COVID‐19 pandemic impact on cytopathology practice in the post‐lockdown period: An international, multicenter study

Vigliar, Elena; Pisapia, Pasquale; Iacovo, Filippo Dello; Alcaraz‐Mateos, Eduardo; Alì, Greta; Ali, Syed Z.; Baloch, Zubair W.; Bellevicine, Claudio; Bongiovanni, Massimo; Botsun, Pavlina; Bruzzese, Dario; Bubendorf, Lukas; Büttner, Reinhard; Canberk, Şule; Capitanio, Arrigo; Casadio, Chiara; Cazacu, E; Cochand‐Priollet, Béatrix; D’Amuri, Alessandro; Davis, Katelynn; Eloy, Catarina; Engels, Marianne; Fadda, Guido; Fontanini, Gabriella; Fulciniti, Franco; Hofman, Paul; Iaccarino, Antonino; Ieni, Antonio; Jiang, Xiaoyin “Sara”; Kakudo, Kennichi; Kern, Izidor; Kholová, Ivana; McDermott, Kathryn M. Linton; Liu, Chinhua; Lobo, Anandi; Lozano, Marı́a D.; Malapelle, Umberto; Maleki, Zahra; Michelow, Pamela; Mikula, Michael W.; Musayev, Jamal; Özgün, Gonca; Öznur, Meltem; Marqués, Francisca Maria Peiró; Poller, David; Pyźlak, Michał; Robinson, Betsy C.; Rossi, Esther Diana; Roy‐Chowdhuri, Sinchita; Saieg, Mauro; Prince, Spasenija Savic; Schmitt, Fernando; Iváñez, Francisco Javier Seguí; Štoos‐Veić, Tajana; Сулаєва, О. М.; Sweeney, Brenda; Tuccari, Giovanni; Velthuysen, Marie-Louise F. van; VanderLaan, Paul A.; Vielh, Philippe; Viola, Patrizia; Voorham, Quirinus J.M.; Weynand, Birgit; Zeppa, Pio; Faquin, William C.; Pitman, Martha B.; Troncone, Giancarlo

doi:10.1002/cncy.22547

Cited by 18 publications

(22 citation statements)

References 19 publications

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“…Samples such as soft tissue, lung, and liver fineneedle aspirates and CSF, peritoneal and pleural fluids showed a faster tendency to recover. In the post-lockdown period, the absolute number of these cases nearly reached pre-Covid-19 practice levels, in agreement with the literature [10].…”

Section: Discussionsupporting

confidence: 90%

Cytopathology Practice in the Covid-19 Pandemic, During the Lockdown and Post-lockdown Period: A Tertiary-Care Center Experience

Kurtulan

Önder

2022

Acta Medica

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Background: Covid-19 pandemic has changed the healthcare delivery and cytopathology practice worldwide. We evaluated our cytopathology laboratory workload during the lockdown and post-lockdown period and compared it with the same period in 2019, to see the impact of the Covid-19 pandemic. Methods: The cytological reports issued during the lockdown (10 March - 31 May 2020) and the post-lockdown period (1 June -31 August 2020); and the corresponding periods in 2019 were retrospectively reviewed from the database. Sample type, sampling site, and diagnostic categories were recorded. Results: During the Covid-19 lockdown period, the total number of cytological specimens, was reduced from n=3197 to n=745, with a rate of 76,7%. The most reduction was in thyroid fine-needle aspiration (FNA) and cervicovaginal smears. Relative increases were observed for soft tissue, lung, and liver FNA samples (p<0.05) and cerebrospinal fluid, peritoneal and pleural fluid samples (p<0.05). In the post-lockdown period, the total number reduced from n=2461 to n=2032 with a rate of 17.4%. Significant reduction continued for thyroid FNAs, but other samples have nearly reached the pre-covid levels. During the total six months period, the rate of the malignant category increased while the negative for malignancy category decreased compared to 2019. Conclusion: During the Covid-19 lockdown period, the reduction was primarily observed in the samples taken for screening purposes, and high-risk oncological patients continued to receive healthcare services. In the initial phase of the post-lockdown period, health services and cytopathology practice have rapidly reached almost the levels of the pre-pandemic period.

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Section: Discussionsupporting

confidence: 90%

Cytopathology Practice in the Covid-19 Pandemic, During the Lockdown and Post-lockdown Period: A Tertiary-Care Center Experience

Kurtulan

Önder

2022

Acta Medica

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“…Their results showed an overall increase in the rate of malignancy but an alarming persistence in the reduction of cytology sample volumes (although the rate of reduction had slowed down in the second half of the assessed period). 12 , 18 Our observations mirror these results, demonstrating that the most significant effect of the pandemic on specimen volume occurred during the first surge (March 11, 2020–June 3, 2020). With the second peak of the pandemic, occurring in late 2020 and early 2021, the effect on sample volume and the number of malignant diagnoses was much less severe compared with the first peak, despite higher COVID‐19 case numbers.…”

Section: Discussionsupporting

confidence: 82%

“…In a follow‐up post‐lockdown study, Vigliar et al surveyed 29 respondents in 17 countries for the first 12‐week post‐lockdown period compared with corresponding periods in 2019. Their results showed an overall increase in the rate of malignancy but an alarming persistence in the reduction of cytology sample volumes (although the rate of reduction had slowed down in the second half of the assessed period) 12,18 . Our observations mirror these results, demonstrating that the most significant effect of the pandemic on specimen volume occurred during the first surge (March 11, 2020–June 3, 2020).…”

Section: Discussionsupporting

confidence: 82%

Quantifying the hidden impact of COVID‐19 pandemic: The cytology perspective

Yousefi

Cibas

Mito

2022

Cancer Cytopathology

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Background The burden of the COVID‐19 pandemic is often enumerated in lives lost, but the strain on health care resources and mobility limitations contributed to the burden of non–COVID related disease. In this study, we evaluated the impact of the pandemic through a time series review of cytology samples. Methods Pathology reports for all cytology specimens received from January 2019 through April 2021 at our institution were reviewed. Time series analysis was performed using moving averages, time trend analysis, cross‐correlation, and tests of homogeneity. Results During the first peak of the pandemic (March–June 2020), breakpoint analysis showed a downward shift in the number of gynecologic (−89.4%) and non‐gynecologic (−70.4%) cytology specimens within a week of declaration of an emergency. Cross‐correlation analysis showed a relationship between sample numbers and COVID‐19 cases during the initial phase of the pandemic (April–June 2020). During the second surge (October 2020–April 2021), despite the higher incidence of COVID‐19, there was a smaller impact on cytology samples (−20.1% and − 24.8% for gynecologic and non‐gynecologic samples, respectively). During the first 3 months of the pandemic, 154 fewer malignant cases were identified compared with the prior year. Although specimen numbers slowly returned to baseline following the first wave of the pandemic, the earlier decline in malignant diagnoses was not offset during the study period. Conclusions The deleterious effects of COVID‐19 extend beyond direct mortality attributed to the disease. The significant decrease in diagnostic cytology specimens during this period has profound implications including delayed care and missed disease.

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“…The total number of pathology reports was reduced by Several studies examine the post-pandemic period from various perspectives and report similar findings. Admissions to dermatology outpatient departments [47][48][49][50], samples submitted to pathology [51] and cytology [52,53] laboratories, and elective surgical procedures performed [54,55] all decreased; however, the distribution of cases varied depending on the region where the study was conducted.…”

Section: Discussionmentioning

confidence: 99%

Dermatopathological Correlation of Clinically Challenging Cutaneous Lesions: A Single Center Experience of 2184 cases

Özcan¹,

Özlü²,

Karagün³

et al. 2022

Dermatol Pract Concept

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Introduction: Although textbooks provide the ideal clinical and histopathological findings, in practice we usually have fewer, and sometimes contradictory, findings to work with. Objectives: The primary goal of this study is to categorize the diagnoses of clinically challenging skin lesions, thereby identifying the most common diagnostic scenarios encountered by dermatopathologists in practice and the most perplexing differential diagnoses submitted by clinicians. Our secondary aim is to investigate how the case profile and clinician decision-making processes changed during the COVID-19 pandemic.Methods: We classified 2184 pathology reports into four major categories: inflammatory, neoplastic, non-diagnostic, and other. In each category, the three most frequently reported diagnoses were listed. For each listed diagnosis, the top 3 most frequently used differential diagnoses by the clinician prior to biopsy are listed. The period one year after and before the first nationally reported COVID-19 case was compared using the same classification.Results: The most common diagnoses and clinical differential diagnoses were listed for each category, with 45.4% being inflammatory and 27.4% being neoplastic diseases. Non-diagnostic reports accounted for 11.4% of all reports. The overall number of reports has decreased drastically since the pandemic, and the rates of keratinocytic and melanocytic neoplasms have increased, while the rates of other malignancies and spongiotic diseases have decreased.Conclusion: Although a trained eye can easily identify skin lesions when they are typical, even diseases we are familiar with can present atypically in real life. In these cases, histopathological examinations and clinicopathological correlation are critical in making an accurate diagnosis.

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COVID‐19 pandemic impact on cytopathology practice in the post‐lockdown period: An international, multicenter study

Cited by 18 publications

References 19 publications

Cytopathology Practice in the Covid-19 Pandemic, During the Lockdown and Post-lockdown Period: A Tertiary-Care Center Experience

Cytopathology Practice in the Covid-19 Pandemic, During the Lockdown and Post-lockdown Period: A Tertiary-Care Center Experience

Quantifying the hidden impact of COVID‐19 pandemic: The cytology perspective

Dermatopathological Correlation of Clinically Challenging Cutaneous Lesions: A Single Center Experience of 2184 cases

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