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

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 2nd visit was 27 days, for the 3rd 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.