{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:53:22Z","timestamp":1774313602752,"version":"3.50.1"},"reference-count":41,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,1,26]],"date-time":"2025-01-26T00:00:00Z","timestamp":1737849600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: In this study, we aimed to assess the impact of the COVID-19 (Coronavirus Disease 2019) pandemic period on the time trend prevalence of thyroid pathology in a university hospital in Romania. Methods: We performed a 6-year retrospective study (2017\u20132022) including all patients who underwent thyroid surgery, registered in the Pathology Department, Emergency County Hospital, T\u00e2rgu-Mure\u0219, Romania (n = 971). Thyroid lesions were grouped into three major categories: (1) benign, non-tumoral; (2) benign, tumoral; and (3) malignant, tumoral. To assess the impact of the COVID-19 pandemic on the annual rate of thyroid surgeries and thyroid pathology, data were analyzed in comparison: before COVID-19 (2017\u20132019) versus the COVID-19 (2020\u20132022) period. Results: A significant decrease in the mean number of thyroid specimens per year was observed in the COVID-19 period compared to the previous period (131 versus 192 cases, p = 0.0023). Thyroid benign lesions were the most frequent, but their prevalence was significantly lower during the pandemic period (50.8%) compared to the previous period (58.6%) (p = 0.017). Benign tumors were rare, revealing similar occurrence rates in both periods. By contrast, the annual rate of malignant tumors increased significantly during the COVID-19 period (26.3% versus 35.4%, p = 0.002), the most common histopathological type being papillary thyroid carcinoma. Conclusions: Along with the COVID-19 pandemic (starting in the year 2020), due to reduced access to medical investigations, many thyroid cancers remained unoperated in our hospital. Consequently, this has led to an increased prevalence of malignant cases in the years that came after.<\/jats:p>","DOI":"10.3390\/diagnostics15030287","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T06:39:51Z","timestamp":1737959991000},"page":"287","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A 6-Year Retrospective Study in Surgery Patients with Thyroid Diseases in Mure\u0219 County, Romania, Before and During the COVID-19 Pandemic"],"prefix":"10.3390","volume":"15","author":[{"given":"Ramona Teodora","family":"C\u0103tan\u0103","sequence":"first","affiliation":[{"name":"Department of Histology, \u201cGeorge Emil Palade\u201d University of Medicine, Pharmacy, Sciences and Technology of T\u00e2rgu-Mure\u015f, 38th Gh. Marinescu Street, 540139 T\u00e2rgu-Mure\u015f, Romania"},{"name":"Department of Endocrinology, T\u00e2rgu-Mure\u015f Emergency County Hospital, 50th Gh. Marinescu Street, 540139 T\u00e2rgu-Mure\u015f, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1165-0071","authenticated-orcid":false,"given":"Adela","family":"Nechifor-Boila","sequence":"additional","affiliation":[{"name":"Department of Histology, \u201cGeorge Emil Palade\u201d University of Medicine, Pharmacy, Sciences and Technology of T\u00e2rgu-Mure\u015f, 38th Gh. Marinescu Street, 540139 T\u00e2rgu-Mure\u015f, Romania"},{"name":"Department of Pathology, T\u00e2rgu-Mure\u015f County Hospital, 28th 1 December 1918 Street, 540061 T\u00e2rgu-Mure\u015f, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ancu\u021ba","family":"Z\u0103han","sequence":"additional","affiliation":[{"name":"Department of Histology, \u201cGeorge Emil Palade\u201d University of Medicine, Pharmacy, Sciences and Technology of T\u00e2rgu-Mure\u015f, 38th Gh. Marinescu Street, 540139 T\u00e2rgu-Mure\u015f, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreea Deborah","family":"Militaru","sequence":"additional","affiliation":[{"name":"Department of Histology, \u201cGeorge Emil Palade\u201d University of Medicine, Pharmacy, Sciences and Technology of T\u00e2rgu-Mure\u015f, 38th Gh. Marinescu Street, 540139 T\u00e2rgu-Mure\u015f, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgian-Nicolae","family":"Radu","sequence":"additional","affiliation":[{"name":"Department of Pathology, T\u00e2rgu-Mure\u015f County Hospital, 28th 1 December 1918 Street, 540061 T\u00e2rgu-Mure\u015f, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Borda","sequence":"additional","affiliation":[{"name":"Department of Histology, \u201cGeorge Emil Palade\u201d University of Medicine, Pharmacy, Sciences and Technology of T\u00e2rgu-Mure\u015f, 38th Gh. Marinescu Street, 540139 T\u00e2rgu-Mure\u015f, Romania"},{"name":"Department of Pathology, T\u00e2rgu-Mure\u015f Emergency County Hospital, 50th Gh. Marinescu Street, 540139 T\u00e2rgu-Mure\u015f, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,26]]},"reference":[{"key":"ref_1","first-page":"157","article-title":"WHO Declares COVID-19 a Pandemic","volume":"91","author":"Cucinotta","year":"2020","journal-title":"Acta Biomed."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"268","DOI":"10.34172\/aim.2020.09","article-title":"Epidemiology and Clinical Characteristics of COVID-19","volume":"23","author":"Huang","year":"2020","journal-title":"Arch. Iran. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e00028-20","DOI":"10.1128\/CMR.00028-20","article-title":"Coronavirus Disease 2019-COVID-19","volume":"33","author":"Dhama","year":"2020","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_4","unstructured":"WHO (2024). Coronavirus Disease (COVID-19) Pandemic, World Health Organization (WHO). Available online: https:\/\/www.who.int\/emergencies\/diseases\/novel-coronavirus-2019\/situation-reports."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Gorchane, A., Ach, T., Sahli, J., Abdelkrim, A.B., Mallouli, M., Bellazreg, F., Hachfi, W., Chaieb, M.C., and Ach, K. (2023). Uncovering the alarming rise of diabetic ketoacidosis during COVID-19 pandemic: A pioneer African study and review of literature. Front. Endocrinol., 14.","DOI":"10.3389\/fendo.2023.1234256"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Darvishi, M., Nazer, M.R., Shahali, H., and Nouri, M. (2022). Association of Thyroid Dysfunction and COVID-19: A Systematic Review and Meta-Analysis. Front. Endocrinol., 13.","DOI":"10.3389\/fendo.2022.947594"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1007\/s12020-022-03281-8","article-title":"A Prospective Follow-up on Thyroid Function, Thyroid Autoimmunity and Long COVID among 250 COVID-19 Survivors","volume":"80","author":"Lui","year":"2023","journal-title":"Endocrine"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e803","DOI":"10.1210\/clinem\/dgaa830","article-title":"Thyroid Function Before, During, and after COVID-19","volume":"106","author":"Khoo","year":"2021","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"bvab076","DOI":"10.1210\/jendso\/bvab076","article-title":"COVID-19 and Thyroid Diseases: A Bidirectional Impact","volume":"5","author":"Duntas","year":"2021","journal-title":"J. Endocr. Soc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1007\/s11154-020-09615-z","article-title":"Impact of COVID-19 on the Thyroid Gland: An Update","volume":"22","author":"Scappaticcio","year":"2021","journal-title":"Rev. Endocr. Metab. Disord."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"03000605221082898","DOI":"10.1177\/03000605221082898","article-title":"Potential Relationships between COVID-19 and the Thyroid Gland: An Update","volume":"50","author":"Naguib","year":"2022","journal-title":"J. Int. Med. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"6191","DOI":"10.2147\/JIR.S332705","article-title":"SARS-CoV-2: Emerging Role in the Pathogenesis of Various Thyroid Diseases","volume":"14","author":"Murugan","year":"2021","journal-title":"J. Inflamm. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1158\/1055-9965.EPI-21-1440","article-title":"Epidemiology of Thyroid Cancer","volume":"31","author":"Kitahara","year":"2022","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Wu, J., Zhao, X., Sun, J., Cheng, C., Yin, C., and Bai, R. (2022). The Epidemic of Thyroid Cancer in China: Current Trends and Future Prediction. Front. Oncol., 12.","DOI":"10.3389\/fonc.2022.932729"},{"key":"ref_15","unstructured":"Ashorobi, D., and Lopez, P.P. (2020). Cancer, Follicular Thyroid, StatPearls Publishing."},{"key":"ref_16","unstructured":"Berger, N., and Borda, A. (2010). Pathologie Thyroidienne, Parathyroidienne et Surrenalienne, Sauramps Medical."},{"key":"ref_17","unstructured":"Rosai, J., Osamura, R.Y., Kl\u00f6ppel, G., and Lloyd, R.V. (2017). WHO Classification of Tumours of Endocrine Organs, WHO."},{"key":"ref_18","first-page":"753","article-title":"Origin, Transmission, Diagnosis and Management of Coronavirus Disease 2019 (COVID-19)","volume":"96","author":"Umakanthan","year":"2020","journal-title":"Postgrad. Med. J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1056\/NEJMoa2001017","article-title":"A Novel Coronavirus from Patients with Pneumonia in China, 2019","volume":"382","author":"Zhu","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1016\/S1473-3099(20)30162-6","article-title":"Interventions to mitigate early spread of SARS-CoV-2 in Singapore: A modelling study","volume":"20","author":"Koo","year":"2020","journal-title":"Lancet Infect. Dis."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Pujolar, G., Oliver-Angl\u00e8s, A., Vargas, I., and V\u00e1zquez, M.L. (2022). Changes in Access to Health Services during the COVID-19 Pandemic: A Scoping Review. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19031749"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e003421","DOI":"10.1136\/bmjgh-2020-003421","article-title":"Reduction in Healthcare Services during the COVID-19 Pandemic in China","volume":"5","author":"Zhang","year":"2020","journal-title":"BMJ Glob. Health"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.1007\/s00392-020-01682-1","article-title":"The Mystery of \u201cMissing\u201d Visits in an Emergency Cardiology Department, in the Era of COVID-19.; a Time-Series Analysis in a Tertiary Greek General Hospital","volume":"109","author":"Tsioufis","year":"2020","journal-title":"Clin. Res. Cardiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1016\/j.amjsurg.2020.04.014","article-title":"Elective Surgery in the Time of COVID-19","volume":"219","author":"Diaz","year":"2020","journal-title":"Am. J. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1038\/s41436-020-01069-7","article-title":"\u201cIt Seems like COVID-19 Now Is the Only Disease Present on Earth\u201d: Living with a Rare or Undiagnosed Disease during the COVID-19 Pandemic","volume":"23","author":"Halley","year":"2021","journal-title":"Genet. Med."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Karavadra, B., Stockl, A., Prosser-Snelling, E., Simpson, P., and Morris, E. (2020). Women\u2019s Perceptions of COVID-19 and Their Healthcare Experiences: A Qualitative Thematic Analysis of a National Survey of Pregnant Women in the United Kingdom. BMC Pregnancy Childbirth, 20.","DOI":"10.1186\/s12884-020-03283-2"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2150132721996892","DOI":"10.1177\/2150132721996892","article-title":"Exploring COVID-19 Related Factors Influencing Antenatal Care Services Uptake: A Qualitative Study among Women in a Rural Community in Southwest Ethiopia","volume":"12","author":"Hailemariam","year":"2021","journal-title":"J. Prim. Care Community Health"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e000985","DOI":"10.1136\/bmjoq-2020-000985","article-title":"Rapid Implementation of Virtual Clinics Due to COVID-19: Report and Early Evaluation of a Quality Improvement Initiative","volume":"9","author":"Gilbert","year":"2020","journal-title":"BMJ Open Qual."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s12020-020-02439-6","article-title":"Thyroid Cancer in the Era of COVID-19","volume":"70","author":"Smulever","year":"2020","journal-title":"Endocrine"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Popa, O., Barna, R.A., Borlea, A., Cornianu, M., Dema, A., and Stoian, D. (2023). The Impact of the COVID-19 Pandemic on Thyroid Nodular Disease: A Retrospective Study in a Single Center in the Western Part of Romania. Front. Endocrinol., 14.","DOI":"10.3389\/fendo.2023.1221795"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Feier, C.V.I., Muntean, C., Faur, A.M., Blidari, A., Contes, O.E., Streinu, D.R., and Olariu, S. (2023). The Changing Landscape of Thyroid Surgery during the COVID-19 Pandemic: A Four-Year Analysis in a University Hospital in Romania. Cancers, 15.","DOI":"10.3390\/cancers15113032"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Kim, S.H., Min, E., Hwang, Y.M., Choi, Y.S., and Yi, J.W. (2022). Impact of COVID-19 Pandemic on Thyroid Surgery in a University Hospital in South Korea. Cancers, 14.","DOI":"10.3390\/cancers14174338"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"bqab004","DOI":"10.1210\/endocr\/bqab004","article-title":"Potential Interaction between SARS-CoV-2 and Thyroid: A Review","volume":"162","author":"Chen","year":"2021","journal-title":"Endocrinology"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1835","DOI":"10.1007\/s40618-022-01786-7","article-title":"Thyroid Dysfunction Following Vaccination with COVID-19 Vaccines: A Basic Review of the Preliminary Evidence","volume":"45","author":"Jafarzadeh","year":"2022","journal-title":"J. Endocrinol. Investig."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e04225","DOI":"10.1002\/ccr3.4225","article-title":"Thyroid Disease and COVID-19 Infection: Case Series","volume":"9","author":"Allam","year":"2021","journal-title":"Clin. Case Rep."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1001\/jamainternmed.2021.4804","article-title":"Evaluation of Gender Inequity in Thyroid Cancer Diagnosis","volume":"181","author":"LeClair","year":"2021","journal-title":"JAMA Intern. Med."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Moleti, M., Sturniolo, G., Di Mauro, M., Russo, M., and Vermiglio, F. (2017). Female Reproductive Factors and Differentiated Thyroid Cancer. Front. Endocrinol., 8.","DOI":"10.3389\/fendo.2017.00111"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.1002\/ijc.29067","article-title":"Reproductive and Menstrual Factors and Risk of Differentiated Thyroid Carcinoma: The EPIC Study","volume":"136","author":"Rinaldi","year":"2015","journal-title":"Int. J. Cancer"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1771","DOI":"10.2217\/fon.10.127","article-title":"Thyroid Cancer Gender Disparity","volume":"6","author":"Rahbari","year":"2010","journal-title":"Future Oncol."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Peterson, E., De, P., and Nuttall, R. (2012). BMI, Diet and Female Reproductive Factors as Risks for Thyroid Cancer: A Systematic Review. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0029177"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1634\/theoncologist.2008-0194","article-title":"Understanding the Relationship Between Age and Thyroid Cancer","volume":"14","author":"Haymart","year":"2009","journal-title":"Oncologist"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/3\/287\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T10:36:21Z","timestamp":1759919781000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/3\/287"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,26]]},"references-count":41,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["diagnostics15030287"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15030287","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,26]]}}}