The impact of COVID-19 on routine patient care from a laboratory perspective

Kruger, E C; Banderker, R; Erasmus, Rajiv T; Zemlin, Annalise E.

doi:10.7196/samj.2020.v110i12.15294

Cited by 10 publications

(14 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is consistent with Carr et al who showed HbA1c testing in UK people with type 2 diabetes reduced by 77%. 7 Similarly, using South African laboratory data, Kruger et al 6 showed that HbA1c testing overall reduced by ~64% during March to June 2020 compared with the same period the previous year, with the most marked reduction (81%) in April.…”

Section: Impact Of Pandemic On Hba1c Testing and Diabetes Service Provisionmentioning

confidence: 97%

“…5 Reflecting this, the demand for blood testing, including for diabetes diagnosis and monitoring, in some countries dropped during lockdowns. 6 Carr et al, 7 for example, showed that testing for the key diabetes marker, glycated haemoglobin (HbA1c), for primary care patients with diabetes reduced in the months following the first UK lockdown. However, the scale and impact of these changes across primary and secondary care diabetes services for both monitoring and diagnosis has not been investigated.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Assessment of the effect of the COVID-19 pandemic on UK HbA1c testing: implications for diabetes management and diagnosis

Holland

Heald

Stedman³

et al. 2021

J Clin Pathol

View full text Add to dashboard Cite

AimsThe COVID-19 pandemic, and the focus on mitigating its effects, has disrupted diabetes healthcare services worldwide. We aimed to quantify the effect of the pandemic on diabetes diagnosis/management, using glycated haemoglobin (HbA1c) as surrogate, across six UK centres.MethodsUsing routinely collected laboratory data, we estimated the number of missed HbA1c tests for ‘diagnostic’/‘screening’/‘management’ purposes during the COVID-19 impact period (CIP; 23 March 2020 to 30 September 2020). We examined potential impact in terms of: (1) diabetes control in people with diabetes and (2) detection of new diabetes and prediabetes cases.ResultsIn April 2020, HbA1c test numbers fell by ~80%. Overall, across six centres, 369 871 tests were missed during the 6.28 months of the CIP, equivalent to >6.6 million tests nationwide. We identified 79 131 missed ‘monitoring’ tests in people with diabetes. In those 28 564 people with suboptimal control, this delayed monitoring was associated with a 2–3 mmol/mol HbA1c increase. Overall, 149 455 ‘screening’ and 141 285 ‘diagnostic’ tests were also missed. Across the UK, our findings equate to 1.41 million missed/delayed diabetes monitoring tests (including 0.51 million in people with suboptimal control), 2.67 million screening tests in high-risk groups (0.48 million within the prediabetes range) and 2.52 million tests for diagnosis (0.21 million in the pre-diabetes range; ~70 000 in the diabetes range).ConclusionsOur findings illustrate the widespread collateral impact of implementing measures to mitigate the impact of COVID-19 in people with, or being investigated for, diabetes. For people with diabetes, missed tests will result in further deterioration in diabetes control, especially in those whose HbA1c levels are already high.

show abstract

Section: Impact Of Pandemic On Hba1c Testing and Diabetes Service Provisionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Assessment of the effect of the COVID-19 pandemic on UK HbA1c testing: implications for diabetes management and diagnosis

Holland

Heald

Stedman³

et al. 2021

J Clin Pathol

View full text Add to dashboard Cite

show abstract

“…In exploring the impact of COVID-19 on the number of laboratory specimens sent to the Tygerberg public sector laboratories in Western Cape Province, SA, it was found that there was a significant decline in the number of tests for non-communicable diseases between March and June 2020 compared with the same period in 2019. [9] The above brief review of some of the literature reporting on the impact of COVID-19 on routine primary-level healthcare services is limited to a short period (mainly March to June 2020) and specific facilities or geographical areas. In this article we analyse routine health services data for the whole of SA over a 10-month period from March 2020 to December 2020 and compare these with similar data for a corresponding period during 2019.…”

Section: In Practicementioning

confidence: 99%

Impact of COVID-19 on routine primary healthcare services in South Africa

Pillay¹,

Pienaar²,

Barron

et al. 2021

S Afr Med J

117

View full text Add to dashboard Cite

show abstract

“…8 Some clinics were closed for short periods to allow for decontamination following confirmation of COVID-19 cases; staff absence because of illness or redeployments to COVID-19 services or fear amongst patients of contracting the virus during follow-up visits. 9,10 Routine data from the District Health Information System in 2019-2020 indicated restricted access to public health services under strict lockdown regulations, with the largest decline reported in the Western Cape. 10 A study looking at the impact of COVID-19 on the number of specimens sent to the Tygerberg public sector laboratories showed a significant decline in the number of tests for NCDs (including 59% reduction in tests for lipids and 64% for creatinine and HbA1c) between March and June 2020 compared with the same period in 2019.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Non-communicable disease care and management in two sites of the Cape Town Metro during the first wave of COVID-19: A rapid appraisal

Delobelle

Abbas

Datay

et al. 2022

African Journal of Primary Health Care & Family Medicine

View full text Add to dashboard Cite

Background: Non-communicable diseases (NCDs), including type-2 diabetes and hypertension, have been associated with increased morbidity and mortality rates because of coronavirus disease 2019 (COVID-19). Maintaining quality care for these conditions is important but data on the impact of COVID-19 on NCD care in South Africa are sparse.Aim: This study aimed to assess the impact of COVID-19 on facility and community-based NCD care and management during the first COVID-19 wave.Setting: Two public health sector primary care sites in the Cape Town Metro, including a Community Orientated Primary Care (COPC) learning site.Methods: A rapid appraisal with convergent mixed-methods design, including semi-structured interviews with facility and community health workers (CHWs) (n = 20) and patients living with NCDs (n = 8), was used. Interviews were conducted in English and Afrikaans by qualified interviewers. Transcripts were analysed by thematic content analysis. Quantitative data of health facility attendance, chronic dispensing unit (CDU) prescriptions and routine diabetes control were sourced from the Provincial Health Data Centre and analysed descriptively.Results: Qualitative analysis revealed three themes: disruption (cancellation of services, fear of infection, stress and anxiety), service reorganisation (communication, home delivery of medication, CHW scope of work, risk stratification and change management) and outcomes (workload and morale, stigma, appreciation and impact on NCD control). There was a drop in primary care attendance and an increase in CDU prescriptions and uncontrolled diabetes.Conclusion: This study described the service disruption together with rapid reorganisation and change management at primary care level during the first COVID-19 wave. The changes were strengthened by the COPC foundation in one of the study sites. The impact of COVID-19 on primary-level NCD care and management requires more investigation.

show abstract

The impact of COVID-19 on routine patient care from a laboratory perspective

Cited by 10 publications

References 10 publications

Assessment of the effect of the COVID-19 pandemic on UK HbA1c testing: implications for diabetes management and diagnosis

Assessment of the effect of the COVID-19 pandemic on UK HbA1c testing: implications for diabetes management and diagnosis

Impact of COVID-19 on routine primary healthcare services in South Africa

Non-communicable disease care and management in two sites of the Cape Town Metro during the first wave of COVID-19: A rapid appraisal

Contact Info

Product

Resources

About