Preparedness and guidelines for neurosurgery in the COVID-19 era: Indian perspective from a tertiary care referral hospital

Raheja, Amol; Agarwal, Nisheeth; Mohapatra, Sarita; Tandon, Vivek; Borkar, Sachin A; Chandra, P. Sarat; Kale, Shashank Sharad; Suri, Ashish

doi:10.3171/2020.9.focus20564

Cited by 12 publications

(5 citation statements)

References 48 publications

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“…10 Many neurosurgical centers have reported a decrease in their outpatient visits as a direct result of the measures taken by the governments. [19][20][21][22] A study by Ferraris et al concluded that the future use of telemedicine in an outpatient setting would provide a viable and safe method for health service delivery during such circumstances, 23 although the application of telemedicine in neurosurgery is still in its infancy. 24 The decrease in workload was subjectively reflected by the neurosurgical residents in terms of increased time spent in conducting research.…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on the Neurosurgical Resident Training Program: An Early Experience

Omer

Al-Afif

Machetanz

et al. 2022

J Neurol Surg A Cent Eur Neurosurg

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Background The present study evaluates the impact of COVID-19 pandemic restrictions during the first lockdown period in spring 2020 on the neurosurgical resident training program, and provides constructive approaches to deal with such situations. Methods A concurrent embedded mixed methods design was used. Qualitative data were collected through in-depth interviews from all neurosurgical residents at three university hospitals in Germany. Concurrently, quantitative data of the number of performed surgeries, outpatient visits, and the usage of telemedicine in the period from October 2019 to July 2020 were collected and analyzed accordingly. Results During the period of COVID-19 pandemic restrictions in spring 2020, there was a marked reduction in the number of surgeries performed by neurosurgical residents, from an average of 41.26 (median 41) surgeries per month to 25.66 (median 24) per month, representing a decrease of 37.80%. The decrease in the operations was concerning mainly spinal and functional surgery. Outpatient visits were reduced significantly, with a concurrent fivefold increase in the usage of telemedicine. General and pediatric neurosurgery outpatient clinics were the most affected. However, although surgical exposure was reduced during the lockdown phase, neurosurgical residents focused on conducting research and improving theoretical knowledge. Nevertheless, the global uncertainties caused by COVID-19 generated notable psychological stress among some residents. Conclusions The COVID-19 pandemic restrictions significantly affected the neurosurgical training program. Innovative solutions need to be developed to increase teaching and research capacities of neurosurgical residents as well as to improve surgical skills by installing surgical skill laboratories or similar constructs.

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Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on the Neurosurgical Resident Training Program: An Early Experience

Omer

Al-Afif

Machetanz

et al. 2022

J Neurol Surg A Cent Eur Neurosurg

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“… The vaccination plan has not been revealed yet officially. [ 13 , 17 , 38 , 39 , 40 , 41 , 42 , 43 , 44 ] Saudi Arabia Regular practice routine without screening for COVID-19 The number of surgical admissions was decreased to about 66% of the number before the pandemic. Priority was according to the urgency of the patients No changes, similar to the pandemic phase.…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 pandemic on the management of glioma patients around the world. An evidence-based review

Azab

Azzam

2021

Brain Disorders

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Background The coronavirus pandemic has affected many health care services worldwide since the emergence of the first case in Wuhan. Surgical neuro-oncology care is a fundamental part of hospital services, making it susceptible to strategic changes amid the COVID-19 pandemic. Methods An electronic search on several databases (PubMed/Medline, Scopus, and Google Scholar) from the beginning of the pandemic to the end of 2020, each paper was reviewed independently. The publication inclusion and exclusion criteria were done using Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Results Eight studies were found to be eligible for our meta-analysis. Most of the studies were on a retrospective basis, except one which was retrospective and prospective. An overall of 951 glioma patients’ were included for surgical admission from the beginning of the pandemic until 2020. Seventy-four patients' had mortality outcomes, and 250 patients had complications for both surgical admitted and non-surgical admitted purposes. Conclusions To our knowledge, we made the first systematic review and meta-analysis regarding the management of glioma patients’ during the pandemic of COVID-19. Our main findings are that the number of surgical admissions for glioma patients’ did not significantly differ between COVID-19 negative and COVD-19 positive cases; however, surprisingly, we found that both overall complications and mortality outcomes were more significant COVID-19 negative patients’ from the reported studies.

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“…None of the members of the team developed symptoms suggestive of COVID. All these guidelines were in accordance with the guidelines followed in other national institutes [ 8 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

Challenges and Outcomes of COVID-19 Positive Neurosurgical Patients: An Institutional Experience With Emphasis on Modifications of Neurosurgical Practice

Singh¹,

Dey²,

Boruah³

et al. 2021

Cureus

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Introduction: There has been a drastic reduction in the number of neurosurgeries performed during the COVID-19 pandemic due to a multitude of challenges prompting restructuring of neurosurgical services. The present study describes the challenges and outcomes of non-elective neurosurgical procedures done on COVID-19 positive patients along with the modifications in neurosurgical practice during the pandemic. Methods: A retrospective study was done in the Department of Neurosurgery over a period of one year and three months. Demographic and clinical details including outcomes of the COVID-19 positive patients, who had undergone non-elective neurosurgical interventions, were collected. Results: Ten patients (3.8%) were COVID-19 positive out of 262 neurosurgical interventions done. The age of the patients ranged from 5 days to 78 years with five males and five females. Out of the 10 patients, five were neurotrauma cases including one patient of head injury with craniovertebral junction injury. The patient with craniovertebral junction injury underwent foramen magnum decompression with C1 lateral mass-C2 pedicle screw on the right and C0-C2 pedicle screw and rod fixation on the left. The rest of the neurotrauma cases underwent craniotomy or burr-hole craniostomy followed by evacuation. Only one patient (10%) had postoperative 30-day mortality. The rest nine patients (90%) survived the post-operative 30-day mortality. The various modifications incorporated in the neurosurgical practice included categorizing the emergency room into various zones, a separate operating theatre for COVID-19 patients, limiting the number of operating members as well as minor modifications in the operating procedures. Conclusions: The postoperative surgical outcome is favorable in COVID-19 positive patients with modifications of the existing neurosurgical practices.

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Preparedness and guidelines for neurosurgery in the COVID-19 era: Indian perspective from a tertiary care referral hospital

Cited by 12 publications

References 48 publications

Impact of COVID-19 on the Neurosurgical Resident Training Program: An Early Experience

Impact of COVID-19 on the Neurosurgical Resident Training Program: An Early Experience

Impact of COVID-19 pandemic on the management of glioma patients around the world. An evidence-based review

Challenges and Outcomes of COVID-19 Positive Neurosurgical Patients: An Institutional Experience With Emphasis on Modifications of Neurosurgical Practice

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