Elsevier

Journal of Clinical Neuroscience

Volume 80, October 2020, Pages 156-161
Journal of Clinical Neuroscience

Clinical study
Collateral damage caused by COVID-19: Change in volume and spectrum of neurosurgery patients

https://doi.org/10.1016/j.jocn.2020.07.055Get rights and content

Highlights

  • The ongoing COVID-19 pandemic has resulted in cancellation/postponement of elective surgeries worldwide.

  • This has resulted in a major change in the volume and spectrum of neurosurgical cases.

  • The number of surgeries performed are decreasing as the number of COVID-19 cases increase.

  • Aerosol generating procedures put the neurosurgeons at a high risk of contracting COVID-19 infection.

Abstract

Background

There has been a dramatic change in the pattern of patients being seen in hospitals and surgeries performed during the ongoing COVID-19 pandemic. The objective of this study is to study the change in the volume and spectrum of surgeries performed during the ongoing COVID-19 pandemic compared to pre-COVID-19 era.

Methods

Details of all patients who were operated under department of neurosurgery at our institute since the onset of COVID-19 pandemic in India were collected and compared to the same time period last year. The demographic profile, diagnosis, surgery performed, type of surgery (routine/emergency, cranial/spinal and major/minor) in these two groups were compared. They were further categorized into various categories [neuro-oncology (brain and spine tumors), neuro-trauma (head injury and spinal trauma), congenital cases, degenerative spine, neuro-vascular, CSF diversion procedures, etc.] and compared between the two groups.

Results

Our study showed a drastic fall (52.2%) in the number of surgeries performed during the pandemic compared to pre-COVID era. 11.3% of patients operated during COVID-19 pandemic were non-emergent surgeries compared to 57.7% earlier (p = 0.000). There was increase in proportion of minor cases from 28.8% to 41.5% (p = 0.106). The proportion of spinal cases decreased from 27.9% to 11.3% during the COVID-19 pandemic (p = 0.043).

Conclusions

The drastic decrease in the number of surgeries performed will result in large backlog of patients waiting for ‘elective’ surgery. There is a risk of these patients presenting at a later stage with progressed disease and the best way forward would be to resume work with necessary precautions and universal effective COVID-19 testing.

Keywords

COVID-19 (coronavirus disease of 2019)
India
Neurosurgical practice
COVID-19 testing
Elective surgeries
Emergency surgeries

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