# Effects of the COVID-19 pandemic on thoracic sympathectomies performed on Brazil’s Public Health System

## TL;DR

The study shows that the number of sympathectomies for hyperhidrosis in Brazil dropped significantly during the pandemic and is still recovering slowly.

## Contribution

The paper quantifies the pandemic's impact on elective sympathectomy surgeries within Brazil's public health system.

## Key findings

- Sympathectomies performed in 2020 and 2021 were 60% lower than in 2018 and 2019.
- The procedure volume in 2022 and 2023 was 30% lower than expected.
- Hospitalization time, costs, and mortality remained stable despite the drop in procedures.

## Abstract

The COVID-19 pandemic affected health resources in Brazil, as priority was given to providing care to those infected. As a result, patients with other pathologies suffered delays in treatment, especially those waiting for elective surgical treatments, such as sympathectomy for hyperhidrosis.

To analyze the number of thoracic sympathectomies performed to treat hyperhidrosis on the Brazilian Unified Health System (SUS), their mortality, demographics, length of hospital stay, and associated costs in the periods before, during, and after the peak of the COVID-19 pandemic.

This is a retrospective cross-sectional study that analyzed the number of video-assisted thoracic sympathectomies performed on the SUS in the 2 years prior to the pandemic (2018 and 2019), the 2 years of peak pandemic (2020 and 2021), and the 2 years after (2022 and 2023). Data on regional distribution, profile of patients, hospitalization, and associated mortality were also analyzed. Figures were extracted from the SUS Department of Informatics (DATASUS) database.

The number of sympathectomies performed in Brazil during 2020 and 2021 was 60% lower than the number recorded in 2018 and 2019, followed by a 30% smaller than expected increase in 2022 and 2023. Half of these procedures were conducted in the Southeast region of the country. The profile of patients was predominantly young women. Hospitalization time, costs, and mortality were stable over the years.

The volume of sympathectomies for treatment of hyperhidrosis in the SUS was severely affected by the COVID-19 pandemic and remains in slow recovery. The regional distribution, demographic profile, hospitalization data, and mortality rate remained stable.