The THYCOVIT (Thyroid Surgery during COVID-19 pandemic in Italy) study: results from a nationwide, multicentric, case-controlled study - Scorecard - MDSpire
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The THYCOVIT (Thyroid Surgery during COVID-19 pandemic in Italy) study: results from a nationwide, multicentric, case-controlled study
Clinical Scorecard: Findings from the THYCOVIT Study: An Analysis of Thyroid Surgery During the COVID-19 Pandemic in Italy Through a Nationwide, Multicentric, Case-Control Approach
At a Glance
Category
Detail
Condition
Thyroid disease requiring surgery, including thyroid malignancies, hyperthyroidism, and multinodular goitre with compressive symptoms
Key Mechanisms
Impact of COVID-19 pandemic on surgical activity and care delivery for thyroid disease; disruption due to resource reallocation and infection control measures
Target Population
Patients undergoing thyroidectomy in Italy during the COVID-19 pandemic phases compared to the previous year
Care Setting
Endocrine Surgical Units affiliated with the Italian Society of Endocrine Surgery (SIUEC) across Italy
Key Highlights
Significant reduction in thyroid surgical activity during COVID-19 pandemic phases due to national lockdown and healthcare resource reallocation
Maintenance of surgical treatment for thyroid malignancies was evaluated to assess adequacy despite pandemic constraints
Post-operative complication rates and tumor aggressiveness were monitored to verify maintenance of standard of care
Guideline-Based Recommendations
Diagnosis
Use of intraoperative nerve monitoring (IONM) to detect recurrent laryngeal nerve injury during thyroidectomy
Post-operative fibrolaryngoscopy to assess vocal fold mobility if RLN injury is suspected
Definition of post-surgical hypoparathyroidism based on PTH levels, calcemia, and need for calcium/vitamin D supplementation
Management
Prioritize thyroidectomy for malignancies and symptomatic conditions during pandemic phases while balancing infection risk
Adapt surgical scheduling according to epidemiological phases and government restrictions
Implement strategies to reduce nosocomial COVID-19 infection risk to patients and staff
Monitoring & Follow-up
Monitor incidence of post-operative complications including hypoparathyroidism, hematoma, and RLN injury
Track pathological features such as tumor size, lymph node metastases, extra-thyroidal extension, and multi-centricity
Evaluate delays in treatment for potential impact on tumor aggressiveness
Risks
Risk of delayed surgical treatment leading to progression or increased aggressiveness of thyroid malignancies
Increased risk of nosocomial COVID-19 infection during hospital stay
Potential reduction in surgical workforce and resources affecting care quality
Patient & Prescribing Data
Patients undergoing thyroidectomy during COVID-19 pandemic phases in Italy
Surgical activity was reduced overall, but efforts were made to maintain treatment for malignancies; standard of care including complication rates was monitored to ensure quality despite pandemic constraints
Clinical Best Practices
Classify patients and surgical scheduling according to pandemic epidemiological phases and government-imposed restrictions
Use intraoperative nerve monitoring routinely to minimize RLN injury
Perform post-operative fibrolaryngoscopy when vocal fold dysfunction is suspected
Define and monitor hypoparathyroidism using biochemical criteria and clinical supplementation needs
Collect and analyze aggregate data to assess impact of pandemic on surgical outcomes and adapt care accordingly
by Fabio Medas, Gian Luca Ansaldo, Nicola Avenia, Giancarlo Basili, Marco Boniardi, Marco Bononi, Aldo Bove, Paolo Carcoforo, Andrea Casaril, Giuseppe Cavallaro, Maria Grazia Chiofalo, Giovanni Conzo, Loredana De Pasquale, Paolo Del Rio, Gianlorenzo Dionigi, Chiara Dobrinja, Giovanni Docimo, Giuseppa Graceffa, Maurizio Iacobone, Nadia Innaro, Celestino Pio Lombardi, Nicola Palestini, Francesco Pedicini, Giuliano Perigli, Angela Pezzolla, Gregorio Scerrino, Stefano Spiezia, Mario Testini, Pietro Giorgio Calò
