Impact of COVID-19 on management and outcomes of NHS patients with recurrent respiratory papillomatosis: evidence from a UK registry

Abstract

Introduction: Patients with recurrent respiratory papillomatosis (RRP) require frequent surgical removal of benign growths in the airway to maintain patency. This study aimed to investigate the impact of the COVID-19 pandemic on these patients, by monitoring their care and outcomes before and after the pandemic.

Methods: Participants were children or adults diagnosed with RRP, receiving treatment within an acute National Health Service hospital in the United Kingdom, registered with the Airway Intervention Registry. Data were captured between 1 April 2018 and 31 March 2022 (2 years pre- and post-COVID-19). Records for a subgroup of patients treated in England were linked to routine administrative data (Hospital Episode Statistics) for additional follow-up. Frequency of hospital visits, method of admission, type of surgical intervention, complications, disease severity (Derkay score) and voice quality were monitored.

Results: There was a reduction in RRP surgery frequency post COVID-19. The reporting clinician noted an intervention delay caused by COVID-19 in 11.8% of cases, and in half of those the treating clinician noted that the delay had resulted in worse symptoms. Despite this, disease severity remained relatively stable in both children and adults, as demonstrated by the Derkay and voice quality scores.

Conclusions: Patients with RRP experienced a reduction in surgical intervention post COVID-19. Although disease severity appeared overall stable within the study period, the long-term impact of changing surgical management of RRP patients in terms of voice quality and quality of life remain uncertain.

Keywords: Health information systems; Human papillomavirus viruses; Pandemics; Patient safety; Treatment outcome.