No lockdown for neurological diseases during COVID19 pandemic infection

Caso, Valeria; Federico, Antonio

doi:10.1007/s10072-020-04389-3

Cited by 55 publications

(57 citation statements)

References 24 publications

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“…Our observations are aligned with reported analogous declines of patient admissions in Italy for minor strokes and transient ischemic attacks during the pandemic spread. [4] Moreover, patient arrivals were increasingly too late to initiate acute stroke treatment, causing reporting rates of thrombolysis and combined thrombolysis-thrombectomy to decline. [5] So far, it is unknown what…”

Section: Discussionmentioning

confidence: 99%

“…[3] Hospitals and intensive care units are near breaking points in dealing with those suffering from this infection, forcing lockdown conditions on one-third of the world´s population. [4] As of April 19 th , 2020, nearly 2 million people had been infected worldwide. In Germany the number of confirmed cases had risen to 145,742 with 4,642 deceased.…”

Section: Introductionmentioning

confidence: 99%

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Involuntary ambulatory triage during the COVID-19 pandemic – A neurosurgical perspective

et al. 2020

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Background The coronavirus disease 2019 (COVID-19) pandemic poses an unprecedented challenge to health-care systems around the world. As approximately one-third of the world´s population is living under "lockdown" conditions, medical resources are being reallocated and hospital admissions are limited to emergencies. We examined the decision-making impact of these actions and their effects on access to hospital treatment in patients with neurosurgical conditions. Methods This retrospective cohort study analyzes hospital admissions of two major neurosurgical services in Germany during the nationwide lockdown period (March 16 th to April 16 th , 2020). Spinal or cranial conditions requiring immediate hospital admission and treatment constituted emergencies. Results A total of 243 in-patients were treated between March 16 th and April 16 th 2020 (122 patients at the University Medical Center Mainz, 121 patients at the University Medical Center Gö ttingen). Of these, 38.0±16% qualified as emergency admission. Another 1,688 admissions were reviewed during the same periods in 2018 and 2019, providing a frame of reference. Overall, emergency admissions declined by 44.7±0.7% during lockdown. Admissions for cranial emergencies fell by 48.1±4.44%, spinal emergencies by 30.9±14.6%. Conclusion Above findings indicate that in addition to postponing elective procedures, emergency admissions were dramatically curtailed during the COVID-19 lockdown. As this surely is unexpected and unintended, reasons are undoubtedly complex. As consequences in

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Involuntary ambulatory triage during the COVID-19 pandemic – A neurosurgical perspective

et al. 2020

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“…This implies that acute stroke management pathways ought to be revised to maintain proper stroke care while protecting patients and health care providers from contracting COVID-19. 3 Acute stroke in triage of ER Figure 1. Modified acute stroke pathway of Ain Shams University stroke centers during the coronavirus disease 2019 (COVID-19) pandemic.…”

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confidence: 99%

Stroke in the Time of Coronavirus Disease 2019: Experience of Two University Stroke Centers in Egypt

et al. 2020

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“…In Lombardia and in other Italian regions, new stroke pathways have been established pointing to the centralization of care in a limited number of centers due to the stroke unit closure and reallocation of health professionals to COVID-19 wards [4,33]. Dedicated stroke triage protocols, including the adequate screening of symptoms and signs of COVID-19 infection, isolation of patients in protected areas, and specific pathways for acute stroke treatments were activated according to regional indications [33,34].…”

Section: Acute Stroke Management and Organization During Covid-19 Panmentioning

confidence: 99%

“…However, the number of hospitalized stroke patients and the amount of acute phase treatments such as thrombectomy was observed to be heavily reduced for several, and still not clarified, reasons [33][34][35]. The most reliable hypothesis is that the general population, and particularly elderly or hypertensive, diabetic, cardiopathic or disabled patients, because of the higher infection risk and mortality rate reported by media in these populations, were discouraged by family doctors and emergency operators to go to the hospital [33][34][35][36]. Hence, the care of people with non-COVID conditions such as stroke, who may have needed urgent care, was deferred or even completely not received [37,38].…”

Section: Acute Stroke Management and Organization During Covid-19 Panmentioning

confidence: 99%

Stroke care in Italy at the time of the COVID-19 pandemic: a lesson to learn

Bersano

Pantoni

2020

J Neurol

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From March to May 2020, the Italian health care system, as many others, was almost entirely devoted to the fight against the COVID-19 pandemic. In this context, a number of questions arose, from the increased stroke risk due to COVID-19 infection to the quality of stroke patient care. The overwhelming need of COVID-19 patient management made mandatory a complete reorganization of the stroke pathways: many health professionals were reallocated and a number of stroke units was turned into COVID-19 wards. As a result, acute stroke care suffered from a shortage of services and delays in time-dependent treatments and diagnostic work-up. In-patient and outpatient care and rehabilitation facilities for stroke survivors were also reduced or slowed down, to direct resources to COVID-19 patients care and to reduce contagion risks. Overall, this is likely to result in a significant future increased burden of complications and disabilities that will impact the health care systems in the coming months. Thus, while still fighting against COVID-19 disease, authorities need to promptly implement robust action plans, including an increase of workforce, without forgetting the assurance of a high level of stroke care. The medical community and the health care administrators should always keep in mind that stroke was before, and will be after the pandemic, a, sometimes, life-threatening condition, and almost always a disease with a severe impact on the quality of life.

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No lockdown for neurological diseases during COVID19 pandemic infection

Cited by 55 publications

References 24 publications

Involuntary ambulatory triage during the COVID-19 pandemic – A neurosurgical perspective

Involuntary ambulatory triage during the COVID-19 pandemic – A neurosurgical perspective

Stroke in the Time of Coronavirus Disease 2019: Experience of Two University Stroke Centers in Egypt

Stroke care in Italy at the time of the COVID-19 pandemic: a lesson to learn

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