Endogenous Reactivation rather than Primary Infection of Sexually Transmitted Viruses in the Community during the Early Phase of the COVID-19 Pandemic in Hong Kong
Journal Title:Journal of Dermatology Research
Aim: We aim to report a retrospective epidemiological study on patients with sexually transmitted infections during the early phase in the COVID-19 pandemic.
Methods: Our settings is a primary care genito-urinary medicine clinic with two sessions per week, attached to a major university teaching hospital. We searched and hand-reviewed the medical records of all patients having consulted us during a Pandemic Period of 90 days (1 February to 30 April 2020). We then reviewed records of all patients having consulted us in two Control Periods each of 90 days before the pandemic. We analysed the records with final diagnoses most likely being sexually-transmitted only.
Results: During the Pandemic Period, 61 episodes of sexually transmitted infections were diagnosed, significantly less than such in the Control Periods (360 episodes in 180 days; RR: 0.34, 95% CI: 0.25-0.45). The commonest pathogens were
Herpes simplex-2 or -1 (recurrent episodes)
Human papillomavirus (recurrent episodes)
During the Pandemic Period, only one out of 24 patients with herpes simplex-2 or -1 infection was a first attack. This rate was significantly lower than such in Control Period 1 (RR: 0.12, 95% CI: 0.02-0.81), Control Period 2 (RR: 0.13, 95% CI: 0.02-0.93), and both Control Periods combined (RR: 0.12, 95% CI: 0.02-0.86).
For human papillomavirus infection, during the Pandemic Period, only one out of 20 patients presented with the first attack. This rate was also significantly lower than such in Control Period 1 (RR: 0.12, 95% CI: 0.02-0.86), Control Period 2 (RR: 0.13, 95% CI: 0.02-0.87), and both Control Periods combined (RR: 0.12, 95% CI: 0.02-0.85).
Conclusions: Endogenous reactivations of sexually-transmitted herpes simplex viruses and human papillomaviruses were significantly more frequent than primary infections during the early phase of the COVID-19 pandemic. This may be associated with less sexual exposures and psychosocial stressors compromising cell-mediated immunity.