Neurosurgery and Coronavirus: Impact and Challenges. Lessons Learnt from the First Wave of a Global Pandemic

Ashkan, Keyoumars; Jung, Josephine; Velicu, Alexandra Maria; Raslan, Ahmed; Faruque, Mohammed; Kulkarni, Pandurang; Bleil, Cristina; Hasegawa, Harumoto; Kailaya-Vasan, Ahilan; Maratos, Eleni; Grahovac, Gordan; Vergani, Francesco; Zebian, Bassel; Barazi, Sinan; Malik, Irfan; Bell, David A.; Walsh, Daniel; Bhangoo, Ranjeev; Tolias, Christos M.; Bassi, Sanj; Selway, Richard; Thomas, Nick; Chandler, Christopher; Gullan, Richard

doi:10.2139/ssrn.3638282

Cited by 7 publications

(12 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…8 COVID-19 has also challenged the surgical services and training, largely due to deployment of doctors in other areas, adherence to the COVID-19 protocols and reduction in training opportunities due to decrease in number of elective surgeries. 9 Decompression craniectomy in stroke is a life-saving procedure in patients with malignant cerebral infarction. The mortality rate among the general population who underwent decompressive craniectomy for malignant middle cerebral artery infarction ranges from 20% to 55% in recent series, even after receiving the best medical care.…”

Section: Discussionmentioning

confidence: 99%

Effect of Decompression Craniectomy on Survival and Functional Outcome in Patients with COVID-19 and Malignant Infarct: A Retrospective Cohort Study and Review of Literature

Sudheer

Gomathy

Agarwal

et al. 2022

Journal of Stroke Medicine

View full text Add to dashboard Cite

Background and objective Amongst the varied neurological manifestations of COVID-19 infection, stroke is one of the common complications. A large portion of patients had large vessel occlusion (LVO) which increases the risk of malignant cerebral infarction requiring decompressive craniectomy. The impact of COVID-19, however, on decompressive craniectomy is not well described. Through this study, we aim to study the impact of decompressive craniectomy in COVID-19 patients presented to our tertiary care hospital. Material and methods Data of all acute ischemic stroke patients who tested COVID positive during the study period was collected. From among them, patients requiring decompressive craniectomy were included. The demographic, clinico-radiological parameters related to stroke, treatment received, outcome and complications were noted. In addition, data from all case reports and case series published on patients with COVID-19, who had developed ischemic stroke and underwent decompression craniectomy was collected and systematically reviewed. Results Twenty-seven stroke patients tested positive for COVID-19 infection, out of whom five patients underwent decompression hemicraniectomy in view of neurologic deterioration. The review of literature yielded 453 abstracts. After reading the full text of 69 articles, 12 studies on 15 patients finally met our inclusion criteria and were included in the systematic review. The mortality rate was 40% among stroke patients requiring decompressive craniectomy in COVID-19 patients. The mortality rate and functional outcomes of this cohort are comparable to the pre-pandemic period. Conclusion Decompressive craniectomy is a life-saving procedure in COVID-19 patients with malignant infarctions similar to patients in the pre-COVID-19 era.

show abstract

Section: Discussionmentioning

confidence: 99%

Effect of Decompression Craniectomy on Survival and Functional Outcome in Patients with COVID-19 and Malignant Infarct: A Retrospective Cohort Study and Review of Literature

Sudheer

Gomathy

Agarwal

et al. 2022

Journal of Stroke Medicine

View full text Add to dashboard Cite

show abstract

“…Overall, this reduction is consistent with available literature with a reported 50 þ % reduction of neurosurgical cases during this time. 1,3 Similarly, in a cross-sectional survey given to African neurosurgeons, 54.7% of responders reported that elective surgeries were not being performed, with an overall median reduction of 80% of elective cases per clinician. 4 The overall significant reduction in elective procedures likely reflected the widespread recommendation to reduce and postpone the number of elective procedures and the reallocation of health care workers to manage COVID-19 patients.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5] The consequences of these recommendations led to significant decreases in the volume of neurosurgical cases, as many neurosurgical and neurointensive care beds were rationed to support COVID-19 patients. 3,[5][6][7] Nigeria, too, was affected by a rising number of COVID-19 cases 4,8 and to cope with the difficulties posed by the pandemic, the health care system appropriately shifted attention and resources to treating patients with COVID-19. As a result of restructuring, modifications were made to streamline operations, and a 60-bed block was dedicated to patients with COVID-19.…”

Section: Introductionmentioning

confidence: 99%

Effects of COVID-19 on Neurosurgical Service: Perspective from a Tertiary Medical Center in Nigeria

Ikwuegbuenyi

Patil

Nie

et al. 2022

JNRP

View full text Add to dashboard Cite

Background The outbreak of COVID-19 caused a significant impact on neurosurgical case volume in Nigeria due to the widespread recommendation to minimize elective procedures and redistribute healthcare resources to support COVID-19 patients. This study aims to analyze the effect of COVID-19 in one tertiary care Nigerian hospital on the demographic characteristics, diagnostic classes, and elective/non-elective procedure statuses. Methods A retrospective single-center chart review study was conducted to review all patients undergoing a neurosurgical procedure between March to June in 2019 and 2020. Descriptive data on patient age, gender, sex, diagnosis, surgical procedure, elective/non-elective surgery status, and month and year of admission were recorded. Diagnoses were categorized into one of seven types by author review. Pearson's Chi-Square and Fisher's Exact Tests were utilized to test for independence of the categorical variables to the year of patient admission, and a Welch two-sample t-test was used to test for a significant difference in mean age between the two cohorts. Results A total of 143 cases were reviewed. There was a 59.8% reduction in overall neurosurgical case volume with an 82% reduction in elective procedures (39 vs. 7, p = 0.017, 95% CI: 1.15 – 8.77) between 2019 and 2020. No significant differences were noted in patient cohorts when comparing demographic characteristics, diagnosis type, or month of admission between the two years. Conclusion There was a significant reduction in elective neurosurgical procedures during the early months of COVID-19 in Nigeria. Further studies should consider examining the effects of COVID-19 into 2021.

show abstract

“…Presence in Corona wards increased the risk of contamination with the Covid-19 in the personnel with underlying diseases, so there were transferred to other wards and the problem of staff shortage became more apparent than before (8,10,11,16,17,18,28).…”

Section: Discussionmentioning

confidence: 99%

“…In the United Kingdom (2021), the results of a study showed that emergency neurosurgery operations were associated with a 33.6% reduction during the Covid-19 pandemic. Mortality rate was 30% thirty days after the surgery where most patients were infected with the Covid-19 and had underlying diseases or postoperative complications (8).…”

Section: Introductionmentioning

confidence: 99%

Managing Neurosurgery in the Covid-19 Pandemic

Aminmansour

Mahmoudkhani

Shafiei

et al. 2021

Preprint

View full text Add to dashboard Cite

BackgroundCovid-19 quickly spread around the world as an epidemic with potentially unknown hazards. Like its impacts on various occupations, neurosurgery has undergone changes due to the virus, including changes in surgical planning, inpatient and outpatient clinics, emergency management, and even academic activities. The present study was performed to determine neurosurgery challenges during the Covid-19 pandemic in Iran.MethodsThe present study was conducted as a mixed qualitative and quantitative study in 2021. In the qualitative section using the targeted sampling method, 11 members of the target community were selected using the available sampling method and completed a questionnaire. The qualitative part was conducted in two stages of reviewing texts and interviewing experts and in the quantitative part we evaluated the validity of the structure and the reliability of the questionnaire.ResultsThis study examined in detail all aspects of the effects of Covid-19 on neurosurgery. 9 dimensions and 61 items were identified as the challenges of neurosurgery during the Covid-19 pandemic. In order of importance, the aspects were: treatment outcome, manpower, management psychological and physical diseases, education and research, tools and physical space, ethics, financial implications and information technology.ConclusionThe outbreak of epidemics has different risks for specialties, among them neurosurgery. Accordingly, to observe patients' right to treatment, all necessary measures were first taken to provide instructions, regulations, policies and ethical guidelines.

show abstract

Neurosurgery and Coronavirus: Impact and Challenges. Lessons Learnt from the First Wave of a Global Pandemic

Cited by 7 publications

References 0 publications

Effect of Decompression Craniectomy on Survival and Functional Outcome in Patients with COVID-19 and Malignant Infarct: A Retrospective Cohort Study and Review of Literature

Effect of Decompression Craniectomy on Survival and Functional Outcome in Patients with COVID-19 and Malignant Infarct: A Retrospective Cohort Study and Review of Literature

Effects of COVID-19 on Neurosurgical Service: Perspective from a Tertiary Medical Center in Nigeria

Managing Neurosurgery in the Covid-19 Pandemic

Contact Info

Product

Resources

About