Introduction
Physical medicine and rehabilitation (PM&R) is an area of medical
specialty that aims to improve the functionality and quality of life of
the patients with a wide range of diseases related with disability and
pain through prevention, medical diagnosis, treatment and rehabilitation
management 1. Therefore, patients should be checked by
the PM&R physicians in any situation that may cause pain and functional
impairment. These diseases are classified as traumatic musculoskeletal
diseases, myofascial pain syndrome, peripheral and/or central nervous
system-related neurological diseases, degenerative joint and spine
disorders, rheumatic, cardiopulmonary, genitourinary, genetic and
congenital diseases, lymphatic system-related disorders, endocrine and
metabolic diseases and cancer-related complications 2.
Among these, degenerative joint and spine diseases are the most common
cases, while the low back, knee, neck and shoulder are the most affected
areas 2,3. Pharmacological or/and non-pharmacological
treatment methods are frequently used in the treatment of these
diseases, usually for long-term periods. Therefore, most of the patients
with such disease needs regular follow-ups. Moreover, with the recovery
rate of patients increasing thanks to the advancing treatment methods,
the population aging and subsequently chronic diseases are surging more
and more patients have been admitted to the PM&R outpatient clinics
with the expectation of reducing their pain, and improving their bodily
functions and quality of life 4.
The coronavirus disease 2019 (COVID-19) that caused
by severe
acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) was first
identified in Wuhan, China, in December 2019 5. To
date, more than 91,5 million confirmed cases and about 2,000,000 deaths
have been reported in 196 countries. COVID-19 has been declared a
pandemic by the WHO, on March 11, 2020. The first case in Turkey was
reported on March 10, 2020. Since then, the number of infected patients
and deaths has been increasing gradually. It prompted the government and
the private sector to introduce several restrictions similar to ones
applied worldwide to contain the spread of COVID-19. In this respect,
people were prohibited from travelling abroad and urged to stay at home
to the extent possible. In addition, a curfew was declared on March 21
for the people above the age of 65 and after a while a weekend curfew
has been introduced for all citizens in 31 cities until early July.
The SARS‑CoV‑2 primarily spread among people through small aerosolized
droplets produced during breathing, coughing, sneezing, and talking to
others within a close distance. People can also be infected, albeit less
commonly, through contacting contaminated surfaces and then touching
their faces. Therefore, social distancing and washing hands frequently
are the basic recommendations to prevent the spread of this disease. The
older people and those with chronic diseases such as diabetes mellitus,
hypertension, cardiovascular diseases are considered as higher risk
group for severe COVID-19 infection 6,7. There exists
no vaccine to boost immunity against this virus yet. Although several
studies have been carried out hastily to identify the potential
treatments for COVID-19, effectiveness of the treatments suggested by
randomized controlled trials has yet to be demonstrated and confirmed
clearly 8,9. Under these circumstances, increasingly
less patients have been admitted to outpatient clinics especially to
those in the pandemic hospitals as a measure to prevent them from
infection. Yagci et al. recently showed that the number of patients
visiting the PM&R outpatient clinics has dramatically decreased
following the first month of the COVID-19 pandemic in Turkey10.
This study is aimed to investigate the characteristics of the patients
who applied to the PM&R outpatient clinics of two pandemic hospitals,
in Istanbul, despite the risk of COVID-19 infection.