transfers were to VHA hospitals. COVID-19 case surges were associated with decreased transfer for veterans with AMI, potentially limiting access to needed care.

Exploring the gap between notified and diagnosed cases of Food-borne Diseases: evidence from a time-trend analysis in Italy.

Foodborne diseases are a major global public health concern, causing significant morbidity and mortality worldwide. The COVID-19 pandemic has had widespread effects on various aspects of life, including the food supply chain, potentially impacting the incidence of foodborne diseases. This study aims to analyze the differences between notified and diagnosed cases and investigate the potential impact of the COVID-19 pandemic on foodborne diseases in the metropolitan area of Bologna, Italy. A retrospective time trend analysis from two databases was conducted. The Local Health Authority of Bologna collected data re/Emilia-Romagna Region on the infectious disease reporting system over a six-year period (2017-2022), which included three years of the COVID-19 pandemic. This data was compared with information collected during the same period at the microbiology laboratory serving the entire metropolitan area of Bologna. Statistical methods included percent change calculations, binomial tests, annual averages, gender and age stratification, and trend analysis with regression. An increase (+34.4%, P-value ≤ 0.01) in notified cases during the pandemic - compared to the pre-pandemic period - was found. However, no differences were observed in diagnosed cases when comparing the two periods. The year 2021 saw a significant increase in reported cases of foodborne diseases among schoolers (+300.0%) and workers (+133.3%) compared to 2020. On the other hand, diagnosed cases decreased significantly in 2020 (-19.1%, P<0.01) and increased in 2021 (+21.9%, P<0.01). In absolute terms, a stark difference was observed between notified and diagnosed cases across all the study years (2017-2022). This study highlights the discrepancy between notified and diagnosed cases of foodborne diseases and how the COVID-19 pandemic has increased reporting without affecting transmission. These findings contribute to the ongoing discussion on improving foodborne disease reporting systems.

Study of indoor and outdoor noise in primary schools in the city of São Paulo - Brazil

Noise pollution has been treated by the World Health Organization as the cause of several diseases, in addition to being the second largest environmental polluter, being surpassed only by air pollution. For schools, excessive noise, in addition to causing illness, is responsible for low levels of cognition and low productivity for both students and teachers. In general, Brazilian public schools are built on land provided by the government, in places that are not suitable for their siting. Thus, in Brazilian schools, students are exposed to noise from the surroundings, as well as noise generated indoors, which is not negligible, reaching levels that can be harmful to health and incompatible with educational activities. This study shows the evaluation of the level of indoor and outdoor noise in classrooms of five primary schools in the city of São Paulo, in the pre-pandemic period of COVID-19, comparing the results with those established by legislation, in addition to evaluating other descriptors such as LAeq, L10, L90, and SIL. The results show that classroom users are exposed to noise levels that complicate the communication of the teacher's message to the student, disrupt concentration and can even be affecting their health

The effects of the COVID-19 pandemic on pediatric dog bite injuries

Background/objectiveShortly after the onset of the COVID Pandemic, when many schools and outside activities were suspended, dog adoption rates increased. It is unknown if increased dog adoption rates along with stay-at-home orders resulted in changes to pediatric dog bite injuries. The objective of this study was to examine the incidence and characteristics of dog bites in children seen in a pediatric emergency department (PED) during the pandemic compared to before.MethodsA retrospective review of children evaluated in the PED of a level 1 pediatric trauma center and its satellite PED from March 2018 through February 2022 who had a discharge diagnosis of dog bite (ICD-10 W54.0XXA) was conducted. Pre-pandemic cases, March 2018 through February 2020, were compared to those that occurred during the pandemic, March 2020 through February 2022.ResultsThere were 2,222 patients included in the study. Compared to pre-pandemic cases, the incidence for the first 12 months of the pandemic was 1.5 times higher than the pre-pandemic 12-month periods but returned closer to the pre-pandemic rates during the second 12 months of the pandemic. More patients were admitted during the pandemic (6.1% vs. 3.7%, p < 0.05). Facial and multiple injuries occurred more frequently during the pandemic (face 35.9% vs. 33.5%: multiple 18.5% vs. 15.6% p < 0.05).ConclusionsThere was a higher incidence of PED visits, higher admission rates, and an increase in multiple body part and facial injuries in children with dog bite injuries during the COVID pandemic compared to pre-pandemic. Pediatric providers should emphasize safe dog interactions with anticipatory guidance.

B-352 Effects of COVID-19 on Breast Cancer Positivity: A Retrospective and Predictive Study

Abstract Background The COVID-19 pandemic has had a significant impact on the healthcare system, resulting in overall reduction in access to healthcare services, including the suspension of screening programs and postponement of surgeries and medical treatments. The aim of this study was to evaluate the effects of the pandemic on breast cancer positivity from cases received at a laboratory in São Paulo, Brazil. Methods A retrospective analysis of a database from a pathology laboratory in São Paulo, Brazil, was performed during the 2017-2023 period and classified as following: pre-pandemic (January 2017-February 2020), pandemic (March 2020 - April-2022), and post-pandemic (May 2022-December 2023). Cases were classified as negative or positive for malignancies. Positive anatomopathological examinations (breast biopsies and surgical specimens) considered primary, metastatic mesenchymal or endothelial malignancies. The Mann-Kendall test was used to evaluate the trend, and the PACF (Partial Autocorrelation Function) correlogram was used to analyze historical memory for definition of the autoregressive model. The augmented Dickey-Fuller hypothesis test was applied to analyze whether the series is stationary or not, and the first differences test was applied. The ARIMA model was used for the estimates (1,1,1). Statistics were performed using the gretl software and pymannkendall library in the Python language. Results A total of 74,973 samples were evaluated during the 2017-2023 period. In the three-year pre-pandemic period, 32,644 tests were recorded, with an average of 29.34% positive cases. From the analysis of the pre-pandemic time series, there was a positive trend towards an increase in cases (p &amp;lt; 0.0001, z=6.1360, Tau=0.6955). In a non-pandemic scenario, from March 2020 to February 2021, the number of new tests expected would be 11,535; however, in the pandemic period, only 8,904 were observed, a 22.81% reduction on expected cases. According to the historical average positivity rate in the pre-pandemic period, the expected and observed total were, respectively, 3,384 and 2,566 positive cases for malignancy. Conclusions This study reveals a significant decrease of approximately 22.81% in new breast anatomopathological diagnoses during the COVID-19 pandemic in a laboratory in São Paulo, Brazil. For comparison purposes, we identified a 24.17% of missed opportunities on diagnoses of new malignancy-positive cases, compared to the pre-pandemic period. These findings highlight the need for strategies to mitigate the negative effects of the pandemic on the early detection and treatment of breast cancer.

Impact of the COVID-19 pandemic on time to treatment, treatment patterns and outcomes among patients with acute coronary syndrome in Yogyakarta, Indonesia: a retrospective cohort study

ObjectiveThis study aimed to evaluate the impact of the COVID-19 pandemic on the management of acute coronary syndrome (ACS) in Yogyakarta, Indonesia with respect to time to treatment, treatment pattern...

Impact of COVID-19 Pandemic Interventions on Sudden Unexpected Death in Infancy Incidence in France

To study the impact of non-pharmaceutical interventions (NPIs) implemented during the COVID-19 pandemic on the monthly incidence of sudden unexpected death in infancy (SUDI) cases overall and those with a viral or bacterial identification. We conducted an interrupted time-series analysis using seasonally adjusted Poisson regression models from the French national prospective and multicenter SUDI registry, that included all SUDI cases under age one year who died from 2016 to 2021 in mainland France. Of 998 SUDI cases analyzed, 750 were recorded during the pre-pandemic period (January 2016 through March 2020) and 248 during the NPI period (April 2020 through December 2021). We found a significant seasonal pattern of overall monthly SUDI incidence, with a peak observed periodically from November to February. The monthly SUDI incidence decreased significantly from the pre-pandemic to NPI periods (adjusted incidence rate ratio 0.83 [95% confidence interval 0·72-0·96]). In particular, the monthly incidence of SUDI cases with a viral or bacterial identification decreased, while no significant difference was found for SUDI cases without a viral or bacterial identification. NPIs were associated with a significant change in the incidence of SUDI cases with a viral or bacterial identification. Further investigations are needed to analyze the pathophysiologic role of viruses and bacteria in the SUDI.