VCOM Carolinas Research Day 2023

Biomedical Studies

The Effect of COVID-19 on Preventative Medicine in El Salvador, Honduras, and the Dominican Republic E. Casey Anders, OMS-II. Ami Changela, OMS-II. Angie Wilson, MBA CSSGB CSSBB. Alexis Stoner, PhD MPH. Edward Via College of Osteopathic Medicine, Spartanburg, SC.

Abstract # BIOM-4

Introduction

Results

Conclusion

-According to the World Health Organization, the first confirmed case of COVID-19 in Honduras was March 9 2020, in El Salvador was March 16 2020, and in the Dominican Republic was March 2 2020 1 -Current literature suggests that Latin America and Caribbean regions had approximately 15% of COVID-19 cases worldwide 2 -The COVID-19 pandemic strained medical systems and affected healthcare across the world, resulting in patients being turned away from the hospital which resulted in an increased number of preventable deaths 3 -This study sought to describe the impact that the COVID-19 pandemic had on patients seeking medical care for chronic diseases in Honduras, El Salvador, and the Dominican Republic -This is a retrospective descriptive study that utilized a Clinical Rotation Evaluation and Document Organizer (CREDO) database -The data was filtered by country: Honduras, El Salvador, Dominican Republic -The data was filtered by ICD10 codes: I10 (essential primary hypertension), E78.5 (hyperlipidemia), U07.1 (COVID-19, virus identified), U07.2 (COVID-19, virus not identified) -The data was divided into quarters: Quarter 1 is defined from January to March, Quarter 2 is defined from April to June, Quarter 3 is defined from July to September, Quarter 4 is defined from October to December -Quarters with a complete lack of diagnoses were eliminated from comparison -Descriptive analysis was performed to describe change in prevalence and a Wilcoxon test was performed to determine significance Methods -There was a significant difference in diagnosis prevalence for COVID-19 (Wilcoxon test =0.0178) between the three countries, with Honduras having more diagnoses than El Salvador and Dominican Republic (Blue lines in Figures 1, 2, 3) -There was a significant difference in diagnosis prevalence for Hypertension (Wilcoxon test <0.0019) between the three countries, with Honduras having more diagnoses than El Salvador and Dominican Republic (Orange lines in Figures 1, 2, 3) -There was no significant difference in diagnosis prevalence for Hyperlipidemia (Wilcoxon test =0.1305) between the three countries (Grey lines in Figures 1, 2, 3) -There was a significant difference in the number of diagnoses seen between countries (p-value <0.05), but the overall prevalence of each diagnosis within each country did not change Results

-This study found a constant prevalence of diagnosis for Hypertension and Hyperlipidemia from July 2020 through June 2022 -Based on the available data in CREDO, we have deduced that COVID-19 did not have an impact on the number of patients continuing to receive preventative medical care for chronic disease -A major limitation of this study is the amount of data available for each diagnosis. The CREDO system is new, so there aren’t previous records of normal preventative care to show if this is an accurate representation of normal care or if the numbers are decreased due to a new software introduction.

Figure 1. In Honduras, there were significantly more (Wilcoxon test < 0.05) patients diagnosed with Hypertension than COVID-19 or Hyperlipidemia. The overall change in prevalence for COVID-19 was 9.46%, for Hypertension was 8.26%, and for Hyperlipidemia was 0.7%. [n=4758]

Study Area

Figure 2. In El Salvador, there were significantly more (Wilcoxon test < 0.05) patients diagnosed with Hypertension than COVID-19 or Hyperlipidemia. The overall change in prevalence for COVID-19 was 1.94%, for Hypertension was 2.62%, and for Hyperlipidemia was 0.2%. [n=11676]

Figure 4. Map from CREDO showing the locations of the clinics in which the data was pulled from

References

1. World Health Organization. “WHO COVID - 19 Dashboard.” World Health Organization , 2022, covid19.who.int/. 2. Schwalb , Alvaro, et al. “COVID ‐ 19 in Latin America and the Caribbean: Two Years of the Pandemic.” Journal of Internal Medicine , 22 Apr. 2022, www.ncbi.nlm.nih.gov/pmc/articles/PMC9115176/, 10.1111/joim.13499. 3. de Oliveira, Mayra Monteiro, et al. “Repercussions of the COVID -19 Pandemic on Preventive Health Services in Brazil.” Preventive Medicine , vol. 155, Feb. 2022, p. 106914, 10.1016/j.ypmed.2021.106914. Accessed 15 July 2022.

Figure 3. In the Dominican Republic, there were significantly more (Wilcoxon test < 0.05) patients diagnosed with Hypertension than COVID-19 or Hyperlipidemia. The overall change in prevalence for COVID-19 was 0.63%, for Hypertension was 2.03%, and for Hyperlipidemia was 0.26%. [n=44824]

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