Diagnosis and treatment delays during the covid -19 pandemic

Aim: This review aims at investigating the diagnosis and treatment delays caused by the shift of health services towards corona virus pandemic management. Methods: An extended literature search using reliable databases and the Terms: coronavirus disease, diagnostic delays, screenings, resulted in 48 relevant records. Out of them 9 were excluded and the remaining 39 were included in the study, 28 Pubmed, Websites10 and 1 Book. Results: During pandemic, cancer screening programs, especially for the second deadliest colorectal cancer, have been decreased from 28 to 100% in different countries, endangering delayed diagnosis and poor treatment and survival outcomes. Delays were reported in care of patients with chronic limb-threatening ischemia and a higher major limb amputation rate (2.6% to 32.2%). Skin cancers biopsies decreased by 18% and 27% for non- melanoma and melanoma cases respectively. A substantial decrease in the number of cutaneous squamous cell carcinoma and basal cell carcinoma diagnoses ( -29% and -50% respectively), when compared to those expected from March to May 2020, was documented in a study, where the skin lesions behind the masks, kept on faces, remaining unnoticed. In the COVID-19 era, the national TB control program received less attention, leading to a worsening of the global TB epidemic. Additionally a new challenge for cholera control efforts in 2020 emerged, disrupting the hard-won years of progress against cholera in Africa, the continent bearing 54% of the global cholera burden. Moreover due to changes in routine health services, leprosy patients under multi- drug- therapy experienced drug shortages and limited access to medical care. Conclusions: It is not an easy task to combine both preventive and emergency medicine under pandemic situation, but it deserves to try, by all means, to alleviate the potentially devastating consequences.