Abstract：
OBJECTIVE: Pelvic inflammatory disease (PID) is usually managed by conservative treatment, but in selected cases, especially in the presence of a tubo-ovarian abscess (TOA), surgical management is a recognized treatment option. We compared the trends in managing PID and short-term outcomes before and during the SARS-CoV-2 pandemic.
METHODS: This is a retrospective study performed in three Italian gynecological centers. We included patients admitted to hospital with a diagnosis of PID. Demographic characteristics, management, time to diagnosis, and time to treatment were compared before versus during the SARS-CoV-2 pandemic.
RESULTS: One hundred nineteen PID patients were screened, eighty-one before the SARS-CoV-2 pandemic, and thirty-eight after the onset. At admission, leukocytosis (median 19.73 vs. 13.99 WBC/mm3, p-value = 0.02) was significantly higher in patients who underwent surgery after the onset of the pandemic. TOA incidence was higher in patients who underwent surgery during the SARS-CoV-2 pandemic, but the difference did not reach statistically significance (p = 0.06). The proportion of patients treated with surgery dropped to 26.3% after the onset from 46% of patients before the onset of pandemic (p = 0.03). Furthermore, a higher percentage of emergency surgical procedures on day 0 of hospital admission were performed after the onset of the pandemic (50% vs. 13.1%, p = 0.01).
CONCLUSIONS: In this retrospective cohort study, we found that the SARS-CoV-2 pandemic influenced the clinical presentation and management of PID in favor of conservative treatment. Patients who underwent surgery during the SARS-CoV-2 pandemic had higher inflammatory markers.
METHODS: This is a retrospective study performed in three Italian gynecological centers. We included patients admitted to hospital with a diagnosis of PID. Demographic characteristics, management, time to diagnosis, and time to treatment were compared before versus during the SARS-CoV-2 pandemic.
RESULTS: One hundred nineteen PID patients were screened, eighty-one before the SARS-CoV-2 pandemic, and thirty-eight after the onset. At admission, leukocytosis (median 19.73 vs. 13.99 WBC/mm3, p-value = 0.02) was significantly higher in patients who underwent surgery after the onset of the pandemic. TOA incidence was higher in patients who underwent surgery during the SARS-CoV-2 pandemic, but the difference did not reach statistically significance (p = 0.06). The proportion of patients treated with surgery dropped to 26.3% after the onset from 46% of patients before the onset of pandemic (p = 0.03). Furthermore, a higher percentage of emergency surgical procedures on day 0 of hospital admission were performed after the onset of the pandemic (50% vs. 13.1%, p = 0.01).
CONCLUSIONS: In this retrospective cohort study, we found that the SARS-CoV-2 pandemic influenced the clinical presentation and management of PID in favor of conservative treatment. Patients who underwent surgery during the SARS-CoV-2 pandemic had higher inflammatory markers.
摘要：
目的：盆腔炎（PID）通常采用保守治疗，但是在某些情况下，尤其是在有输卵管卵巢脓肿（TOA）的情况下，手术治疗是公认的治疗选择.我们比较了在SARS-CoV-2大流行之前和期间管理PID和短期结果的趋势。
方法：这是一项在意大利三个妇科中心进行的回顾性研究。我们纳入了入院诊断为PID的患者。人口特征，管理,诊断时间到了,比较SARS-CoV-2大流行之前和期间的治疗时间。
结果：筛选了119名PID患者，在SARS-CoV-2大流行之前，发病后38岁。入院时,白细胞增多（中位数19.73vs.13.99WBC/mm3，p值=0.02）在大流行发作后接受手术的患者中明显更高。在SARS-CoV-2大流行期间接受手术的患者中，TOA发病率较高，但差异无统计学意义(p=0.06)。发病后接受手术治疗的患者比例从大流行前的46％降至26.3％（p=0.03）。此外，大流行发作后第0天进行急诊外科手术的比例更高(50%vs.13.1%,p=0.01)。
结论：在这项回顾性队列研究中，我们发现SARS-CoV-2大流行影响了PID的临床表现和管理，有利于保守治疗。在SARS-CoV-2大流行期间接受手术的患者具有较高的炎症标志物。
方法：这是一项在意大利三个妇科中心进行的回顾性研究。我们纳入了入院诊断为PID的患者。人口特征，管理,诊断时间到了,比较SARS-CoV-2大流行之前和期间的治疗时间。
结果：筛选了119名PID患者，在SARS-CoV-2大流行之前，发病后38岁。入院时,白细胞增多（中位数19.73vs.13.99WBC/mm3，p值=0.02）在大流行发作后接受手术的患者中明显更高。在SARS-CoV-2大流行期间接受手术的患者中，TOA发病率较高，但差异无统计学意义(p=0.06)。发病后接受手术治疗的患者比例从大流行前的46％降至26.3％（p=0.03）。此外，大流行发作后第0天进行急诊外科手术的比例更高(50%vs.13.1%,p=0.01)。
结论：在这项回顾性队列研究中，我们发现SARS-CoV-2大流行影响了PID的临床表现和管理，有利于保守治疗。在SARS-CoV-2大流行期间接受手术的患者具有较高的炎症标志物。
