The Impact of the COVID-19 Pandemic on the Management of Patients with Oral Potentially Malignant Disorders in a Tertiary Care Hospital, Sri Lanka

Kalpana Jeewanthi Subasinghe; Nadisha Sewwandi Piyarathne; Pilana Vithanage Kalani Shihanika Hettiarachchi; Ruwan Duminda Jayasinghe

doi:10.31557/apjcc.2023.8.1.29-34

Authors

Kalpana Jeewanthi Subasinghe Department of Oral Medicine and Periodontology, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka.
Nadisha Sewwandi Piyarathne Department of Basic Sciences, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka. https://orcid.org/0000-0001-5834-6854
Pilana Vithanage Kalani Shihanika Hettiarachchi Department of Oral Medicine and Periodontology, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka. https://orcid.org/0000-0003-2618-5050
Ruwan Duminda Jayasinghe Department of Oral Medicine and Periodontology, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka. https://orcid.org/0000-0002-8054-4301

DOI:

https://doi.org/10.31557/apjcc.2023.8.1.29-34

Keywords:

oral potentially malignant disorders, Covid-19, pandemic

Abstract

Introduction: Oral potentially malignant disorders (OPMD) have a higher risk to develop into oral cancer, which is the comments cancer in males in Sri Lanka. The covid-19 pandemic had significant ill effects on the health care systems, worldwide.
Objective: To retrospectively investigate the management of OPMD patients presented to the oral medicine clinic of the University Dental Teaching Hospital Peradeniya, Sri Lanka before and during the pandemic.
Methods: This was a hospital-based cross-sectional study using medical records. The pre-pandemic group included patients diagnosed with OPMD presenting between Jan 2018 - Dec 2019; the pandemic group from Jan 2020 to Dec 2021.
Results: There were 321 eligible medical records. Of these, 247 belong to the pre-pandemic group and 74 in the pandemic (3:1). In the pre-pandemic group, 32% of biopsies were performed within the first week, while it was 56% in the pandemic group. We found a significant increase in the loss of follow-up in the pandemic group compared to the pre-pandemic group (p=0.01). The average delay for the 2^nd visit was 27 days, for the 3^rd visit it was 127 days in the pre-pandemic; and 89 and 152 days respectively in the pandemic group.
Conclusions: We recommend following evidence-based practices for the management of OPMD in anticipated pandemics. Strategies to diagnose patients at home must be developed and implemented. There is a higher need for the prevention of habit-related risk factors. Biopsy at the first visit or first week is recommended. Patients should be monitored using digital technologies in the absence of physical follow-up.