The Changing Landscape of Thyroid Surgery during the COVID-19 Pandemic: A Four-Year Analysis in a University Hospital in Romania.

ABSTRACT

The aim of this study was to highlight the changes in the surgical treatment of patients with thyroid pathology over a 4-year period. The dynamics of various parameters during this period at a tertiary University Hospital in Timisoara, Romania were examined. Data from 1339 patients who underwent thyroid surgery between 26 February 2019 and 25 February 2023 were analyzed. The patients were divided into four groups Pre-COVID-19, C1 (first year of the pandemic), C2 (second year), and C3 (third year). Multiple parameters of the patients were analyzed. Statistical analysis revealed a significant decrease in the number of surgical interventions performed during the first two years of the pandemic (p < 0.001), followed by an increase in subsequent periods (C3). Furthermore, an increase in the size of follicular tumors was observed during this period (p < 0.001), along with an increase in the proportion of patients with T3 and T4 stage in C3. There was also a reduction in the total duration of hospitalization, postoperative hospitalization, and preoperative hospitalization (p < 0.001). Additionally, there was an increase in the duration of the surgical procedure compared to the pre-pandemic period (p < 0.001). Moreover, correlations were observed between the duration of hospitalization and the duration of the surgical procedure (r = 0.147, p < 0.001), and between the duration of the surgical procedure and postoperative hospitalization (r = 0.223, p < 0.001). These findings confirm the modification of clinical and therapeutic management of patients who underwent thyroid surgery over the past 4 years, with the pandemic generating an impact whose full consequences are not yet fully known.