Title : Concerns about covid-19 delays in the diagnosis and treatment of paediatric brain tumours
Abstract:
Introduction:
The COVID-19 pandemic has had a significant impact on healthcare systems all over the world. Concerns have been expressed regarding the potential for diagnostic and therapeutic delays in diseases such as cancer because of this. The delays in hospital admissions and late diagnosis of cancer patients have been a concern, particularly for adult patients, and this issue remains unclear for children. This study aimed to evaluate the time from diagnosis to operation as well as compare the duration of symptoms in children with newly diagnosed brain tumours during the pandemic (2020) and the pre-pandemic period (2019).
Objectives:
1. To evaluate the impact of the COVID-19 pandemic on the duration of symptoms, diagnosis, and treatment timelines of paediatric brain tumours in the local hospital setting.
2. To observe the effectiveness of the implemented protocols during the COVID-19 pandemic for the diagnosis and treatment of paediatric brain tumours.
Methods:
A literature review was conducted using several databases including government-approved official sites evaluating the impact of COVID-19 on delays in diagnosing and treating cancer. Electronic patient records were accessed, and all children diagnosed with new brain tumours covering both pre-pandemic (2019) and pandemic (2020) periods were included in the study. Their age, duration of symptoms, date of diagnosis and date of operation were also recorded. Patients with a previously known brain tumour diagnosis were excluded from the study.
Statistical analysis was applied to compare both the 2019 and 2020 data collected using the Mann-Whitney U test.
Results:
A total of 58 paediatric patients diagnosed with brain tumours were analysed retrospectively throughout 2019 and 2020. There was no statistically significant difference found for the onset of symptoms to diagnosis during the pandemic compared to the pre-pandemic period (median: 42.0 vs. 21.0) (P = 0.399). However, there was a noted statistical significance for the onset from diagnosis to operation time during the pandemic compared to pre-pandemic (median: 5.5 vs. 3.0) (P = 0.032) indicating operations seemed to occur quicker during the Coronavirus time frame, which is an unexpected outcome.
Conclusion:
We concluded that there were no significant delays in the diagnosis and treatment of paediatric brain tumours during the COVID-19 pandemic. However, operations seemed to move more quickly during the Coronavirus period. This was most likely due to the hospital implementing a specific COVID-19 protocol, which in every case was prioritised depending on its urgency. Elective cases were cancelled in favour of urgent and semi-urgent cases. Since a brain tumour in children is always considered urgent, these surgeries would be prioritised at the top of the operating theatre list.
