Influence of the COVID-19 pandemic on the incidence and mortality of primary spinal tumors in the United States: A SEER analysis.

Introduction: The effects of the COVID-19 pandemic on the incidence and mortality of patients with primary spinal tumors remain less explored. We sought to illuminate the influence of the pandemic on the diagnosis and treatment of primary spinal tumors, providing valuable information for improving diagnosis and treatment strategies when facing unprecedented healthcare strains.

Methods: Initially, we assessed the demographic characteristics and pathological types of patients with primary spinal tumors who died attributed to COVID-19 during the pandemic (2020-2021). Next, we extracted data on the age-adjusted incidence and mortality rates of primary spinal tumors between 2018 and 2021. The rates for the entire population were retrieved first, followed by stratification based on demographic characteristics and type of pathology. The rates from 2018 to 2019, before the pandemic, served as a reference for comparison with the pandemic period (2020-2021). The SEER 22 Registries database was adopted for this study.

Results: In 2020 and 2021, COVID-19 emerged as the leading cause of death among patients with primary spinal tumors. The majority of patients who died attributed to COVID-19 were male, white, and over 60 years of age. Notably, 46.8% (58 out of 124) of them were diagnosed with primary spinal meningiomas. Between the pre-pandemic (2018-2019) and pandemic (2020-2021) periods, the incidence of primary spinal tumors decreased from 1.31 to 1.22 per 100,000 individuals, with a particularly significant decline observed in meningiomas. Moreover, the mortality rates increased from 0.30 to 0.37 per 100,000 individuals during the same period. This increase in mortality was significant among white individuals, those aged ≥ 70 years, and patients with primary spinal meningiomas.

Conclusions: Our analysis revealed that COVID-19 emerged as the primary threat to the survival of patients with primary spinal tumors during the pandemic. Compared with pre-pandemic data, we observed a significant decline in the incidence rates and a rise in mortality rates for primary spinal tumors.