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.