Neurological Patients during the Covid-19 Pandemic

With the current pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), measures of social isolation were necessary, and this resulted in the interruption of several treatments. Regarding neuro-oncological patients, especially those with central nervous system (CNS) disorders, this interruption can cause serious damage or even compromise the success of the treatment in the future. It is essential that each case be evaluated separately to decide how to continue treatment during the pandemic, always considering the risk of SARS-CoV-2 infection and the benefits that the treatment will bring. The policy of not prescribing potentially toxic drugs, chemotherapy, and immunosuppressive therapies, as well as the use of techniques like stereotactic biopsy and telemedicine are important strategies at this time. Copyright © 2023. Sociedade Brasileira de Neurocirurgia. All rights reserved.

Neurological Patients during the Covid-19 Pandemic

With the current pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), measures of social isolation were necessary, and this resulted in the interruption of several treatments. Regarding neuro-oncological patients, especially those with central nervous system (CNS) disorders, this interruption can cause serious damage or even compromise the success of the treatment in the future. It is essential that each case be evaluated separately to decide how to continue treatment during the pandemic, always considering the risk of SARS-CoV-2 infection and the benefits that the treatment will bring. The policy of not prescribing potentially toxic drugs, chemotherapy, and immunosuppressive therapies, as well as the use of techniques like stereotactic biopsy and telemedicine are important strategies at this time.

Influence of COVID-19 on the CNS

The pandemic caused by the novel coronavirus (SARS-Cov-2), has generated huge problems and inquiries in healthcare systems around the world. Several studies are emerging to prove the capacity of coronavirus neurotropism and its short and long-term consequences. Therefore, here, we aim to give information about the relationship between coronavirus and central nervous system in different aspects. The present study was conducted on search of the published studies available in NCBI;PubMed, MEDLINE, Scielo and Google Scholar for all kind of articles using keywords related to coronavirus and central nervous system. In addition to the most common symptoms of COVID-19 that are fever, cough, dyspnea and myalgia, anosmia and ageusia also have a high incidence in patients infected with SARS-CoV-2. Brain invasion by coronavirus, that had previously been related with glial cells, has been reported, as well as evidence that confirm the frequency and three times higher prevalence of cerebrovascular diseases in patients affected by COVID-19. Understanding the effects that the coronavirus may have on the central nervous system is essential to learn more about the possible consequences of COVID-19. It is known that the disease can cause neurological complications and the understanding of these processes may help in the detection of viral presence and in the appropriate treatment for these patients. It is hoped that soon there will be more ways to continue to deepen this knowledge. © 2020 Editora Cientifica Nacional Ltda. All rights reserved.

Approaching glioblastoma during COVID-19 pandemic: current recommendations and considerations in Brazil

BACKGROUND: Cancer patients in general and glioblastoma patients, in particular, have an increased risk of developing complications from the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and reaching a balance between the risk of exposure to infection and the clinical benefit of their treatment is ideal. The aggressive behavior of this group of tumors justifies the need for a multidisciplinary team to assist in clinical decisions during the current pandemic. Brazil is now ranked #2 in the number of cases and deaths from COVID-19 pandemic, and existing disparities in the treatment of neuro-oncology patients in Brazil will challenge the clinical and surgical decisions of this population, possibly affecting global survival. OBJECTIVE: To search the literature about the management of glioblastomas during COVID-19 pandemic to guide surgical and clinical decisions in this population of patients in Brazil. METHODS: We performed a systematic search on the PubMed electronic database targeting consensus statements concerning glioblastoma approaches during COVID-19 pandemic up to July 18, 2020. RESULTS: When approaching glioblastoma during the COVID-19 pandemic, important parameters that help in the decision-making process are age, performance status, tumor molecular profile, and patient consent. Younger patients should follow the standard protocol after maximal safe resection, mainly those with MGMT methylated tumors. Aged and underperforming patients should be carefully evaluated, and probably a monotherapy scheme is to be considered. Centers are advised to engage in telemedicine and to elaborate means to reduce local infection. CONCLUSION: Approaching glioblastoma during the COVID-19 pandemic will be challenging worldwide, but particularly in Brazil, where a significant inequality of healthcare exists.