Table 5.
Distribution of nonmalignant diseases by study period.⁎
| Diagnostic categories | Prepandemic (Jan 1–Feb 19)a |
P for difference | Pandemic (Feb 26–Apr 22) |
P for difference | Postpandemic (Apr 29–Jul 8)b |
P value a vs. b |
|---|---|---|---|---|---|---|
| Referrals (n = 384) | Referrals (n = 193) | Referrals (n = 450) | ||||
| Benign neoplasms, n (%) | 17 (4.43) | 0.132 | 4 (2.07) | 0.057 | 27 (6.00) | 0.231 |
| Warthin tumor | 1 (0.26) | 0 (0.00) | 1 (0.22) | |||
| Branchial and thyroglossal cyst | 1 (0.26) | 0 (0.00) | 1 (0.22) | |||
| Intestinal polyp | 7 (1.82)† | 2 (1.04)† | 8 (1.78)† | |||
| Gastric polyp | 1 (0.26) | 0 (0.00) | 3 (0.67) | |||
| Pancreatic benign neoplasm | 1 (0.26) | 0 (0.00) | 2 (0.44) | |||
| Benign lipomatous neoplasm | 2 (0.52) | 1 (0.52) | 4 (0.89) | |||
| Leiomyoma of uterus | 1 (0.26)† | 0 (0.00) | 2 (0.44)† | |||
| Benign neoplasm of ovary | 1 (0.26) | 0 (0.00) | 2 (0.44) | |||
| Benign neoplasm of thyroid gland | 2 (0.52) | 1 (0.52) | 4 (0.89) | |||
| Hematological disorders, n (%) | 17 (4.43) | 0.051 | 0 (0.00) | 0.078 | 17 (3.78) | 0.228 |
| Nutritional iron-deficiency anemia | 4 (1.04) | 0 (0.00) | 5 (1.11) | |||
| Anemia of chronic disease | 6 (1.56) | 0 (0.00) | 4 (0.89) | |||
| Multifactorial anemia | 5 (1.30) | 0 (0.00) | 5 (1.11) | |||
| Iron-deficiency anemia secondary to blood loss⁎ | 63 (16.41)† | <0.001 | 14 (7.25)† | 0.049 | 54 (12.00)† | 0.001 |
| Monoclonal gammopathy of undetermined significance | 2 (0.52) | 0 (0.00) | 3 (0.67) | |||
| Nonspecific lymphadenitis, n (%) | 16 (4.17) | 0.162 | 3 (1.55) | 0.139 | 22 (4.89) | 0.212 |
| Gastrointestinal disorders, n (%) | 75 (19.53) | <0.001 | 79 (40.93) | <0.001 | 94 (20.89) | 0.134 |
| Inflammatory bowel disease | 2 (0.52) | 1 (0.52) | 1 (0.22) | |||
| Irritable bowel syndrome | 25 (6.51) | <0.001 | 33 (17.10) | <0.001 | 36 (8.00) | 0.142 |
| Gastroesophageal reflux disease with esophagitis | 6 (1.56)† | 6 (3.11)† | 8 (1.78)† | |||
| Achalasia | 2 (0.52) | 1 (0.52) | 4 (0.89) | |||
| Barrett esophagus | 2 (0.52) | 1 (0.52) | 1 (0.22) | |||
| Peptic ulcer | 5 (1.30)† | 6 (3.11)† | 6 (1.33)† | |||
| Gastroduodenitis | 8 (2.08)† | 0.045 | 13 (6.74)† | 0.039 | 10 (2.22)† | 0.375 |
| Chronic atrophic gastritis | 4 (1.04)† | 4 (2.07) | 6 (1.33)† | |||
| Ischemic colitis | 1 (0.26) | 0 (0.00) | 0 (0.00) | |||
| Diverticulitis | 2 (0.52) | 2 (1.04) | 1 (0.22) | |||
| Angiodysplasia of small intestine and/or colon | 3 (0.78)† | 1 (0.52)† | 3 (0.67)† | |||
| Ulcer of intestine | 2 (0.52)† | 1 (0.52)† | 1 (0.22)† | |||
| Hemorrhoids | 9 (2.34) | 7 (3.63) | 12 (2.67) | |||
| Retroperitoneal fibrosis | 1 (0.26) | 1 (0.52) | 1 (0.22) | |||
| Celiac disease | 2 (0.52) | 1 (0.52) | 2 (0.44) | |||
| Postgastric surgery syndromes | 1 (0.26) | 1 (0.52) | 2 (0.44) | |||
| Liver disorders, n (%) | 17 (4.43) | 0.152 | 4 (2.07) | 0.289 | 6 (1.33) | 0.097 |
| Alcoholic liver disease | 3 (0.78) | 1 (0.52) | 1 (0.22) | |||
| Toxic liver disease | 2 (0.52) | 0 (0.00) | 1 (0.22) | |||
| Chronic hepatitis, unspecified | 5 (1.30) | 1 (0.52) | 1 (0.22) | |||
| Liver cirrhosis | 2 (0.52) | 2 (1.04) | 2 (0.44) | |||
| Nonalcoholic steatohepatitis | 4 (1.04) | 0 (0.00) | 1 (0.22) | |||
| Autoimmune hepatitis | 1 (0.26) | 0 (0.00) | 0 (0.00) | |||
| Pancreaticobiliary disorders, n (%) | 17 (4.43) | 0.222 | 5 (2.59) | 0.494 | 13 (2.89) | 0.155 |
| Cholelithiasis | 6 (1.56) | 2 (1.04) | 5 (1.11) | |||
| Choledocholithiasis | 2 (0.52) | 0 (0.00) | 2 (0.44) | |||
| Calculus of bile duct with cholangitis | 2 (0.52) | 0 (0.00) | 1 (0.22) | |||
| Cholecystitis | 1 (0.26) | 0 (0.00) | 1 (0.22) | |||
| Acute pancreatitis | 2 (0.52) | 1 (0.52) | 0 (0.00) | |||
| Chronic pancreatitis | 2 (0.52) | 1 (0.52) | 2 (0.44) | |||
| Pseudocyst of pancreas | 1 (0.26) | 1 (0.52) | 1 (0.22) | |||
| Primary biliary cholangitis | 1 (0.26) | 0 (0.00) | 1 (0.22) | |||
| Rheumatic and systemic autoimmune diseases, n (%) | 16 (4.17) | 0.167 | 5 (2.59) | 0.703 | 12 (2.67) | 0.148 |
| Rheumatoid arthritis | 2 (0.52) | 0 (0.00) | 2 (0.44) | |||
| Palindromic rheumatism | 1 (0.26) | 0 (0.00) | 1 (0.22) | |||
| Polyarteritis nodosa | 1 (0.26) | 0 (0.00) | 1 (0.22) | |||
| Giant cell arteritis and polymyalgia rheumatica | 4 (1.04) | 1 (0.52) | 2 (0.44) | |||
| Systemic lupus erythematosus | 2 (0.52) | 2 (1.04) | 1 (0.22) | |||
| Dermatopolymyositis | 1 (0.26) | 1 (0.52) | 0 (0.00) | |||
| Sjogren's syndrome | 2 (0.52) | 1 (0.52) | 2 (0.44) | |||
| Cryoglobulinemia | 1 (0.26) | 0 (0.00) | 1 (0.22) | |||
| ANCA-associated vasculitis | 1 (0.26) | 0 (0.00) | 1 (0.22) | |||
| Diffuse (eosinophilic) fasciitis | 1 (0.26) | 0 (0.00) | 1 (0.22) | |||
| Sarcoidosis, n (%) | 3 (0.78) | 0.634 | 1 (0.52) | 0.605 | 0 (0.00) | 0.200 |
| Bone disorders, n (%) | 5 (1.30) | 0.285 | 1 (0.52) | 0.422 | 4 (0.89) | 0.271 |
| Osteoporosis with vertebral fracture | 3 (0.78) | 1 (0.52) | 2 (0.44) | |||
| Adult osteomalacia | 1 (0.26) | 0 (0.00) | 1 (0.22) | |||
| Fibrous dysplasia (monostotic) | 1 (0.26) | 0 (0.00) | 1 (0.22) | |||
| Autoinflammatory syndromes, n (%) | 1 (0.26) | 0.724 | 0 (0.00) | 0.807 | 1 (0.22) | 0.599 |
| Infectious diseases, n (%) | 35 (9.11) | 0.100 | 10 (5.18) | 0.144 | 36 (8.00) | 0.158 |
| Acute viral infections and viral hepatitis | 17 (4.43) | 3 (1.55) | 20 (4.44) | |||
| Acute lower respiratory infection, unspecified | 6 (1.56) | 2 (1.04) | 4 (0.89) | |||
| Intestinal infectious diseases | 4 (1.04) | 2 (1.04) | 4 (0.89) | |||
| Sexually transmitted diseases | 3 (0.78) | 1 (0.52) | 1 (0.22) | |||
| Tuberculosis | 3 (0.78) | 1 (0.52) | 4 (0.89) | |||
| Visceral leishmaniasis | 1 (0.26) | 0 (0.00) | 0 (0.00) | |||
| Herpes simplex and herpes zoster | 1 (0.26) | 0 (0.00) | 2 (0.44) | |||
| Acute/subacute infective endocarditis | 0 (0.00) | 1 (0.52) | 1 (0.22) | |||
| Endocrine disorders, n (%) | 14 (3.65) | 0.240 | 5 (2.59) | 0.711 | 11 (2.44) | 0.208 |
| Type 2 and 1 diabetes mellitus (uncontrolled) | 5 (1.30) | 2 (1.04) | 4 (0.89) | |||
| Hyperthyroidism | 3 (0.78) | 1 (0.52) | 2 (0.44) | |||
| Hypothyroidism | 2 (0.52) | 2 (1.04) | 4 (0.89) | |||
| Acute thyroiditis | 2 (0.52) | 0 (0.00) | 1 (0.22) | |||
| Primary hyperparathyroidism | 2 (0.52) | 0 (0.00) | 0 (0.00) | |||
| Respiratory diseases, n (%) | 8 (2.08) | 0.874 | 4 (2.07) | 0.451 | 11 (2.44) | 0.230 |
| Pleural effusion, unspecified | 3 (0.78) | 1 (0.52) | 2 (0.44) | |||
| Interstitial pulmonary disease, unspecified | 3 (0.78) | 1 (0.52) | 5 (1.11) | |||
| Chronic obstructive pulmonary disease | 2 (0.52) | 2 (1.04) | 4 (0.89) | |||
| Cardiovascular diseases, n (%) | 16 (4.17) | 0.205 | 6 (3.11) | 0.513 | 15 (3.33) | 0.283 |
| Heart failure, unspecified | 4 (1.04) | 2 (1.04) | 4 (0.89) | |||
| Acute idiopathic pericarditis | 3 (0.78) | 1 (0.52) | 2 (0.44) | |||
| Pulmonary embolism | 2 (0.52) | 0 (0.00) | 3 (0.67) | |||
| Cerebral infarction, unspecified | 3 (0.78) | 1 (0.52) | 2 (0.44) | |||
| Lymphedema | 1 (0.26) | 0 (0.00) | 1 (0.22) | |||
| Phlebitis and thrombophlebitis of lower or upper limbs | 1 (0.26) | 2 (1.04) | 2 (0.44) | |||
| Hypotension, unspecified | 2 (0.52) | 0 (0.00) | 1 (0.22) | |||
| Urologic diseases, n (%) | 8 (2.08) | 0.268 | 5 (2.59) | 0.139 | 6 (1.33) | 0.202 |
| Urinary tract infection including acute prostatitis | 4 (1.04) | 2 (1.04) | 5 (1.11) | |||
| Hydronephrosis with ureteral obstruction | 2 (0.52) | 1 (0.52) | 0 (0.00) | |||
| Renal colic, unspecified | 2 (0.52) | 2 (1.04) | 1 (0.22) | |||
| Dysfunctional uterine bleeding, n (%) | 8 (2.08)† | 0.216 | 2 (1.04)† | 0.211 | 9 (2.00)† | 0.624 |
| Diseases of the nervous system, n (%) | 12 (3.13) | 0.304 | 5 (2.59) | 0.266 | 8 (1.78) | 0.160 |
| Migraine and other headache syndromes | 2 (0.52) | 1 (0.52) | 1 (0.22) | |||
| Degenerative disease of nervous system, unspecified | 3 (0.78) | 1 (0.52) | 2 (0.44) | |||
| Sleep disorders, unspecified | 2 (0.52) | 2 (1.04) | 1 (0.22) | |||
| Trigeminal neuralgia and postherpetic neuralgia | 1 (0.26) | 0 (0.00) | 1 (0.22) | |||
| Nerve root and plexus disorder, unspecified | 2 (0.52) | 0 (0.00) | 2 (0.44) | |||
| Mononeuropathy, unspecified | 0 (0.00) | 0 (0.00) | 0 (0.00) | |||
| Polyneuropathy, unspecified | 1 (0.26) | 0 (0.00) | 1 (0.22) | |||
| Myopathy, unspecified | 1 (0.26) | 1 (0.52) | 0 (0.00) | |||
| Fibromyalgia and chronic fatigue syndrome, n (%) | 3 (0.78) | 0.694 | 2 (1.04) | 0.558 | 3 (0.67) | 0.503 |
| Mental and behavioral disorders, n (%) | 13 (3.39) | <0.001 | 30 (15.54) | <0.001 | 27 (6.00) | 0.119 |
| Anxiety disorder, unspecified | 5 (1.30) | 0.050 | 12 (6.22) | 0.134 | 11 (2.44) | 0.157 |
| Health anxiety/somatic symptom disorder | 1 (0.26) | 0.116 | 8 (4.15) | 0.149 | 7 (1.56) | 0.123 |
| Depression, unspecified | 7 (1.82) | 0.145 | 10 (5.18) | 0.152 | 9 (2.00) | 0.333 |
| Medically unexplained physical symptoms, n (%) | 1 (0.26) | 0.028 | 11 (5.70) | 0.048 | 7 (1.56) | 0.120 |
ANCA, antineutrophil cytoplasmic antibodies.
⁎
According to the International Statistical Classification of Diseases and Related Health Problems (ICD-10 Version: 2019) [22].
†
Patients presenting with iron-deficiency anemia were diagnosed with the gastrointestinal disorders and uterine conditions indicated here and in Table 4 and are not included in the final computation of cases.