Impact of treatment delays on vitiligo during the COVID-19 pandemic: A retrospective study.

Due to the COVID-19 pandemic, routine treatments are delayed to some extent and their negative impacts have been widely reported. However, virtually nothing is known about vitiligo in the context of COVID-19. Therefore, we analyzed treatment delays and its impact on vitiligo, aiming to provide suggestions on vitiligo management within this special period. We performed a retrospective cohort study on 322 patients who visited our clinics at least 2 times from January to December 2020, and their medical records and photographs were reviewed. Patients were divided into normal (n = 155) and late group (n = 167) based on whether experienced treatment delays. As for the active cases, the late group showed higher progression rate than normal group (35 of 86 [40.7%] vs. 10 of 81 [12.3%]; p = 0.002). Moreover, we observed higher recurrence rate in delay group than those of normal group (26 of 81[32.1%] vs. 9 of 74 [12.2%]; p = 0.018) among stable cases. Further univariate and multivariate analysis determined treatment delays as the most important independent risk factor for disease progression and recurrence, and maintenance therapy (>2 years) as a protective factor against recurrence. This study, for the first time, revealed the independent adverse impact of treatment delays on the progression and recurrence of vitiligo and indicated the significance of continuous treatment for halting progression and long-term maintenance therapy for preventing recurrence for vitiligo, which should be highly valued in the management of vitiligo during the COVID-19 pandemic.

Estimation of Incubation Period and Serial Interval for SARS-CoV-2 in Jiangxi, China, and an Updated Meta-Analysis.

INTRODUCTION: This paper aims to estimate the incubation period and serial intervals for SARS-CoV-2 based on confirmed cases in Jiangxi Province of China and meta-analysis method. METHODOLOGY: Distributions of incubation period and serial interval of Jiangxi epidemic data were fitted by "fitdistrplus" package of R software, and the meta-analysis was conducted by "meta" package of R software. RESULTS: Based on the epidemic data of Jiangxi, we found the median days of incubation period and serial interval were 5.9 days [IQR: 3.8 - 8.6] and 5.7 days [IQR: 3.6 - 8.3], respectively. The median days of the infectivity period at pre-symptomatic was 1.7 days [IQR: 1.1 - 2.4]. The meta-analysis based on 64 papers showed the pooled means of the incubation period and serial interval were 6.25 days (95% CrI: 5.75 - 6.75) and 5.15 days (95% CrI: 4.73 - 5.57), respectively. CONCLUSIONS: Our results contribute to a better understanding of COVID-19 and provide useful parameters for modelling the dynamics of disease transmission. The serial interval is shorter than the incubation period, which indicates that the patients are infectious at pre-symptomatic period, and isolation of detected cases alone is likely to be difficult to halt the spread of SARS-CoV-2.