Author: Lucia Gonzalez-Buendia (Spain)
Co-authors: Lucia Gonzalez-Buendia, Jorge Ruiz-Medrano, Jose M. Ruiz-Moreno
Purpose
The disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), COVID-19, has caused a global pandemic with millions of infected people around the world. This unprecedented situation led to a lockdown in many countries, in which population’s movements were strongly restricted. In Spain, this quarantine lasted for more than three months, from March 15th to June 21st 2020 and affected remarkably how outpatient care was provided in health facilities. In this study, we wanted to evaluate the impact of the lockdown on number of visits, intravitreal injections and surgeries in the department of ophthalmology of a Hospital in Madrid, Spain. Deeper understanding of the effects of this situation will allow us to optimize resources and design new strategies to mitigate the negative effect of the pandemic and therefore improve clinical care
Setting/Venue
Puerta de Hierro-Majadahonda University Hospital, Madrid
Methods
We performed a retrospective, cross-sectional study with data collected from hospital’s administrative services. We reviewed the data from the year 2020 and compared the variables before, during and after the lockdown in Spain, from March 15th 2020 to June 21st 2020. Primary outcome measures studied were number of outpatient (general ophthalmology and retina) and emergency room (ER) visits, number of intravitreal injections and number of surgeries per week. Data were assessed with one-way analysis of variance followed by Dunnett’s multiple comparisons test
Results
Number of visits per week was 1050.5± 164.21 before, 489.2± 419 during and 811.1± 243.48 after the lockdown. This reduction was significant during the lockdown (p=0.0007). Retina visits per week were 428.33± 50.29 prior, 210.93± 165.1 during and 342.07± 98.89 after, being this difference significant in the lockdown period (p=0.0009). Similarly, ER weekly visits significantly decreased during the lockdown (p less than 0.0001); 174± 53.56 before, during 93.40± 51.05 and after 154.3± 18.61. There were no significant differences regarding number of general ophthalmology, retina nor ER visits before and after lockdown. Intravitreal injections per week were 89.17± 15.96 before, 72.00± 34.96 during and 99.67± 25.64 after. We found no significant differences during nor after the lockdown in this number. Moreover, no differences between the drugs used were seen. Weekly surgeries were 80.33± 15.49 before, 21.53± 30.47 during and 60.04± 33.39 after. Among these, retina surgeries were 9.33± 2.34 per week before, 5.4± 3.29 during and 6.04± 1.63 after. A significant decline in surgeries was observed during the lockdown (p=0.0005). However, a decrease in number of retina surgeries was observed during (p=0.0021) and after lockdown (p=0.0056)
Conlusions
A significant decrease in the number of visits and surgeries during the lockdown was observed. After the lockdown, although still reduced, no statistically significant differences were found regarding number of visits and surgeries between the pre-pandemic and post-lockdown periods. Number of weekly intravitreal injections was dramatically reduced during the first weeks of the quarantine, but interestingly, we saw no statistically significant decline in this variable and the number of injections remained unchanged throughout the lockdown. Further investigation regarding the effect of this pandemic in the clinical setting is mandatory to warrant optimal ophthalmology care
Financial Disclosure
Jose M. Ruiz-Moreno: Grant of the Spanish Ministry of Health, Instituto deSaludCarlos III, Red Temática de Investigación Cooperativa en Salud: “Prevención, detección precoz, y tratamiento de la patología ocular prevalente, degenerativa y crónica” (RD16/0008/0021). Research support from Topcon, Co. Advisory board of Allergan, Bayer and Novartis. The rest of the authors have no financial relations to disclose
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