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Impact of COVID-19 pandemic on neuropathology service: Experience at one Canadian center
Shervin Pejhan1, Christopher Tran1, David K Driman1
1Department of Pathology & Lab Medicine, London Health Sciences Centre, Schulich Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada.
Insights
The COVID-19 pandemic reduced neuropathology (NP) services, with fewer muscle and epilepsy specimens. However, diagnoses of high-grade glioma and temporal arteritis increased during this period.
Area of Science:
- Neuropathology
- Pathology
- Medical Services
Background:
- The COVID-19 pandemic significantly impacted healthcare, leading to postponements of non-emergent procedures to conserve resources.
- While surgical backlogs have been studied, the specific effects on neuropathology (NP) services remain under-examined.
Approach:
- This study analyzed all neuropathology reports from London Health Sciences Centre between January 2018 and December 2021.
- Demographic and pathology data were collected, focusing on tumor characteristics (site, histopathology, WHO grade) and non-tumoral diagnoses.
- Pre-pandemic and pandemic periods were compared for pathological diagnoses.
Key Points:
- The total volume of NP samples decreased, reaching a low in April 2020 during the initial Ontario lockdown.
- Muscle and epilepsy-related specimens saw a more significant reduction compared to neoplastic specimens.
- In 2020, there was an increased proportion of tumor specimens from patients over 40, higher-grade gliomas, and brain metastases.
- Biopsies for temporal arteritis and other inflammatory conditions markedly increased.
Conclusions:
- The COVID-19 pandemic altered the landscape of neuropathology diagnostics, with shifts in specimen types and diagnostic patterns.
- The findings highlight the need to understand and mitigate the pandemic's specific impact on specialized pathology services.
Abstract:
The COVID-19 pandemic has had a significant impact on medical services. Many countries postponed nonemergent procedures to preserve hospital resources for the unprecedented situation. Surgical backlogs caused by the COVID-19 pandemic have been evaluated by different groups. However, the impact of this pandemic on pathology and specifically neuropathology (NP) services has received limited attention. In this study, we reviewed all NP reports of the London Health Sciences Centre from January 2018 (2 years before the pandemic declaration) until the end of the year 2021. Demographic information and pathology details were collected. For tumors, site, histopathology types, and WHO grading were analyzed. In nontumoral specimens, pathological diagnoses were compared in pre- and postpandemic time. The total number of NP samples reached its lowest in April 2020, corresponding to the first Ontario provincial lockdown, and fluctuated throughout the studied period. Among the different types of NP surgical specimens, muscle and epilepsy-related specimens showed a more significant reduction, compared to neoplastic specimens. In 2020, the proportion of tumor specimens from patients older than 40 years of age increased. Similarly, the proportion of high-grade glioma and brain metastasis diagnoses also increased. Lastly, we observed a marked increase in biopsies for temporal arteritis and other inflammatory lesions.
