Thyroid fine-needle aspiration trends before, during, and after the lockdown: what we have learned so far from the COVID
- PDF / 614,307 Bytes
- 6 Pages / 595.276 x 790.866 pts Page_size
- 112 Downloads / 160 Views
ORIGINAL ARTICLE
Thyroid fine-needle aspiration trends before, during, and after the lockdown: what we have learned so far from the COVID-19 pandemic Raffaele Palladino1 Ilaria Migliatico1 Roberta Sgariglia1 Mariantonia Nacchio1 Antonino Iaccarino1 Umberto Malapelle1 Elena Vigliar1 Domenico Salvatore1 Giancarlo Troncone1 Claudio Bellevicine1 ●
●
●
●
●
●
●
●
●
1234567890();,:
1234567890();,:
Received: 27 September 2020 / Accepted: 15 November 2020 © The Author(s) 2020
Abstract Purpose Nowadays, the clinical management of thyroid nodules needs to be multi-disciplinary. In particular, the crosstalk between endocrinologists and cytopathologists is key. When FNAs are properly requested by endocrinologists for nodules characterised by relevant clinical and ultrasound features, cytopathologists play a pivotal role in the diagnostic work-up. Conversely, improper FNA requests can lead to questionable diagnostic efficiency. Recently, recommendations to delay all non-urgent diagnostic procedures, such as thyroid FNAs, to contain the spread of COVID-19 infection, have made the interplay between endocrinologists and cytopathologists even more essential. The objective of this study was to assess the impact of COVID-19 pandemic on our practice by evaluating the total number of FNAs performed and the distribution of the Bethesda Categories before, during, and after the lockdown. Methods We analysed the FNA trends before (1st January 2019 to March 13th 2020), during (March 14th to May 15th), and after (May 16th to July 7th) the lockdown. Results Although the total number of weekly FNAs dropped from 62.1 to 23.1, our referring endocrinologists managed to prioritise patients with high-risk nodules. In fact, in the post-lockdown, the weekly proportion of benign diagnoses dropped on average by 12% and that of high-risk diagnoses increased by 6%. Conclusions The lesson we have learned so far from this pandemic is that by applying safety protocols to avoid contagion and by increasing the threshold for FNA requests for thyroid nodules, we can continue to guarantee our services to high-risk patients even in times of a health crisis. Keywords Thyroid Fine-needle aspiration COVID-19 Patient prioritisation ●
●
●
Introduction The recent COVID-19 outbreak has had great consequences on our healthcare system. At the beginning of the outbreak, Italy was the second most impacted country after China—a phenomenon that led to a national lockdown [1]. Such drastic containment measure led to the postponement of non-urgent and elective medical and surgical procedures, among these FNA cytology for thyroid nodules [2, 3]. It is
* Giancarlo Troncone [email protected] 1
Department of Public Health, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
now well established that clinical management of thyroid nodules needs to be multi-disciplinary. In particular, a direct crosstalk between endocrinologists and cytopathologists is key [4]. When thyroid fine-needle aspiration is properly requested by endocrinologists f
Data Loading...
