ABSTRACT
INTRODUCTION: New York City (NYC) is the epicenter of the novel coronavirus disease 2019 (COVID-19) pandemic in the United States. Cancellation of non-essential activities and social distancing policies are implemented during this crisis to avoid spread of the infection. METHODS: Retrospective and prospective reviews were performed from a Level-II trauma-center from November 2019 (one month before the outbreak started in China) to April 2020. General demographics, mechanism of trauma, diagnosis, and treatment were recorded. We dichotomized the data between pre-COVID-19 (before March 1st) and COVID-19 period, and compared differences between the two groups. RESULTS: A total of 150 patients composed our cohort, with a mean age of 66.2 years (SD+/-: 18.9), and 66% male. An average of 25 neuro-traumas/month was observed, with the highest average cases per day in March (1 case/day), and the lowest in April (0.6 cases/day). We noticed a progressive decrease of neuro-traumas since the beginning of March (from 11 cases to 2 cases a week), with the lowest point in the first week of April. This tendency was evident after March 16th, simultaneously with the cancellation of all non-essential activities in NYC during COVID-19 era, the most common mechanism of trauma was mechanical fall, but it was less frequent compared to the pre-COVID-19 period (61.4% vs 40.8;P = .04). Subdural hematomas were the most common pathology in both periods. Non-operative management was selected for most patients (79.2 vs 87.8%, P = .201) in both periods, but the tendency to convert code status to Do-Not-Intubate/Do-Not-Resuscitate (DNI/DNR) increased during the COVID-19 crisis (5.9% to 12.2%, P = .041). CONCLUSION: A temporary decrease of neuro-traumas was observed during the initial phase and peak of the crisis. This tendency was observed simultaneously with the implementation of social-distancing policies as the number of total infected patients was rising in NYC. Mechanical falls were the most frequent cause of neuro-trauma in both periods. More neuro-trauma patients were converted to DNI/DNR code during the crisis and this was not necessarily related to patient's COVID-19 status.