Evolving trends in the management of pelvic inflammatory disease (PID) during SARS‐CoV‐2 pandemic: A multicenter retrospective cohort study

Abstract

AbstractBackground and AimPelvic inflammatory disease (PID) is usually managed by conservative treatment, but in selected cases, especially in the presence of a tubo‐ovarian abscess (TOA), surgical management is a recognized treatment option. We compared the trends in managing PID and short‐term outcomes before and during the SARS‐CoV‐2 pandemic.MethodsThis is a retrospective study performed in three Italian gynecological centers. We included patients admitted to hospital with a diagnosis of PID. Demographic characteristics, management, time to diagnosis, and time to treatment were compared before versus during the SARS‐CoV‐2 pandemic.ResultsOne hundred nineteen PID patients were screened, eighty‐one before the SARS‐CoV‐2 pandemic, and thirty‐eight after the onset. At admission, leukocytosis (median 19.73 vs. 13.99 WBC/mm3, p‐value = 0.02) was significantly higher in patients who underwent surgery after the onset of the pandemic. TOA incidence was higher in patients who underwent surgery during the SARS‐CoV‐2 pandemic, but the difference did not reach statistically significance (p = 0.06). The proportion of patients treated with surgery dropped to 26.3% after the onset from 46% of patients before the onset of pandemic (p = 0.03). Furthermore, a higher percentage of emergency surgical procedures on day 0 of hospital admission were performed after the onset of the pandemic (50% vs. 13.1%, p = 0.01).ConclusionsIn this retrospective cohort study, we found that the SARS‐CoV‐2 pandemic influenced the clinical presentation and management of PID in favor of conservative treatment. Patients who underwent surgery during the SARS‐CoV‐2 pandemic had higher inflammatory markers.