Liu Mingjuan, Zhou Jia, Lan Yining, Zhang Hanlin, Wu Mengyin, Zhang Xinyi, Leng Ling, Mi Xia, Li Jun
Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China.
State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China.
Clin Cosmet Investig Dermatol. 2023 Sep 12;16:2485-2496. doi: 10.2147/CCID.S417522. eCollection 2023.
The COVID-19 pandemic has profoundly changed our lives. While healthcare resources were redistributed and mobilized to focus on dealing with the COVID-19 crisis, there have been unmet medical needs of patients with other diseases such as syphilis, weaving an integral but neglected component of the pandemic story. In different countries, the epidemiology of newly reported syphilis underwent diverse changes during the COVID-19 pandemic. Asymptomatic cases experienced the largest decline in number. From the perspective of transmission, on one hand, the implementation of lockdown measures led to a higher degree of abstinence and sex distancing in many countries, thereby reducing the transmission of syphilis. On the other hand, vertical transmission was reported to have increased significantly during COVID-19. Meanwhile, the volume of STI clinic capacity declined, and STI staff were redeployed to facilitate the contact tracing of COVID-19. As a result, many STI centers converted traditional in-person clinical services to telemedicine and self-testing. However, syphilis testing and clinical treatment cannot fully adapt to this conversion. In syphilis diagnosis, COVID-19 infection and vaccination were reported to cause false positivity in syphilis serological tests. Diverse cutaneous manifestations of COVID-19 could resemble the skin lesions in syphilis patients, requiring differential diagnosis from clinicians. As for the post-pandemic years, consequent to service interruptions and diagnosis delays, a surge in the number of confirmed cases of syphilis is expected. The COVID-19 pandemic has also been a meaningful lesson for the control and prevention of infectious diseases. The experience in combating COVID-19 has underscored the importance of maintaining a robust and well-supported medical system for the provision of sexual health services and better healthcare equality even during eras of crisis, not least for syphilis patients.
新冠疫情深刻改变了我们的生活。在医疗资源被重新分配和调动以专注应对新冠危机之际，梅毒等其他疾病患者的医疗需求未得到满足，这成为疫情故事中一个不可或缺却被忽视的部分。在不同国家，新冠疫情期间新报告梅毒的流行病学情况发生了多样变化。无症状病例数量下降幅度最大。从传播角度来看，一方面，封锁措施的实施导致许多国家的禁欲程度更高、性接触距离更远，从而减少了梅毒传播。另一方面，据报道新冠疫情期间垂直传播显著增加。同时，性传播感染诊所的服务能力下降，性传播感染工作人员被重新调配以协助新冠疫情的接触者追踪。结果，许多性传播感染中心将传统的面对面临床服务转变为远程医疗和自我检测。然而，梅毒检测和临床治疗无法完全适应这种转变。在梅毒诊断中，据报道新冠感染和疫苗接种会导致梅毒血清学检测出现假阳性。新冠的多种皮肤表现可能类似于梅毒患者的皮肤病变，需要临床医生进行鉴别诊断。至于疫情后的年份，由于服务中断和诊断延误，预计梅毒确诊病例数会激增。新冠疫情对于传染病的控制和预防也是一堂意义重大的课。抗击新冠疫情的经验凸显了即使在危机时期，维持一个强大且得到充分支持的医疗系统以提供性健康服务和更好的医疗平等的重要性，尤其是对于梅毒患者而言。
