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Impact of the COVID pandemic on melanoma thickness and ulceration: a meta-analysis.

Author information

Affiliations

  • 1. Dermatology Unit, University of Campania L. Vanvitelli, Naples, Italy.
      Authors
    • Scharf C 1
    • Briatico G 1
    • Brancaccio G 1
    • Moscarella E 1
    • Argenziano G 1
    (5 authors)
  • 2. Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.
      Authors
    • Mongardini FM 2
    • Fisone F 2
    • Tolone S 2
    • Docimo L 2
    • Gambardella C 2
    • Lucido F 2
    • Parisi S 2
    (7 authors)
  • 3. Maxillofacial Surgery Unit, University of Campania "Luigi Vanvitelli", Naples, Italy.
      Authors
    • Chirico F 3
    (1 author)
  • 4. Department of Translational Medicine Science, School of Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
      Authors
    • Iovino F 4
    (1 author)

ORCIDs linked to this article

International Journal of Dermatology, 02 Aug 2024,
https://doi.org/10.1111/ijd.17401 PMID: 39095953 

Review

Abstract 

The global healthcare sector faced immense challenges due to the COVID-19 pandemic. Oncologists noted reduced cancer screening, which impacted melanoma diagnosis and treatment, leading to concerns about delayed care and poorer outcomes. This review analyzes how the pandemic influenced melanoma ulceration risk and Breslow thickness index through a meta-analysis of published studies. Following PRISMA guidelines, we conducted a systematic review of literature from January 2021 to December 2022 on cutaneous melanoma before and during the COVID-19 pandemic. Upon screening 1854 manuscripts, the review led to 13 studies meeting inclusion standards. The quality assessment followed MINORS and Newcastle-Ottawa Scale criteria. Regarding ulceration, post-COVID ulceration surpassed pre-COVID levels significantly, with a risk ratio of 1.31 and an estimated odds ratio of 1.41, indicating a 44% rise post-COVID. As for Breslow thickness, studies show a rising trend in the Breslow index post-COVID, but less significantly, with an effect size of 0.08 regarding the meta-analysis model (P = 0.02) with a pre-COVID mean Breslow of 1.56 mm and post-COVID of 1.84 mm. This meta-analysis concluded that post-COVID ulceration rates significantly surpassed pre-COVID levels. Considering that ulcerated melanomas usually undergo sentinel lymph node biopsy and are more likely to benefit from adjuvant therapies, this indicates important implications, as many patients might have missed the opportunity to start therapy appropriately, regardless of their Breslow thickness status.

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Read article at publisher's site: https://doi.org/10.1111/ijd.17401

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