Impact of the COVID-19 Pandemic on Melanoma Diagnosis in Romania—Data from Two University Centers

Abstract

The COVID-19 pandemic affected the healthcare system in our country and led non-COVID patients to postpone medical visits that were not urgent. The purpose of this study was to investigate the impact of the first year of the COVID-19 pandemic on the trends in melanoma diagnosis and to compare the pathological characteristics of melanoma patients before and during the pandemic. The number of primary cutaneous melanomas diagnosed each month between 1st March 2019 and 29th February 2020 (pre-COVID-19) and between 1st March 2020 and 28th February 2021 (COVID-19) in the North-Western Region of Romania (Cluj and Bihor counties) was determined. The pathological characteristics of melanomas diagnosed in the two intervals were compared. The number of melanoma diagnoses substantially decreased during the pandemic, with 66 (−19.3%) fewer cutaneous melanomas being diagnosed in the first year of the pandemic when compared with the previous year. The tumor thickness and mitotic rate were significantly higher in cases found during the COVID-19 pandemic. Our study suggests that COVID-19 has delayed diagnosis in patients with melanoma, leading to the detection of thicker melanomas that may increase morbidity and mortality. Further studies are needed to determine the consequences of this delay on outcomes.

Impact of the COVID-19 Pandemic on Melanoma Diagnosis: Increased Breslow Thickness in Primary Melanomas—A Single Center Experience

“…Our results showed greater median Breslow thickness with a higher mitotic index that we believe is in correlation with the former. These findings coincide with other similar studies conducted during these two years [ 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ]. Although Ricci et al observed a significant increase in melanoma lesions thicker than 1 mm during the pandemic (0.88 vs. 1.96 mm) [ 30 , 37 ], we noted a 2 mm Breslow thickness depth being an important breaking point, having seen a trend of increase in pT3-4 stage melanomas during the pandemic.…”

“…These findings coincide with other similar studies conducted during these two years [ 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ]. Although Ricci et al observed a significant increase in melanoma lesions thicker than 1 mm during the pandemic (0.88 vs. 1.96 mm) [ 30 , 37 ], we noted a 2 mm Breslow thickness depth being an important breaking point, having seen a trend of increase in pT3-4 stage melanomas during the pandemic. This is in correlation with Shannon et al, who noted an increase in median tumor depth and the proportion of T3-4 staged cases among surgical patients [ 31 ].…”

“…Since the beginning of the pandemic, several studies have reported a significant reduction in melanoma patient diagnoses [ 27 , 28 , 29 ]. In addition, it was reported that newly discovered melanomas were thicker during the pandemic period in comparison to the prepandemic era [ 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ]. Moreover, a study by Lallas et al reported a significantly higher-than-expected percentage of newly diagnosed melanomas in stages IIc, III, and IV after the 2020 lockdown when compared to previous years [ 38 ].…”

A Disguising Fast-Growing Metachronous Melanoma and COVID-19

“…During the COVID-19 pandemic, patients' compliance dropped, and scheduled follow-up visits were postponed. These led to delayed diagnoses and a significant effect on life expectancy in skin cancer patients [ 6 ]. Hence, total body skin examination is mandatory during pandemic.…”

“…The COVID-19 pandemic has had a catastrophic impact on melanoma morbidity and mortality due to delayed diagnosis and treatment. The tumor thickness and mitotic rate have increased during the pandemic [ 6 ]. This paper describes the case of a 52-year-old female who developed metachronous nodular melanoma one month after COVID-19.…”