A 10-year analysis of Helicobacter pylori positivity in gastric biopsies: Impact of seasonality and the COVID-19 pandemic a single-center experience

Objective: This study aimed to investigate the annual, seasonal, and monthly trends in Helicobacter pylori (HP) positivity over ten years and to assess the potential impact of the COVID-19 pandemic on diagnostic patterns.Method: A retrospective analysis was conducted on 17,091 gastric biopsies performed between 2015 and 2024. HP infection was diagnosed histologically using toluidine blue staining. The data were classified by month, season, and year, and comparisons were made across the pre-pandemic (2015-2019), pandemic (2020-2021), and post-pandemic (2022-2024) periods.Results: The overall HP positivity rate was 29.1%. Positivity was significantly higher in males (30.3%) than in females (28.2%) (p=0.002), although the effect size was minimal. Younger individuals had a significantly higher HP positivity rate (mean age: 49.0 vs. 54.1 years, p<0.001). HP positivity showed minor monthly variation, with the highest rate in August (33.3%) and the lowest in February (27.3%) (p=0.044; minimal effect size). No significant differences were observed in seasonal positivity rates. HP positivity decreased during the pandemic years (26.4%) and showed a significant upward trend post-pandemic, reaching 32.0% in 2024 (p=0.002). However, the pandemic's overall effect on HP positivity rates was limited.Conclusion: Although minor seasonal and monthly fluctuations were detected, they were not clinically meaningful. The pandemic temporarily reduced HP detection rates, likely due to restricted access to healthcare services. Post-pandemic increases in positivity may reflect delayed diagnoses and rising antibiotic resistance. Continued monitoring of HP trends is essential for guiding public health strategies.