Covid-19 and possible scientific consequences of postponed treatments
A COVID-19 e possíveis consequências científicas da postergação de tratamentos

Among the consequences of the Covid-19 pandemic, more patients with decompensation or worsening of diseases were observed. Of interest to plastic surgery, neoplastic diseases and complex reconstruction due to later staging and delayed therapeutic indications are expected.

Cancer screening was suspended in several countries, routine diagnostic work was postponed, and only urgent symptomatic cases were prioritized for diagnostic intervention. In addition, the need to direct beds to treat patients affected by Covid-19 and the fear of patients seeking care potentiates the aggravation of diseases such as cancer.

Substantial increases in the number of preventable cancer deaths are expected in the medium term due to diagnostic delays due to the COVID-19 pandemic¹. According to a study published by Hartman et al. (2020)² the delay in cancer treatment had a variable impact on disease-specific survival and mortality, as the main consequence of delaying the treatment recommended in a non-quantitative, non-objective and non-personalized manner^2,3.

Nevertheless, the problem goes further: the entire delayed treatment process will generate a demand for complex cases. Thus, a cohort of advanced cases at an unexpected historical moment may unwittingly provide new information that is scientifically useful if adequately explored.

For most tumors of interest, such as skin neoplasms, including malignant melanoma and breast cancer, one would expect an advanced case series at all levels of treatment, including public and private health services, at this time in the natural history of diseases. Early diagnosis and optimized treatment have effectively cured these neoplasms, and the opportunity to apply more modern methods in more advanced cases translates into a unique opportunity to evaluate new treatment options that can help manage all patients. It is up to researchers to seize this opportunity and offer a positive return to society so affected by this genuine worldwide pandemic.

. Editor-in-chief.