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. 2023 Dec 7:10:1222767.
doi: 10.3389/fmed.2023.1222767. eCollection 2023.

The impact of Sars-Cov-2 infection on the wound healing of cervical treatment in patients with squamous intraepithelial lesions: a retrospective cohort study

Lili Xu  1   2   3 , Yuying Wu  3 , Chengzhi Li  1   2 , Renfeng Zhao  3 , Zhibiao Wang  1   2
Affiliations

The impact of Sars-Cov-2 infection on the wound healing of cervical treatment in patients with squamous intraepithelial lesions: a retrospective cohort study

Lili Xu et al. Front Med (Lausanne). .

Abstract

Objective: SARS-CoV-2 infection has been associated with an increase in inflammatory factors, a weakening of the immune system, and a potentially delay in wound healing following surgery or ablative treatment. In this retrospective cohort study, we aimed to investigate the impact of SARS-CoV-2 infection on wound healing following cervical treatment in patients with squamous intraepithelial lesions (SIL).

Method: From November 2022 to February 2023, patients with SIL who underwent cervical ablative treatment or loop electrosurgical excision procedure at the People's Hospital of Guangxi Zhuang Autonomous Region, China, were enrolled in the study. Of these, 29 patients who developed symptoms of SARS-CoV-2 infection and confirmed by an antigen test within one month after cervical treatment were included as experimental group, while the other 31 patients who received cervical treatment after recovering from SARS-CoV-2 infection were included in the control group. The cervical wound condition of all patients was documented using colposcopy immediately and one month after the procedure. Image J software was utilized to analyze the wound healing rate at one month post-treatment, and the wound healing status between two groups was compared. A vaginal discharge examination was performed before and one month after cervical treatment.

Results: No significant differences in age, severity, treatment, or time between groups. Experimental group had significantly lower healing rate 83.77(62.04, 97.09) % than control 98.64(97.10, 99.46)%，p < 0.001, and a higher scab non-shedding rate (24.14% vs. 3.22%, p = 0.024). Among patients who were infected with SARS-CoV-2 after undergoing cervical treatment, we observed 5 out of 7 patients (71.43%) contracted SARS-CoV-2 within 2 weeks after cervical treatment. No significant correlation was found between white blood cell count or leukocyte esterase in vaginal discharge and delayed wound healing of the cervix (p = 0.947 and 0.970, respectively).

Conclusion: SARS-CoV-2 infection may prolong the healing time of cervical treatment in patients with SIL. To minimize the risk of delayed healing, it's crucial for patients to avoid viral infections such as SARS-CoV-2 within the first month of treatment. Taking necessary precautions to prevent infection is essential for successful cervical treatment outcomes in patients with SIL.

Keywords: SARS-CoV-2; ablative treatment; cervical squamous intraepithelial lesion; loop electrosurgical excision procedure; wound healing.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Vaginal colposcopy images of patients who received focused ultrasound ablation for LSIL in different groups. (a,d) are vaginal colposcopy images before treatment; (b,e) are vaginal colposcopy images taken immediately after the procedure; (c), are vaginal colposcopy images taken one month after the cervical treatment. (A) Shows vaginal colposcopy images of a patient in control group. Which Indicates good healing of the cervical wound after treatment. (B) Shows vaginal colposcopy images of a patient in experimental group. Which shows that the patient’s cervical wound was still unhealed one month after the cervical treatment.
Figure 2
Figure 2
Vaginal colposcopy images of patients who received radiofrequency ablation for LSIL in different groups. (a, d) are vaginal colposcopy images before treatment; (b, e) are vaginal colposcopy images taken immediately after the procedure; (c), are vaginal colposcopy images taken one month after the cervical treatment. (A) shows vaginal colposcopy images of a patient in control group who received radiofrequency ablation for SIL 26 days after SARS-CoV-2 infection. Which Indicates good healing of the cervical wound after treatment. (B) Shows vaginal colposcopy images of a patient in experimental group who infected SARS-CoV-2 10 days after radiofrequency ablation. Which shows that the patient’s cervical wound was still unhealed one month after the cervical treatment.
Figure 3
Figure 3
Vaginal colposcopy images of patients who received LEEP treatment for HSIL in different groups. (a,d) are vaginal colposcopy images before treatment; (b,e) are vaginal colposcopy images taken immediately after the procedure; (c), are vaginal colposcopy images taken one month after the cervical treatment. (A) Shows vaginal colposcopy images of a patient in control group who received LEEP excision for HSIL 38 days after SARS-CoV-2 infection. Which Indicates good healing of the cervical wound after treatment. (B) Shows vaginal colposcopy images of a patient in experimental group who infected SARS-CoV-2 16 days after LEEP excision. Which shows that the patient’s cervical wound was still unhealed one month after the cervical treatment.
Figure 4
Figure 4
Representative images of wound area measurement with ImageJ software immediately and one month after cervical treatment.
See this image and copyright information in PMC

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