Social media in neurosurgery during COVID-19: an evaluation of the role of Neurosurgery Cocktail platform.

BACKGROUND: Social media use in neurosurgery remains an understudied phenomenon. Our study aims to examine the global membership and engagement of the prominent Neurosurgery Cocktail Facebook group with over 25,000 neurosurgeons and trainees worldwide, specifically during the COVID-19 pandemic. METHODS: Neurosurgery Cocktail's numbers of members, posts, comments, and reactions were collected from December 2019 to November 2020. Anonymized aggregate data of members' characteristics, including age, sex, and country of origin in November 2020, were also obtained. The most engaging posts in November 2020 were categorized into topics by a majority consensus of 3 reviewers. RESULTS: The average number of members steadily increased from 21,266 in December 2019 to 25,218 in November 2020. In November 2020, 18.8% of members were women, and 71.3% were between 25-44 years old. With members from 100 countries, 77.9% are from low-and middle-income countries, with the highest representation from India, Egypt, and Brazil. After the COVID-19 pandemic declaration, daily engagement peaked in April 2020 with a daily average of 41.63 posts, 336.4 comments, and 1,914.6 reactions before returning to prepandemic levels. Among the 99 top posts in November 2020, the majority (56.5%) were classified as "interesting cases", with "education-related" as the second-most common topic (16.2%). CONCLUSIONS: Neurosurgery Cocktail has shown steady growth since its creation. The COVID-19 pandemic was correlated with a spike in activity without lasting impact. The group demonstrates social media's potential for knowledge exchange and promoting organic international collaborations.

Neurosurgery Subspecialty Practice During a Pandemic: A Multicenter Analysis of Operative Practice in 7 U.S. Neurosurgery Departments During Coronavirus Disease 2019.

OBJECTIVE: Changes to neurosurgical practices during the coronavirus disease 2019 (COVID-19) pandemic have not been thoroughly analyzed. We report the effects of operative restrictions imposed under variable local COVID-19 infection rates and health care policies using a retrospective multicenter cohort study and highlight shifts in operative volumes and subspecialty practice. METHODS: Seven academic neurosurgery departments' neurosurgical case logs were collected; procedures in April 2020 (COVID-19 surge) and April 2019 (historical control) were analyzed overall and by 6 subspecialties. Patient acuity, surgical scheduling policies, and local surge levels were assessed. RESULTS: Operative volume during the COVID-19 surge decreased 58.5% from the previous year (602 vs. 1449, P = 0.001). COVID-19 infection rates within departments' counties correlated with decreased operative volume (r = 0.695, P = 0.04) and increased patient categorical acuity (P = 0.001). Spine procedure volume decreased by 63.9% (220 vs. 609, P = 0.002), for a significantly smaller proportion of overall practice during the COVID-19 surge (36.5%) versus the control period (42.0%) (P = 0.02). Vascular volume decreased by 39.5% (72 vs. 119, P = 0.01) but increased as a percentage of caseload (8.2% in 2019 vs. 12.0% in 2020, P = 0.04). Neuro-oncology procedure volume decreased by 45.5% (174 vs. 318, P = 0.04) but maintained a consistent proportion of all neurosurgeries (28.9% in 2020 vs. 21.9% in 2019, P = 0.09). Functional neurosurgery volume, which declined by 81.4% (41 vs. 220, P = 0.008), represented only 6.8% of cases during the pandemic versus 15.2% in 2019 (P = 0.02). CONCLUSIONS: Operative restrictions during the COVID-19 surge led to distinct shifts in neurosurgical practice, and local infective burden played a significant role in operative volume and patient acuity.

The significant impact of Coronavirus disease 2019 (COVID-19) on in-hospital mortality of elderly patients with moderate to severe traumatic brain injury: A retrospective observational study.

BACKGROUND: Traumatic brain injury (TBI) is one of the main causes of death and disability among the elderly patient population. This study aimed to assess the predictors of in-hospital mortality of elderly patients with moderate to severe TBI who presented during the Coronavirus disease 2019 (COVID-19) pandemic. METHODS: In this retrospective analytical study, all elderly patients with moderate to severe TBI who were referred to our center between March 2nd, 2020 to August 1st, 2020 were investigated and compared against the TBI patients receiving treatment during the same time period within the year 2019. Patients were followed until discharge from the hospital or death. The demographic, clinical, radiological, and laboratory test data were evaluated. Data were analyzed using SPSS-21 software. FINDINGS: In this study, 359 elderly patients were evaluated (n = 162, Post-COVID-19). Fifty-four patients of the cohort had COVID-19 disease with a mortality rate was 33.3%. The patients with COVID-19 were 5.45 times more likely to expire before discharge (P < 0.001) than the TBI patients who were not COVID-19 positive. Other variables such as hypotension (OR, 4.57P < 0.001), hyperglycemia (OR, 2.39, P = 0.002), and use of anticoagulant drugs (OR, 2.41P = 0.001) were also associated with in-hospital death.According to the binary logistic regression analysis Age (OR, 1.72; 95% CI: 1.26-2.18; P = 0.033), Coronavirus infection (OR, 2.21; 95% CI: 1.83-2.92; P = 0.011) and Glasgow Coma Scale (GCS) (OR, 3.11; 95% CI: 2.12-4.53; P < 0.001) were independent risk factors correlated with increased risk of in-hospital mortality of elderly patients with moderate to severe TBI. CONCLUSION: Our results showed that Coronavirus infection could increase the risk of in-hospital mortality of elderly patients with moderate to severe TBI significantly.

Coronavirus disease 2019 (COVID-19) can predispose young to Intracerebral hemorrhage: a retrospective observational study.

BACKGROUND: The respiratory system involvement is the most common presentation of Coronavirus disease 2019 (COVID-19). However, other organs including the central nervous system (CNS) could be affected by the virus. Strokes, seizures, change in mental status, and encephalitis have been reported as the neurological manifestation of the disease. We hypothesized that COVID-19 could predispose younger patients to spontaneous intracerebral hemorrhage (ICH). The present study aimed to investigate whether COVID-19 has any relationship with the occurrence of spontaneous ICH in young or not. METHODS: We retrospectively evaluated all the patients with spontaneous ICH who were referred to our center between 20 Feb and 1 Sep 2020. The demographic, clinical, radiological, and laboratory test data were evaluated. Patients were divided into two groups. The COVID-19 positive patients and COVID-19 negative ones. All the variables including age, sex, history of hypertension, diabetes mellitus, smoking, Glasgow Coma Scale (GCS), hematoma volume and location, the presence of intraventricular hemorrhage and hydrocephalus on admission, the length of hospital stay, the lab test results and the clinical outcome at last visit or discharge as Glasgow Outcome Scale (GOS) were compared between the two groups. RESULTS: There were 22 COVID-19 positive patients (20.8%) and 84 COVID-19 negative ones (79.2%). The mean age of the patients in the case group (54.27 ± 4.67) was significantly lower than that in the control group (69.88 ± 4.47) (p < 0.05). Meanwhile, our results showed a significant difference between the two groups based on the presence of chronic arterial hypertension (p < 0.05). There were no significant differences between the two groups based on gender, diabetes mellitus, smoking, Glasgow Coma Scale (GCS), hematoma volume, need for surgery, the presence of intraventricular hemorrhage and hydrocephalus on admission, White Blood Cell (WBC) count, platelet count, Prothrombin Time (PT), and Partial Thromboplastin Time (PTT) (p > 0.05). CONCLUSIONS: Our results show that COVID positive patients with ICH are younger and with less predisposing factors than COVID negative subjects with ICH.

COVID-19 and Neurosurgery Consultation Call Volume at a Single Large Tertiary Center With a Propensity-Adjusted Analysis.

BACKGROUND: The COVID-19 pandemic has significantly affected patient care across specialties. Ramifications for neurosurgery include substantial disruptions to surgical training and changes in nonurgent patient presentations to the emergency department. This study quantifies the effects of the COVID-19 pandemic on the number of emergency department patients who were referred to the neurosurgery department for further consultation and treatment and identifies and describes trends in the characteristics of these visits. METHODS: A retrospective review was performed of neurosurgical consultations at a single high-volume institution for 28 call-day periods before and after the official announcement of the pandemic. Primary outcomes included consultations per call-day, patient presentation category, and patient admission. RESULTS: The neurosurgical service was consulted regarding 629 patients (367 male patients) during the study period, with 471 (75%) and 158 (25%) patients presenting before and after the announcement of the COVID-19 pandemic, respectively. The mean number of neurosurgical consultations per call-day was significantly lower in the COVID-19 period (5.6 consultations) compared with the pre-COVID-19 period (16.8 consultations) (P < 0.001). After adjusting for patient demographics, the rate of presentation for general nonurgent concerns, such as back pain, headaches, and other general weaknesses, significantly decreased (odds ratio [95% confidence interval], 0.60 [0.47-0.77], P < 0.001). CONCLUSIONS: Neurosurgical consultations significantly decreased after the onset of the COVID-19 pandemic, with a substantially lower overall number of consultations necessitating operative interventions. Furthermore, the relative number of patients with nonemergent neurological conditions significantly decreased during the pandemic.