Assessment of the Impact of the COVID-19 Pandemic on the Epidemiology of Maxillofacial Trauma in the Municipality of Diamantina - MG

Abstract

Introduction/Justification: The COVID-19 pandemic, caused by the SARS-CoV-2 virus, began in the middle of November and December 2019, being formally announced by the World Health Organization on January 30, 2020, lasting for about three years, and resulting in a significant impact on society. Some authors emphasize that natural disasters and severe health emergencies change the course of epidemiological patterns of diseases affecting the population1. Monitoring and assessing the change in these patterns is of utmost importance because it is only through this that public health planning can be carried out, with a focus on prevention and structuring the healthcare system. Oral and maxillofacial surgery, responsible for a significant portion of trauma care and conditions related to the face, was severely affected during the lockdowns imposed to contain the spread of the virus. Objectives: This study aimed to assess the impacts on patient care during the pandemic and whether there were changes in the epidemiological patterns of maxillofacial trauma. Methodology: A retrospective study was conducted using the clinical records of the Oral and Maxillofacial Surgery and Traumatology team (CTBMF) at the Santa Casa de Caridade de Diamantina (SCCD) and the Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM). The data from the clinical records were divided into two groups: "pre-pandemic" and "during the pandemic," with the date of February 26, 2020, marking the division between the two groups. The first group was assessed two years prior to this date, and the second group, two years after. Statistical analysis was performed using the Statistical Package for Social Science for Windows 22 (SPSS). Results: The results indicated a decrease in patient care during the pandemic, as observed in other studies in the field2. This decrease in the number of patient visits can be attributed to social isolation and the fear of contracting COVID-19, especially in cases where hospitalization was a possibility. The sociodemographic characteristics of trauma patients continued to show a prevalence of males, individuals in their third and fourth decades of life, of mixed race, and rural workers. Motorcycle accidents remained the leading cause of maxillofacial trauma, followed by physical assault and workplace accidents. The increase in cases of physical assault can be attributed to increased stress related to social isolation, higher alcohol consumption, and political conflicts2, 3, 4. Additionally, there was a decrease in sports-related injuries due to social isolation measures, as well as trauma resulting from falls from one's own height, primarily because the average age of patients treated by the CTBMF service was older. The most affected facial regions were the zygomatic bone, mandibular body and angle, and nasal bones2, 3. There was a predominance of simple facial fractures without or with minimal displacement, with no observed increase in the severity of maxillofacial trauma due to the COVID-19 pandemic. The most commonly used treatment during the pandemic period was conservative treatment, in contrast to the pre-pandemic period when open reduction with rigid internal fixation was the preferred approach. The preference for conservative treatment was driven by the overcrowding of SCCD, which was responsible for managing high-complexity cases resulting from COVID-19 complications. Associations between etiology, risk factors, and the severity of trauma could not be determined due to the lack of information in the clinical records. Conclusion: It was concluded that the majority of patients treated were male, with an average age of 35 years, of mixed race, and rural workers. This type of work activity justifies the increase in cases of workplace-related traumas. Motorcycle accidents remained the leading cause of maxillofacial trauma, regardless of the period assessed. To minimize errors in future research arising from incomplete clinical records, we suggest a new medical record model for the UFVJM CTBMF team.