The Increased Mortality Rate with Lower Incidence of Traumatic Brain Injury during the COVID-19 Pandemic: A National Study

Abstract

Background: the COVID-19pandemic with the following lockdown strategies have affected virtually all aspects of everyday life. Health services all over the world faced the crisis on an unprecedented scale, hampering timely care delivery. The present study was designed to assess the impact of the COVID-19 outbreak on the incidence and treatment of traumatic brain injuries in Poland. Methods: the data on hospital admissions with traumatic brain injuries as the primary diagnosis were extracted from the National Health Fund of Poland. For the purpose of this study, the search was limited to four relevant diagnosis-related groups. The overall in-house mortality was calculated. Results: there were 115,200 hospitalizations due to traumatic brain injury identified in the database. Overall, in comparison with the average of six prior years, in 2020 the volume of patients with traumatic brain injury dropped by 24.68% while the in-house mortality rate was increased by 26.75%. Conclusions: the COVID-19 pandemic with the resulting lockdown caused a radical reduction in human mobility. It had a profound impact on the incidence of traumatic brain injury, which dropped significantly. At the same time, the mortality rate increased drastically.

Extracellular cold-inducible RNA-binding protein mediated neuroinflammation and neuronal apoptosis after traumatic brain injury

“…However, there were no obvious differences in the apoptosis of neurons between the 1 and 2 μg/ml groups. Thus, we examined the ultrastructure and expression of ERS markers including p-PERK, GRP78, ATF4 and CHOP in neuron-2a cells after they were treated with 0, 0.5 or 1 μg/ml eCIRP for 48 h. The results confirmed that eCIRP treatment, especially at a dose of 1 μg/ml, could activate apoptosis pathways related to ERS in neuron-2a cells and upregulate the expression of p-PERK, GRP78, ATF4 and CHOP in neuron-2a cells (interaction F [ 6 , 24 ] = 0.41, p = 0.861; group F [ 2 , 24 ] = 51.35; p < 0.001, Figure 3b ) and cause significant expansion of the ER ( Figure 3c ).…”

“…BV2 cells were transfected with CIRP-siRNA or NC, and 24 h later they were treated with 1 μg/ml LPS for 24 h. The expression of H3K9ac in different cells was examined via WB analysis, and the untreated BV2 cells that were transfected with NC served as the control. The results showed that CIRP knockdown in BV2 cells alleviated the decreases in H3K9ac and α7nAChR expression, thus attenuating the increase in L-1β and TNF-α expression induced by LPS stimulation (interaction F [ 8 , 30 ] = 21.32, p < 0.001; group effect F [ 2 , 30 ] = 3.335, p < 0.05; Figure 8b ).…”

“…A previous report revealed that histone H3 acetylation is involved in the microglial inflammatory response after TBI [ 26 ]; herein, WB analysis of TBI animals revealed that the levels of IL-1β and TNF-α were decreased but that the expression of H3K9ac and the α7 nicotinic acetylcholine receptor (α7nAChR) was augmented in KO TBI mice compared to WT TBI mice at dpi 1 (interaction F [ 8 , 30 ]=21.32, p < 0.001; group effect F [ 2 , 30 ] = 3.335, p < 0.05; Figure 8a ).…”

“…Approximately 69 million people suffer from traumatic brain injury (TBI) annually worldwide [ 1 , 2 ]. TBI can progress through a process that includes primary injury and secondary craniocerebral injury.…”

Evaluating Changes in Trauma Epidemiology during the COVID-19 Lockdown: Insights and Implications for Public Health and Disaster Preparedness

“…Colcuc et al included only severely injured patients, while in this paper, we analyzed the entire trauma population of Lublin Province. Miekisiak et al, in the national analysis of TBI incidence in Poland, found that the volume of TBI in 2020 dropped by almost 25% in comparison with the previous six years, with a significant reduction in conservatively treated patients [54]. In several single-center analyses of TBI epidemiology during the lockdown period, a decrease in head trauma was reported during the time of COVID-19 restrictions [55][56][57][58][59].…”