Corrosive poisonings during the COVID-19 pandemic: trends and demographic shifts in the pre- and early vaccination periods (2020–2021)

Abstract

The COVID-19 pandemic significantly disrupted global healthcare and societal norms, leading to changes in poisoning patterns, particularly corrosive poisonings (CP). This study aimed to evaluate the impact of the pandemic on CP trends in North Macedonia by comparing observed data from 2020 and 2021 with predicted values (PV) based on a 10-year trend. Methods: A retrospective study was conducted using data from the Poisoning Registry at the PIC, University Clinic of Toxicology, Skopje. Patients with confirmed acute upper gastrointestinal corrosive injuries were included. Results: Between 2010 and 2021, 1,668 CP cases were recorded. While an overall downward trend was observed (y = -6.5x + 181.4, R² = 0.56), CP cases declined by 1.5% in 2020 and by 25.5% in 2021 compared to PV. Female cases decreased by 27.5% in 2021; male cases declined by 16.6% in 2020 and 32.4% in 2021. Adolescent CP increased by 12.8% in 2020 and 80.0% in 2021; cases in those over 75 years rose by 2.5% and 6.2%, respectively. The mean age of CP patients rose by 7.6% in 2020 and 11.0% in 2021. Suicidal poisonings increased by 9.9% in 2021. Disinfectant poisonings rose by 74.5% in 2020, while hydrochloric acid (+6.2%), detergents (+3.4%), and degreasers (+32.0%) increased in 2021. Case fatality ratios rose by 36.2% in 2020 and 44% in 2021. Conclusion: Although the overall number of cases declined, the increased severity, lethality, and demographic shifts—particularly among adolescents and the elderly—highlight the high-risk groups, mental health burden and toxicological risks associated with public health emergencies