The impact of Covid-19 in the follow-up of glaucoma patients: a 2-year pandemic analysis

RESUMO

INTRODUÇÃO: Glaucoma is the leading cause of irreversible blindness in the world, affecting over 76 million people in 2020 and 40 million more in the years to come. In Brazil, it is estimated that over 6 million people are affected by the disease. Since 2020, Covid-19 pandemic has forced countries to focus the efforts on emergency units. As a result, a high amount of chronic patients were left without medical assistance during the period. The short- and mid-term impacts of these measures on chronic patients are still not clarified.

OBJETIVOS: To evaluate the impact of 2-year Covid-19 pandemic in glaucoma patients visits, surgeries and medication released compared to the corresponding year before the pandemic outbreak.

MÉTODOS: Data from glaucoma patients was obtained from electronic records of our institution. The analysis enrolled the total number of clinical visits, surgeries and medication released. Baseline period was considered from March 2019-February 2020. First-year pandemic (P1) and second-year pandemic (P2) were considered from March 2020-February 2021 and March 2021-February 2022, respectively. The mean number of clinical visits, surgical procedures and medication release per patient during the 3 periods was also compared in a non-paired analysis. Normality of the data was assessed by Shapiro-Wilk test. Kruskall-Wallis test was used to compare the groups. A p-value<0.05 was considered significant.

RESULTADOS: Total number of visits, surgical procedures and medication released decreased 92.52% and 44.03% (7,117 vs 532 vs 3,983), 78.85% and 65.05% (681 vs 144 vs 238), and 19.65% and 29.35% (23,259 vs 18,692 vs 16,432), respectively, when compared the baseline period to P1 and P2. The mean number of clinical visits per patient decreased when compared baseline period to P1 (1.8±0.79 vs 1.04±0.18), but increased in P2 (2.68±3.5) (p<0.001). The mean number of surgeries per patient decreased from baseline period to P1, but slightly recovery during P2 (1.46±0.82 vs 1.13±0.4 vs 1.27±0.58, p<0.001). Also, the mean number of medication released increased from the first to the second period (28.61±19.11 vs 30.34±20.15), but decreased in the third period (27.39±17.88). There was no statistical difference between the means of the groups (p=0.08).

CONCLUSÃO: The pandemic severely impacted the assistance of glaucoma patients. The total number of visits and surgeries decreased during the first year, with a partial recovery in the second year. Medication released was less affected compared to the other two parameters, which may indirectly indicate that patients continued their treatment during this period.

BIBLIOGRAFIA: Ranzani OT, Bastos LSL, Gelli JGM, et al. Characterisation of the first 250 000 hospital admissions for COVID-19 in Brazil: a retrospective analysis of nationwide data. Lancet Respir Med. 2021;9(4):407–418. Subathra G, Rajendrababu SR, Senthilkumar VA, Mani I, Udayakumar B. Impact of COVID-19 on follow-up and medication adherence in patients with glaucoma in a tertiary eye care centre in south India. Indian J Ophthalmol. 2021;69(5):1264–1270. Holland LJ, Mercieca KJ, Kirwan JF. Effect of COVID-19 pandemic on glaucoma surgical practices in the UK. Br J Ophthalmol. 2021:1–5. dell’Omo R, Filippelli M, Virgili G, et al. Effect of COVID-19-related lockdown on ophthalmic practice in Italy: a report from 39 institutional centers. Eur J Ophthalmol. 2021:1–9.

PALAVRA-CHAVE: Glaucoma ; Covid-19; SARS-CoV-2