The Impact of the COVID-19 Pandemic on Follow-Ups for Vertigo/Dizziness Outpatients

Abstract

Objectives: In the present report, we aimed to investigate the impact of the coronavirus disease (COVID-19) pandemic on vertigo/dizziness outpatient cancellations in Japan. Methods: We examined 265 vertigo/dizziness outpatients at the ear, nose, and throat department of the Nara Medical University between March 01, 2020, and May 31, 2020, during the COVID-19 pandemic in Japan. We also focused on 478 vertigo/dizziness outpatients between March 01, 2019, and May 31, 2019, before the COVID-19 pandemic, to compare the number of cancellations between these 2 periods. The reasons for cancellation and noncancellation were investigated using telephone multiple-choice questionnaires (telMCQs), particularly for patients with benign paroxysmal positional vertigo (BPPV) and Meniere’s disease (MD). Results: There were many cancellations for medical examinations during the 2020 study period. The total number of vertigo/dizziness outpatients decreased by 44.6% in the 2020 period compared to the same period in 2019. The percent reduction in clinic attendance from 2019 to 2020 (ie, [2019-2020]/2019) for patients with BPPV was higher than that for patients with MD. Compared to the other vertigo-associated conditions, patients with MD exhibited a lower percent reduction in clinic attendance. According to the results of the telMCQs, 75.0% of BPPV cases and 88.2% of MD cases cancelled their appointment and gave up visiting hospitals due to fear of COVID-19 infection, even if they had moderate to severe symptoms. On the contrary, 25.0% and 80.0% patients with BPPV and MD, respectively, did not cancel their appointment; they should not have visited the hospital but stayed at home because they had slight symptoms. Conclusions: These findings suggest that advanced forms should be prepared for medical care, such as remote medicine. These forms should not only be for the disease itself but also for the mental distress caused by persistent symptoms.

Sudden hearing loss and vestibular disorders during and before COVID-19 pandemic: An audiology tertiary referral centre experience

“…However, the incidence at our institution during the pandemic year period was higher in comparison to the previous two years. This was due to a reduction in the overall number of outpatient visits, as previously reported [3] , [10] . This is consistent with the pandemic restrictions enforced by the Italian government that limited activity to urgent and oncological cases, so patients with acute audiological symptoms were admitted to the clinic while patients with slowly progressive hearing loss, or other mild audiological symptoms were postponed (see Table 1 ).…”

“…Likewise, the total outpatient audiological visits performed at our institution during 2020 showed a notable reduction [10] . Ueda et al [3] investigated the impact of the COVID-19 pandemic on vertigo/dizziness outpatient cancellations. They found a 45% reduction in the total number of vertigo-associated visits between March and May 2020 in comparison to the same period of 2019.…”

“…They found a 45% reduction in the total number of vertigo-associated visits between March and May 2020 in comparison to the same period of 2019. Interestingly, patients with Ménière's disease (MD) exhibited a lower percentage reduction in clinic attendance with respect to other vestibular conditions [3] . According to this, we discovered a significantly higher incidence of MD-related acute vertigo attacks and MD first diagnosis during 2020, probably due to the pandemic-associated stress and anxiety load [10] .…”

“…A large decrease in the number of Ear Nose and Throat outpatient urgent consultations was observed during the first phase of the pandemic probably due to national lockdown orders associated with patients' reticence and fear of going to the hospitals [2] . Consequently, a reduction in the diagnosis of many otorhinolaryngological and audiological disorders such as epistaxis, pharyngo-tonsillitis, otitis media, equilibrium disorders, and sudden sensorineural hearing loss (SSNHL) has been reported [2] , [3] , [4] .…”

The Impact of the COVID-19 Pandemic on Avoidance of Health Care, Symptom Severity, and Mental Well-Being in Patients With Coronary Artery Disease

“…Regarding DMP consultations, one in six CAD patients in our study reported not going to regular DMP consultations any longer since the outbreak of the COVID-19 pandemic, whereas only a minor group of patients who already had a scheduled appointment decided to cancel or postpone it. Specifically, the fear of infection with COVID-19 accounted for one third of postponed or canceled appointments, which has also been observed in other medical sectors ( 48 , 49 ). This patient group may have tried to cope with the perceived risk due to pre-existing health conditions by a general avoidance behavior toward situations with potentially elevated infection risk—such as doctor's offices –, which has also been reported in other studies ( 50 , 51 ).…”