EFFECTS OF COVID-19 ON THE DIAGNOSIS OF BRAIN METASTASES. A RETROSPECTIVE ANALYSIS

Abstract

Delays in cancer diagnosis and treatment can significantly impact patient survival and quality of life. The COVID-19 pandemic intensified these challenges by limiting access to medical services and postponing essential oncologic interventions. This study aimed to evaluate the effects of such delays on the diagnosis and management of brain metastases in neuro-oncology patients during the pandemic period. Materials and methods: A retrospective analysis was conducted on 100 patients who underwent surgical treatment for brain metastases at the Department of Neurosurgery, “Prof. Dr. Nicolae Oblu” Emergency Clinical Hospital, Iași, Romania. Patients were divided into two groups: the pre-COVID group (2018-2019, n = 57) and the COVID group (2020-2022, n = 43). Demographic, clinical, and pathological data were collected from medical records. Tumor volume, anatomical location, and histopathological characteristics were compared between groups. Results: The mean age of patients was 57.9 years, with a female-to-male ratio of 1.17: 1. The most common primary tumors were breast (27%), bronchopulmonary (20%), and gastrointestinal cancers (18%). Brain metastases were predominantly located in the supratentorial region (80%), especially in the parietal and occipital lobes. The median tumor volume was higher in the COVID group (16.8 cm³) compared with the pre-COVID group (12.1 cm³), suggesting delayed diagnosis and disease progression during the pandemic, although the difference did not reach statistical significance (p = 0.11). Conclusions: The COVID-19 pandemic contributed to diagnostic delays and increased tumor burden in patients with brain metastases, reflecting reduced access to timely healthcare. While demographic characteristics remained similar between periods, larger tumor volumes observed during the pandemic indicate that healthcare disruptions had tangible effects on disease progression. Continued research is necessary to assess the long-term impact of these delays on treatment outcomes and survival, as well as to develop adaptive strategies to ensure continuity of oncologic care during future healthcare crises.