Skip to main navigation menu Skip to main content Skip to site footer
##common.pageHeaderLogo.altText##

Original article

Vol. 151 No. 4142 (2021)

Reduction of otorhinolaryngological consultations due to the COVID-19 lockdown and its impact on disease progression

  • Sarina Bucher
  • Aline S. Neumann
  • Christian M. Meerwein
  • David Holzmann
  • Michael B. Soyka
DOI
https://doi.org/10.4414/SMW.2021.w30068
Cite this as:
Swiss Med Wkly. 2021;151:w30068
Published
18.10.2021

Summary

OBJECTIVES: To compare consultations at the Otorhinolaryngological Department at a tertiary referral centre between the COVID-19 lockdown in 2020 and the same period in 2019, as well as to study the impact of deferring visits on disease progression.

METHODS: The emergency consultations during these time periods were analysed retrospectively. The effect of postponing appointments on disease progression was examined for 122 patients with chronic rhinosinusitis, for 50 patients with a benign tumour and for 22 patients with the diagnosis of a malignant tumour. To compare disease progression, patients with the diagnosis of a malignant tumour were matched to patients seen over the same period in 2019.

RESULTS: During the lockdown, a reduction of 44.1% in emergency consultations compared with 2019 was observed. The largest significant decrease of consultation numbers was seen for otitis media and for Eustachian tube dysfunction. Fewer patients with tonsillitis sought emergency assistance; however, no difference in frequency of abscesses was observed. Disease progression was seen in 44.4% of  patients with chronic rhinosinusitis. In 2020, 18.8% of patients with the diagnosis of a malignant tumour showed disease progression, yet no difference from the previous year was observed.

CONCLUSION: Fewer emergency consultations took place during the COVID-19 lockdown; among others, there were fewer visits due to otitis media and tonsillitis. However, no change in the incidence of complications was noted. Almost 50% of patients with chronic rhinosinusitis showed disease progression, leading to prolonged suffering due to the rescheduling of appointments. The treatment of patients with the diagnosis of a malignant tumour was not affected by the postponement of consultations.

References

  1. Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis. 2020 May;20(5):533–4. https://doi.org/10.1016/S1473-3099(20)30120-1
  2. Bundesamt für Gesundheit (BAG). Verordnung 2 über Massnahmen zur Bekämpfung des Coronavirus (COVID-19) (COVID-19-Verordnung 2). 2020;https://www.bag.admin.ch/bag/de/home/das-bag/aktuell/medienmitteilungen.msg-id-78454.html. Accessed January 18, 2021.
  3. Boserup B, McKenney M, Elkbuli A. The impact of the COVID-19 pandemic on emergency department visits and patient safety in the United States. Am J Emerg Med. 2020 Sep;38(9):1732–6. https://doi.org/10.1016/j.ajem.2020.06.007
  4. Herranz-Larrañeta J, Klein-Rodríguez A, Menéndez-Riera M, Mejuto-Torreiro L, López-Eiroa A, Vázquez-Barro JC, et al. ENT emergencies during the first wave of COVID-19 pandemic in Spain: our experience. Am J Otolaryngol. 2021 Mar-Apr;42(2):102865. https://doi.org/10.1016/j.amjoto.2020.102865
  5. Gelardi M, Iannuzzi L, Trecca EM, Kim B, Quaranta NA, Cassano M. COVID-19: what happened to all of the otolaryngology emergencies? Eur Arch Otorhinolaryngol. 2020 Nov;277(11):3231–2. https://doi.org/10.1007/s00405-020-06046-z
  6. Piccirillo JF, Merritt MG Jr, Richards ML. Psychometric and clinimetric validity of the 20-Item Sino-Nasal Outcome Test (SNOT-20). Otolaryngol Head Neck Surg. 2002 Jan;126(1):41–7. https://doi.org/10.1067/mhn.2002.121022
  7. Elli F, Turri-Zanoni M, Arosio AD, Karligkiotis A, Battaglia P, Castelnuovo P. Changes in the use of Otorhinolaryngology Emergency Department during the COVID-19 pandemic: report from Lombardy, Italy. Eur Arch Otorhinolaryngol. 2020 Dec;277(12):3525–8. https://doi.org/10.1007/s00405-020-06119-z
  8. Rosenfeld RM, Kay D. Natural history of untreated otitis media. Laryngoscope. 2003 Oct;113(10):1645–57. https://doi.org/10.1097/00005537-200310000-00004
  9. Bundesamt für Statistik. Sektion Mobilität. Linien- und Charterverkehr. 2020; https://www.bfs.admin.ch/bfs/de/home/statistiken/mobilitaet-verkehr/querschnittsthemen/zivilluftfahrt/linien-charterverkehr.html. Accessed March, 8, 2021.
  10. Rosenfeld RM, Schwartz SR, Cannon CR, Roland PS, Simon GR, Kumar KA, et al. Clinical practice guideline: acute otitis externa. Otolaryngol Head Neck Surg. 2014 Feb;150(1 Suppl):S1–24. https://doi.org/10.1177/0194599813514365
  11. Spinks A, Glasziou PP, Del Mar CB. Antibiotics for sore throat. Cochrane Database Syst Rev. 2013 Nov;(11):CD000023.
  12. Pelucchi C, Grigoryan L, Galeone C, Esposito S, Huovinen P, Little P, et al.; ESCMID Sore Throat Guideline Group. Guideline for the management of acute sore throat. Clin Microbiol Infect. 2012 Apr;18 Suppl 1:1–28. https://doi.org/10.1111/j.1469-0691.2012.03766.x
  13. Costelloe C, Metcalfe C, Lovering A, Mant D, Hay AD. Effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: systematic review and meta-analysis. BMJ. 2010 May;340(may18 2):c2096. https://doi.org/10.1136/bmj.c2096
  14. Sanmark E, Wikstén J, Välimaa H, Aaltonen LM, Ilmarinen T, Blomgren K. Peritonsillar abscess may not always be a complication of acute tonsillitis: A prospective cohort study. PLoS One. 2020 Apr;15(4):e0228122. https://doi.org/10.1371/journal.pone.0228122
  15. Kunz SM, Holzmann D, Soyka MB. Association of epistaxis with atherosclerotic cardiovascular disease. Laryngoscope. 2019 Apr;129(4):783–7. https://doi.org/10.1002/lary.27604
  16. DeConde AS, Mace JC, Levy JM, Rudmik L, Alt JA, Smith TL. Prevalence of polyp recurrence after endoscopic sinus surgery for chronic rhinosinusitis with nasal polyposis. Laryngoscope. 2017 Mar;127(3):550–5. https://doi.org/10.1002/lary.26391
  17. Koskinen A, Salo R, Huhtala H, Myller J, Rautiainen M, Kääriäinen J, et al. Factors affecting revision rate of chronic rhinosinusitis. Laryngoscope Investig Otolaryngol. 2016 Jul;1(4):96–105. https://doi.org/10.1002/lio2.27
  18. Hopkins C, Slack R, Lund V, Brown P, Copley L, Browne J. Long-term outcomes from the English national comparative audit of surgery for nasal polyposis and chronic rhinosinusitis. Laryngoscope. 2009 Dec;119(12):2459–65. https://doi.org/10.1002/lary.20653
  19. Givi B, Schiff BA, Chinn SB, Clayburgh D, Iyer NG, Jalisi S, et al. Safety Recommendations for Evaluation and Surgery of the Head and Neck During the COVID-19 Pandemic. JAMA Otolaryngol Head Neck Surg. 2020 Jun;146(6):579–84. https://doi.org/10.1001/jamaoto.2020.0780
  20. Agrawal A, Hammond TH, Young GS, Avon AL, Ozer E, Schuller DE. Factors affecting long-term survival in patients with recurrent head and neck cancer may help define the role of post-treatment surveillance. Laryngoscope. 2009 Nov;119(11):2135–40. https://doi.org/10.1002/lary.20527