Massachusetts Chapter of the American College of Surgeons

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Pilonidal disease severity worsens during covid-19 clinic shutdown
Nikki M. Check, PA-C, Nicole Wynne, BS, Susan K. Zotto, BSN, RN, CPN, Mary M. Pena, CA, David P. Mooney, MD, MPH
Boston Children's Hospital, Boston, MA

Background:
Pilonidal disease is a common condition afflicting adolescents. Care in a specialized Pilonidal Care Clinic improves this condition. During the COVID-19 pandemic the Clinic closed for 4 months. We identified patients affected by the COVID shutdown and compared them to similar patients seen during the same time period in 2019.

Methods:
20 patients who were seen within 2 months prior to clinic shutdown on 3/10/2020 and then again after restart on 7/2/2020 were compared to 20 severity matched patients seen during a similar time period in 2019. Patient photos and notes from the EMR were analyzed while blinded to group and the number of pilonidal pits, any interventions required, and a determination of a change in clinical status were determined.

Results:
In 2019, prior to COVID-19, across a 196 day time period 17 patients were better, 1 unchanged and 2 worse. In 2020, across a 188 day time period 2 patients were better, 2 unchanged and 16 were worse. Group disease severity decreased by 15 pre-COVID and increased by 14 during. Patients healed 23 pilonidal pits pre-COVID but acquired 8 new pits during COVID. One patient developed an abscess pre-COVID and 4 developed one during.

Conclusion:
The COVID-19 Pandemic interrupted health care for a variety of conditions, including pilonidal disease. Interrupting care in a Pilonidal Care Clinic resulted in increased disease severity.


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