Is COVID-19 Impacting Cancer Screening? A Survey of Prostate-Specific Antigen Test Requests during a Local Outbreak (preprint)

Background. Although the ongoing coronavirus disease 2019 (COVID-19) pandemics is directly contributing to derange global health and fitness, the restrictive measures applied for containing the outbreaks are also impacting detection and management of many diseases, including cancers. This study aimed to establish if and how the COVID-19 outbreak may have impacted the practice of routine prostate cancer screening in Verona, Italy.Methods. We searched the laboratory information system of the Service of Laboratory Medicine of the University Hospitals of Verona to identify all test requests for prostate-specific antigen (PSA) and vitamin D (Vit D; i.e., the most locally requested immunochemical test) for outpatients during the last five years (December 10, 2016, to December 10, 2020). The weekly requests for these tests placed between February 25 and December 9, 2020, was compared to those placed during the period of the previous four years (i.e., 2016-2019).Results. The volume of test requests for both Vit D and PSA did not differ in 2020 compared to the previous four years. However, a dramatic decline was observed during the local lockdown period (between March 10 and May 17, 2020), with a median decrease of 76% for Vit D and 62% for PSA, respectively. This reduction was compensated by 13% increase for Vit D and 43% increase for PSA in the post-lockdown period. Conclusion. These results show that the lockdown period established during the first peak of the COVID-19 outbreak in Italy’s Verona province was associated with a dramatic decrease in routine prostate cancer screening.

Is COVID-19 Lockdown Associated with Vitamin D Deficiency? (preprint)

This work was aimed at assessing whether the ongoing coronavirus disease 2019 (COVID-19) outbreak, along with associated social restrictions, may have impacted the vitamin status of the general population. To this end, we reviewed all vitamin D test results carried out for outpatients aged 18 years or older during the last three years at an Italian University Hospital. The median serum vitamin D concentrations measured from the first day of Italian lockdown to present time did not significantly differ from those of the same period in the previous two years (78 vs. 77 nmol/L; p=0.277), whilst the prevalence of vitamin D deficiency was found to be marginally lower in 2020 than in the previous two years (16.0% vs. 17.9%; p=0.003). These results suggest that vitamin D deficiency in our province has not increased during the Italian COVID-19 outbreak or in correspondence with the nationwide lockdown.

Clinical characteristics and laboratory biomarkers changes in COVID-19 patients requiring or not intensive or sub-intensive care: a comparative study (preprint)

Background: Identifying risk factors for severe novel-coronavirus disease (COVID-19) is useful to ascertain which patients may benefit from advanced supportive care. The study offers a description of COVID-19 patients, admitted to a general ward for a non-critical clinical picture, with the aim to analyse the differences between those transferred to the intensive (ICU) and/or sub-intensive care (SICU) units and those who were not. Methods: This observational retrospective study includes all COVID-19 patients admitted to the Infectious Diseases Unit. Clinical, laboratory, radiological and treatment data were collected. The primary outcome was a composite of need of transfer to the ICU and/or SICU during the hospitalization. Patients who did not require to be transferred are defined as Group 1; patients who were transferred to the ICU and/or SICU are defined as Group 2. Demographic, clinical characteristics and laboratory findings at the 1 st , 3 rd and last measurements were compared between the two groups. Results: 303 patients were included. The median age was 62 years. 69 patients (22.8%) met the primary outcome and were defined as Group 2. The overall fatality rate was 6.8%. Group 2 patients were predominantly male (76.8% vs. 55.1%, p<0.01), had a higher fatality rate (14.5% vs. 3.8%, p<0,01), had more hypertension (72.4% vs. 44%, p<0,01) and diabetes (31.9% vs. 21%, p=0.04) and were more likely to present dry cough (49.3% vs. 25.2%, p<0.01). Overall, chest X-ray at admission showed findings suggestive of pneumonia in 63.2%, and Group 2 were more likely to develop pathological findings during the hospitalization (72.7% vs. 17.2%, p=0.01). At admission, Group 2 presented significantly higher neutrophil count, aspartate-transaminase and C-reactive-protein. At the 3 rd measurement, Group 2 presented persistently higher neutrophil count, hepatic inflammation markers and C-reactive-protein. Group 1 presented a shorter duration from admission to negativization of follow-up swabs (20 vs. 35 days, p<0.01). Conclusions: The presence of comorbidities and the persistent observation of abnormal laboratory findings should be regarded as predisposing factors for clinical worsening.