Turkiye Klinikleri Journal of Dermatology

.: ORIGINAL RESEARCH
Evaluation of Elderly Patients That Presented to Dermatology Outpatient Clinics During the COVID-19 Pandemic: A Retrospective Study
COVID-19 Pandemisi Sürecinde Dermatoloji Polikliniklerine Başvuran Yaşlı Hastaların Değerlendirilmesi: Retrospektif Çalışma
Tuğba FALAY GÜRa, Sevil SAVAŞ ERDOĞANa, Bilal DOĞANb
aClinic of Dermatology, Sultan 2. Abdülhamid Han Training and Research Hospital, İstanbul, TURKEY
bDepartment of Dermatology, Maltepe University Faculty of Medicine, İstanbul, TURKEY
Turkiye Klinikleri J Dermatol. 2021;31(2):125-31
doi: 10.5336/dermato.2021-82809
Article Language: EN
Full Text
ABSTRACT
 Objective: During the ongoing coronavirus disease-2019 (COVID-19) pandemic, the overall number of patients presented to dermatology outpatient clinics has decreased. This study aims to examine the number of elderly patients presented to dermatology outpatient clinics during the ongoing COVID-19 pandemic, the periodic variation in the number of patients, and the most common reasons for their presentation. Material and Methods: This study retrospectively analyzed 448 presentations of 381 patients aged ≥60 years between March 11 and May 31, 2020. These cases were evaluated considering the age, gender, presentation diagnoses, presence of chronic diseases, the urgency of complaints, duration of symptoms, and whether they had contracted COVID-19. Results: Overall, 15% of the patients were diagnosed with eczematous dermatitis, followed by psoriasis and senile pruritus. Chronic diseases were present in 319 (83.7%) patients. Most patients applied between March 11 and March 31, in the first period of the pandemic. It was determined that seven of the patients had contracted COVID-19 infection. Conclusion: This study suggests that the curfew policy in Turkey has greatly affected the decision of elderly people in visiting dermatology outpatient clinics. However, the number of elderly patients presented to the outpatient clinic remains substantial. The spectrum of the presentation diagnoses of the patients was similar to the pre-pandemic period. Determining the reasons for the elderly population to visit these clinics during the pandemic can provide a guide in taking the necessary precautions to meet the health needs of this population in similar situations in the future.

Keywords: COVID-19; dermatology; aged; outpatient clinics, hospital; pandemics
ÖZET
 Amaç: Koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)] pandemi sürecinde, dermatoloji polikliniklerine başvuran hasta sayısı azalmıştır. Bu çalışmada, pandemi sırasında dermatoloji polikliniklerine başvuran yaşlı hastaların sayısı, başvuran hasta sayısındaki periyodik değişimler ve en sık başvuru sebeplerinin incelenmesi planlanmıştır. Gereç ve Yöntemler: Bu çalışmada, 11 Mart 2020'den 31 Mayıs 2020 tarihine kadar olan süreçte 60 yaş ve üzeri 381 hastanın 448 poliklinik başvurusu retrospektif olarak incelendi. Hastaların yaşı, cinsiyeti, başvuru tanısı, kronik hastalık varlığı, şikâyetlerinin aciliyeti, semptom süresi ve COVID-19 geçirip geçirmedikleri belirlendi. Bulgular: Hastaların %15'i egzamatöz dermatit tanısı aldı, bu tanıyı psöriyazis ve senil pruritus takip etti. Hastaların 319'unda (%83,7) kronik hastalık mevcuttu. En çok hasta, pandeminin ilk dönemi olan 11 Mart ve 31 Mart tarihleri arasında başvurdu. Yedi hastanın, COVID-19 enfeksiyonu geçirdiği belirlendi. Sonuç: Türkiye'de sokağa çıkma yasağı politikası, yaşlı hastaların dermatoloji polikliniğine başvurma kararını büyük oranda etkilemiştir. Buna rağmen polikliniğe başvuran yaşlı hastaların sayısı yüksektir. Hastaların başvuru tanıları, pandemi öncesi dönemle benzerdir. Yaşlı hastaların pandemi sürecinde dermatoloji polikliniklerine başvuru sebeplerinin incelenmesi, gelecekte benzer durumlarda bu hastaların sağlık ihtiyaçlarını karşılamak için gerekli önlemlerin alınmasına rehberlik edebilir.

Anahtar Kelimeler: COVID-19; dermatoloji; yaşlı; poliklinikler, hastane; pandemi
REFERENCES:
  1. Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020;395(10224):565-74. [Crossref]  [PubMed]  [PMC] 
  2. Guo YR, Cao QD, Hong ZS, Tan YY, Chen SD, Jin HJ, et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak - an update on the status. Mil Med Res. 2020;7(1):11. [Crossref]  [PubMed]  [PMC] 
  3. Cengiz FP, Emiroglu N, Bahali AG, Dizman D, Taslidere N, Akarslan TC, et al. Which dermatology patients attend to Dermatology Outpatient Clinics during the SARS-CoV-2 outbreak in Turkey and what happened to them? Dermatol Ther. 2020;33(4):e13470. [Crossref]  [PubMed] 
  4. Kutlu Ö, Güneş R, Coerdt K, Metin A, Khachemoune A. The effect of the "stay-at-home" policy on requests for dermatology outpatient clinic visits after the COVID-19 outbreak. Dermatol Ther. 2020;33(4):e13581. [Crossref]  [PubMed]  [PMC] 
  5. Turan Ç, Metin N, Utlu Z, Öner Ü, Kotan ÖS. Change of the diagnostic distribution in applicants to dermatology after COVID-19 pandemic: What it whispers to us? Dermatol Ther. 2020;33(4):e13804. [Crossref]  [PubMed]  [PMC] 
  6. Turkmen D, Altunisik N, Mantar I, Durmaz I, Sener S, Colak C. Comparison of patients' diagnoses in a dermatology outpatient clinic during the COVID-19 pandemic period and pre-pandemic period. Int J Clin Pract. 2021; 75(4):e13948. [Crossref]  [PubMed]  [PMC] 
  7. Kutlu Ö, Metin A. Relative changes in the pattern of diseases presenting in dermatology outpatient clinic in the era of the COVID-19 pandemic. Dermatol Ther. 2020;33(6):e14096. [Crossref]  [PubMed] 
  8. Kartal SP, Çelik G, Sendur N, Aytekin S, Serdaroğlu S, Doğan B, et al. Multicenter study evaluating the impact of COVID-19 outbreak on dermatology outpatients in Turkey. Dermatol Ther. 2020;33(6):e14485. [Crossref]  [PubMed] 
  9. Çaytemel C, Erdem O, Ağırgöl Ş, Türkoğlu Z. Dermatology outpatient clinic outcomes after COVID-19 outbreak: What is new normal? Dermatol Ther. 2021:e14950. [Crossref]  [PubMed] 
  10. Remuzzi A, Remuzzi G. COVID-19 and Italy: what next? Lancet. 2020;395(10231):1225-8. [Crossref]  [PubMed]  [PMC] 
  11. Tao J, Song Z, Yang L, Huang C, Feng A, Man X. Emergency management for preventing and controlling nosocomial infection of the 2019 novel coronavirus: implications for the dermatology department. Br J Dermatol. 2020;182(6):1477-8. [Crossref]  [PubMed] 
  12. Worldometer [Internet]. © Copyright Worldometers.info [Cited 25.7.2020]. COVID-19 coronavirus pandemic. Available from: [Link] 
  13. Altın Z. Covid-19 pandemisinde yaşlılar [Elderly people in Covid-19 outbreak]. The Journal of Tepecik Education and Research Hospital. 2020;30 (Suppl 2):49-57. [Link] 
  14. Wang W, Tang J, Wei F. Updated understanding of the outbreak of 2019 novel coronavirus (2019-nCoV) in Wuhan, China. J Med Virol. 2020;92(4):441-7. [Crossref]  [PubMed]  [PMC] 
  15. Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, et al. Dysregulation of immune response in patients with coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020;71(15): 762-8. [Crossref]  [PubMed]  [PMC] 
  16. Fang L, Karakiulakis G, Roth M. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? Lancet Respir Med. 2020;8(4):e21. Erratum in: Lancet Respir Med. 2020;8(6):e54. [Crossref]  [PubMed]  [PMC] 
  17. Yalçin B, Tamer E, Toy GG, Oztaş P, Hayran M, Alli N. The prevalence of skin diseases in the elderly: analysis of 4099 geriatric patients. Int J Dermatol. 2006;45(6):672-6. [Crossref]  [PubMed] 
  18. Özyurt K, Avcı A, Çınar SL, Silay E. Geriatrik hastalarda dermatolojik sorunlar [Dermatological disorders in geriatric patients]. Turk J Dermatol. 2014;4:206-9. [Crossref] 
  19. Liao YH, Chen KH, Tseng MP, Sun CC. Pattern of skin diseases in a geriatric patient group in Taiwan: a 7-year survey from the outpatient clinic of a university medical center. Dermatology. 2001;203(4):308-13. [Crossref]  [PubMed] 
  20. Sunderkötter C, Aebischer A, Neufeld M, Löser C, Kreuter A, Bialek R, et al. Increase of scabies in Germany and development of resistant mites? Evidence and consequences. J Dtsch Dermatol Ges. 2019;17(1):15-23. [Crossref]  [PubMed] 

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30.03.2014

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