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[新型冠状病毒肺炎对西班牙国家眼内肿瘤参考单位的一种罕见疾病(葡萄膜黑色素瘤)的影响]

[Impact of COVID-19 on a rare disease (uveal melanoma) in a national reference unit of intraocular tumors in Spain].

作者信息

Bermúdez Castellanos I, Saornil Álvarez M A, Almaraz Gómez A, Villoría Díaz S, García Álvarez C

机构信息

Servicio de Oftalmología, Hospital Universitario Río Hortega, Valladolid, España.

Servicio de Oftalmología, Hospital Clínico Universitario de Valladolid, Valladolid, España.

出版信息

Arch Soc Esp Oftalmol. 2023 May;98(5):254-258. doi: 10.1016/j.oftal.2023.01.010. Epub 2023 Mar 2.

Abstract

OBJECTIVE

To analyze the impact of the COVID-19 pandemic on the diagnosis and management of uveal melanoma (a tumor included in the Orphanet catalog of rare diseases) in a Spanish national reference unit for intraocular tumors during the first year of the pandemic.

MATERIAL AND METHODS

An observational retrospective study of patients with uveal melanoma in the National Reference Unit for Adult Intraocular Tumors of the Hospital Clínico Universitario de Valladolid (Spain) was performed, analyzing the pre- and post-COVID-19 periods: from March 15, 2019 to March 15, 2020 and from March 16, 2020 to March 16, 2021. Demographic data, diagnostic delay, tumor size, extraocular extension, treatment and evolution were collected. A multivariable logistic regression model was used to identify factors that were associated with the variable: enucleation.

RESULTS

Eighty-two patients with uveal melanoma were included, of which 42(51.21%) belonged to the pre-COVID-19 period and 40(40.78%) to the post-COVID-19 period. An increase in tumor size at diagnosis and in the number of enucleations was observed during the post-COVID-19 period (p < 0.05). Multivariable logistic regression demonstrated that both medium-large tumor size and patients diagnosed in the post-COVID-19 period were independently related to an increased risk of enucleation (OR 250, 95%CI, 27.69-2256.37; p < 0.01 and OR 10; 95% CI,1.10-90.25; p = 0.04, respectively).

CONCLUSIONS

The increase in tumor size observed in uveal melanomas diagnosed during the first year of the COVID-19 pandemic may have favored the increase in the number of enucleations performed during that period.

摘要

目的

分析新冠疫情第一年期间,在西班牙一家全国性眼内肿瘤参考单位中,新冠疫情对葡萄膜黑色素瘤(一种列入《国际罕见病名录》的肿瘤)诊断和治疗的影响。

材料与方法

对西班牙巴利亚多利德大学临床医院成人眼内肿瘤国家参考单位的葡萄膜黑色素瘤患者进行了一项观察性回顾性研究,分析新冠疫情前后两个时期:2019年3月15日至2020年3月15日以及2020年3月16日至2021年3月16日。收集了人口统计学数据、诊断延迟、肿瘤大小、眼外扩展、治疗及病情演变情况。采用多变量逻辑回归模型来确定与眼球摘除这一变量相关的因素。

结果

纳入了82例葡萄膜黑色素瘤患者,其中42例(51.21%)属于新冠疫情前时期,40例(40.78%)属于新冠疫情后时期。在新冠疫情后时期,观察到诊断时肿瘤大小增加以及眼球摘除数量增加(p < 0.05)。多变量逻辑回归表明,中等至大肿瘤大小以及在新冠疫情后时期确诊的患者均与眼球摘除风险增加独立相关(比值比分别为250,95%置信区间为27.69 - 2256.37;p < 0.01以及比值比为10;95%置信区间为1.10 - 90.25;p = 0.04)。

结论

在新冠疫情第一年诊断出的葡萄膜黑色素瘤中观察到的肿瘤大小增加,可能促使了该时期进行的眼球摘除数量增加。

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