Impact of COVID-19 on Head and Neck Cancer Advancement Measured by Increasing Numbers of Urgent Dyspnea Cases-What Could Be Improved in the Event of Subsequent Pandemics?

The COVID-19 pandemic has altered all aspects of the healthcare system's organization and impacted patients with head and neck cancer (HNC) who have experienced delayed diagnosis and treatment. The pandemic resulted in the admission of patients with severe dyspnea and a need for tracheotomy due to extremely advanced HNC. This study's objective was to evaluate the clinical characteristics of two multi-center cohorts, "pre-COVID-19" and "COVID-19", of HNC patients admitted as emergencies for dyspnea. The therapeutic activity of HNC patients in four University Departments of Otolaryngology was studied over two time periods: September-February 2019/2020 and 2020/2021. A group of 136 HNC patients who underwent a tracheotomy in two-time cohorts, pre-COVID-19 (N = 59) and COVID-19 (N = 77), was analyzed. The mean tracheotomies incidence proportion was 1.82 (SD: 1.12) for the pre-COVID-19 and 3.79 (SD: 2.76) for COVID-19 period. A rise in the occurrence of emergency dyspnea was observed in the COVID-19 cohort, and the greatest increase was seen in the centers with the highest limitations on planned surgeries. In the pre-COVID-19 period, 66% of patients presented with symptoms for more than a month in comparison to 78% of patients in the COVID-19 period (p = 0.04). There was a higher incidence of laryngeal and laryngopharyngeal cancer in the COVID-19 period (63% vs. 75%, respectively). The number of tracheotomies performed under general anesthesia dropped in favor of local anesthesia during COVID-19 (64% vs. 56%, respectively) due to extremely advanced HNC. In the COVID-19 cohort, most patients received a telemedicine consultation (N = 55, 71%) in comparison to the pre-COVID-19 period (N = 14, 24%). Reorganization of the referral system, adjustment of treatment capacity for an increased number of HNC, and a reserve for more extensive resection and reconstruction surgeries should be made in the profile of otorhinolaryngological departments, ensuring future HNC treatment is not hampered in case of a new pandemic wave.

The impact of the COVID 19 pandemic on the functioning of the Universal Newborn Hearing Screening Program in Poland.

The Newborn Hearing Screening Program has existed in Poland for almost 20 years. However, for the first time in the history of his activity, he had to deal with large logistic and staffing problems. The analysis compared the years 2020 and 2021 in terms of the functioning of centers that conduct audiological diagnostics of the Program during the Covid-19 pandemic. In order to obtain relevant information, a telephone survey was conducted at the beginning of 2022 with questions about the performance of standard activities related to the Program. Results In 2020, 60 centers conducting audiological diagnostics (66.67%) were suspended, and 30 were working under the sanitary and epidemiological regime (33.33%). In 2021, only 5 (5.26%) diagnostic centers with their headquarters in facilities transformed into so-called homonymous hospitals, dealing only with the treatment of patients infected with SARS-CoV-2 virus, were suspended. Discussion The development of the pandemic and the related limitations around the world had a significant impact on the quality and scope of medical services provided. Many hospitals were quickly transformed into closed centers treating only patients with SARS-CoV-2. Audiological consultations take place in closed, soundproof rooms. Face-to-face contact was required for hearing assessment, fitting hearing aids, troubleshooting, and rehabilitation. The COVID-19 pandemic has forced audiology to modify existing practices. The use of telemedicine was increasingly preferred. In Poland, as all over the world, the scope of remote consultations has expanded, but due to technological and hardware limitations, audiological procedures remained in the sphere of direct contact with the patient. Conclusions In the first year after the announcement of the pandemic, significant difficulties were observed in the functioning of centers dealing with the diagnosis of children with suspected hearing loss. The appearance of the SARS-CoV-2 virus forced us to develop innovative methods of early diagnosis and treatment of children with hearing impairment, which resulted in the stabilization of the work of individuals in the following year.

Recommendations of the Main Board of the Polish Society of Otorhinolaryngologists, Head and Neck Surgeons for providing services during the COVID-19 pandemic for outpatient and hospital practices.

Recommendations of the Main Board of the Polish Society of Otorhinolaryngologists, Head and Neck Surgeons for providing services during the COVID-19 pandemic constitute the guidance to outpatient and hospital practices in all cases where contact with a patient whose status of COVID-19 is unknown. They have been created based on world publications and recommendations due to the current state of the COVID-19 pandemic. Justification for suspension of planned provision of services in the first phase of a pandemic was presented. The indication of the best medical practices for the time of stabilization, but with the persistence of the risk of COVID-19 infection in the population are discussed. The possibility of providing services in the following months of the pandemic is important. We provide the rationale for launching medical activities and indicate optimal practices until the consolidation of SARS COV-2 prevention and treatment methods.