Retrospective analysis of patients WHO made fiberoptic bronchoscopy during and prior to the pandemic period

INTRODUCTION: The aim of this study is to define the demographic characteristics of the patients who underwent FOB in our clinic, to determine the indications for the procedure, to evaluate the Thorax CT findings, to determine the FOB findings, to review the complications related to FOB, to evaluate the FOB culture and FOB pathology results, and to compare the pandemic period and pre-pandemic periods with each other. It was investigated whether the pandemic process affected these results in patients who were diagnosed. METHODS: Patients who underwent FOB in our clinic during the pandemic period (11 March 2020 – 10 March 2021) and during the pre-pandemic period (11 March 2019 – 10 March 2020) in our Chest Diseases Bronchoscopy Unit at Dokuz Eylül University Medical Faculty Hospital were retrospectively screened. All patient data, including demographic information, vital data, imaging and procedure reports, were accessed from the electronic patient record system. Patients under the age of 18 and patients with insufficient data in the system were not included. RESULTS: The data of 663 patients included in the study were reviewed retrospectively. 427 (64.4%) were men and 236 (35.6%) were women, and the majority of patients who underwent FOB were men. The mean age of the patients was 59.7±13.4 years. Of 663 patients who underwent FOB, 337 were diagnosed with FOB. Among 337 patients diagnosed with FOB, 133 (39.5%) were diagnosed with malignancy. 99 patients (29.4%) had interstitial lung disease, 78 patients (23.1%) had pneumonia, 19 patients (6.5%) had tuberculosis, and 5 patients had other diagnoses. The diagnosis rate independent of the period was 50.8%. Before the Covid-19 pandemic, 266 of 542 patients who underwent FOB were diagnosed, and the rate of diagnosis with FOB was found to be 49.0%. During the Covid-19 pandemic, 71 of 121 patients were diagnosed, this rate increased to 58.6%. 377 patients diagnosed with malignancy before and during the pandemic were examined according to their demographic characteristics. The number of female patients in the diagnosed group was 122, 27 (22.1%) of them were diagnosed with malignancy and 95 (77.9) of them were not diagnosed with malignancy. The total number of men in the diagnosed group was 215, and 106 (49.3%) of them were diagnosed with malignancy. 109 (50.7%) were not diagnosed with malignancy. In the evaluation made among 337 patients who were diagnosed, the mean age of the patients diagnosed with malignancy was 64.7±9.2. Patients diagnosed with malignancy are between the ages of 39-85. Among the patients diagnosed with malignancy, 320 patients with smoking information were identified. 62 (56.9%) of 109 patients in the active smoker group, 44 (47.3%) of 93 patients in the group who quit smoking, and 18 (15.3%) of 113 patients in the never smoked group were in the group diagnosed with malignancy. When 202 patients with a history of smoking and pack-year information were examined, it was found that while the pack-year was 48.5 in the group diagnosed with malignancy, it was 36.2 in the patients with non-malignant diagnosis. When patients diagnosed with malignancy according to the period were examined, it was determined that 95 (35.1%) of 266 patients diagnosed before the pandemic were diagnosed with malignancy, and 40 (56.3%) of 71 patients in the pandemic period were diagnosed with malignancy. The difference between them was found to be significant (P<0.001). Histopathological classification in those diagnosed with malignancy was squamous cell carcinoma, adenocarcinoma, and small cell carcinoma, respectively. In the evaluation made according to the period, although their rates have changed, their ranking has not changed. CONCLUSION: When the patients who underwent FOB during the pandemic period and the previous one-year periods were examined, it was determined that there was a significant decrease in the number of patients during the pandemic period. Curfews put into effect during the pandemic period can be explained by postponing elective cases in hospitals and giving priority to emergency cases. In challenging pandemic conditions, performing FOB in patients with pre-diagnosis of malignancy was not interrupted, but on the contrary, it was concluded that there was a significant increase in the rate of patients diagnosed with malignancy. Keywords: Bronchoscopy, Diagnosis, Malignancy, Pandemic Period, Pre-Pandemic Period