Lyme borreliosis in the Lublin Province during the COVID-19 pandemic

Background
Lyme borreliosis is the most common tick-borne disease in Poland. The onset of tick exposure in early spring 2020 coincided with the start of the COVID-19 pandemic. The aim of the study was to analyze the incidence of Lyme borreliosis in the Lublin Province and in individual counties of the area in the year preceding the start of the COVID-19 pandemic in Poland and in the first year of its duration (2019-2020).

Material and methods
Epidemiological analysis was performed on the basis of data from the National Institute of Public Health – National Research Institute and data from the Regional Sanitary- Epidemiological Station in Lublin.

Results
In 2020, the incidence rate of Lyme borreliosis in the Lublin Province was registered to decrease more than 2 times compared to 2019 (from 87.4/100,000 to 37.4/100,000). Decreases in the number of recorded cases were observed in all quarters of 2020. The largest, more than 5-fold decrease in the number of recorded cases was seen in Q4 (523 cases in 2019, 101 cases in 2020). The largest numerical decrease of the incidence rate was registered in Włodawa County (-158.12/100,000), Biała Podlaska County (-143.43), Kraśnik County (-122.20) and the city of Biała Podlaska (-83.92). On the other hand, the largest percentage decrease of the rate was noted in Lublin County (-92%), Biała Podlaska County (-91%), Ryki County (-90%) and the city of Biała Podlaska (-89%).

Conclusions
Significant decreases in the incidence of Lyme borreliosis observed in 2020 in the Lublin Province are undoubtedly related to the COVID-19 pandemic and difficulties in accessing medical care for patients with ailments other than those resulting from SARS-CoV-2 infection. Local healthcare providers should be alert to the possibility that more patients than ever before are presenting with a diagnosis of Lyme borreliosis delayed by the COVID-19 pandemic and, therefore, late manifestations of the disease.