Emergency treatment of ophthalmologic diseases during the first phase of SARS-CoV2 pandemic in a tertiary referral center in Germany – the COVID-DETOUR questionnaire study

Abstract

Background:During the first wave of the COVID-19 pandemic, the need of treatment of urgent ophthalmological diseases and the possible risk of a SARS-CoV-2 infection had to be weighed against each other. In this questionnaire study, we aimed to analyze potential barriers and patients’ health beliefs during and after the lockdown early 2020 in a tertiary referral center in Kiel, Germany.Methods:Patients admitted for the treatment of urgent ophthalmic diseases between March 1st, 2020, and June 3rd, 2020, were asked to participate in a questionnaire study. After informed consent was obtained, patients were interviewed using a standardized questionnaire which addressed aspects of their medical history, their health beliefs concerning the COVID-19 pandemic and barriers on their way to the treatment center. The study group was subdivided into two subgroups, depending on the occurrence of their symptoms, before and after the lockdown was ended on April 20th, 2020.Results:Ninety-three patients were included, 43 in subgroup A (before April 20th) and 50 in subgroup B (April 20th or later). Retinal disorders were most common (approximately 60%), with retinal detachments being the most singular reason for admission. Only 8 patients (8.6%) experienced a delay between their decision to visit a doctor until the actual examination. Every fourth patient was afraid of a COVID-19 infection, and expected a higher likelihood for an infection at the hospital. Patients with comorbidities tended to be more likely to be afraid of an infection (correlation coefficient 0.183, p=0.0785) and were significantly more likely to be concerned about problems with organizing follow-up care (corr. coefficient 0.222, p=0.0328). Higher age was negatively correlated with fear of infection (corr. coefficient -0.218, p-value 0.034).Conclusion:In this questionnaire study, only a minority of patients indicated a delay in treatment, regardless of whether symptoms occurred before or after the lockdown before April 20th. While patients with comorbidities were more concerned about infection and problems during follow-up care, patients of higher age – who have a higher mortality – were less afraid. Protection of high-risk groups should be prioritized during the SARS-CoV-2 pandemic.Trial registration:The study was registered as DRKS00021630 at the DRKS (Deutsches Register Klinischer Studien) before the conduction of the study on May 5th, 2020.