Department of Pathology, Erasmus Medical Center, Rotterdam, Netherlands.
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands.
BMC Health Serv Res. 2022 Feb 9;22(1):166. doi: 10.1186/s12913-022-07546-w.
The COVID-19 pandemic has a huge impact on healthcare provided. The nationwide pathology registry of the Netherlands, PALGA, offers an outstanding opportunity to measure this impact for diseases in which pathology examinations are involved.
Pathology specimen numbers in 2020 were compared with specimen numbers in 2019 for 5 periods of 4 weeks, representing two lockdowns and the periods in between, taking into account localization, procedure and benign versus malignant diagnosis.
The largest decrease was seen during the first lockdown (spring 2020), when numbers of pathology reports declined up to 88% and almost all specimen types were affected. Afterwards each specimen type showed its own dynamics with a decrease during the second lockdown for some, while for others numbers remained relatively low during the whole year. Generally, for most tissue types resections, cytology and malignant diagnoses showed less decrease than biopsies and benign diagnoses. A significant but small catch-up (up to 17%) was seen for benign cervical cytology, benign resections of the lower gastro-intestinal tract, malignant skin resections and gallbladder resections.
The COVID-19 pandemic has had a significant effect on pathology diagnostics in 2020. This effect was most pronounced during the first lockdown, diverse for different anatomical sites and for cytology compared with histology. The data presented here can help to assess the consequences on (public) health and provide a starting point in the discussion on how to make the best choices in times of scarce healthcare resources, considering the impact of both benign and malignant disease on quality of life.
COVID-19 大流行对所提供的医疗保健产生了巨大影响。荷兰全国病理学注册处 PALGA 为衡量涉及病理检查的疾病的这种影响提供了绝佳机会。
将 2020 年的病理标本数量与 2019 年同期的标本数量进行比较，共分为 5 个为期 4 周的时间段，考虑到定位、程序以及良性与恶性诊断，分别代表两次封锁和封锁之间的时期。
在第一次封锁（2020 年春季）期间，病理报告数量下降了最多 88%，几乎所有标本类型都受到影响，降幅最大。此后，每种标本类型都表现出自己的动态，第二次封锁期间某些标本类型的数量下降，而其他标本类型在全年的数量保持相对较低。通常，对于大多数组织类型的切除、细胞学和恶性诊断，其下降幅度小于活检和良性诊断。良性宫颈细胞学、下胃肠道良性切除、恶性皮肤切除和胆囊切除的良性诊断出现了显著但较小的追赶（高达 17%）。
COVID-19 大流行对 2020 年的病理诊断产生了重大影响。这种影响在第一次封锁期间最为明显，对于不同的解剖部位和细胞学与组织学相比，其影响各不相同。这里呈现的数据可以帮助评估对（公众）健康的影响，并为在医疗资源稀缺的情况下如何做出最佳选择提供起点，同时考虑良性和恶性疾病对生活质量的影响。
