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Journal of Neuroanaesthesiology and Critical Care ; : 7, 2022.
Article in English | Web of Science | ID: covidwho-1978061


Background Patients with coronavirus disease 2019 (COVID-19) presenting for neurosurgery are not rare. Considering the lack of literature informing the outcomes in this subset, present study was conducted to compare perioperative management and postoperative outcomes between COVID-19 and non-COVID-19 neurosurgical patients. Methods After ethics committee approval, data of all patients with COVID-19 along with an equal number of age and diagnosis matched non-COVID-19 patients undergoing neurosurgery between April 2020 and January 2021 was analyzed retrospectively. Predictors of poor outcome were identified using multivariate logistic regression analysis. Results During the study period, 50 COVID-19 patients (28 laboratory confirmed (group-C) and 22 clinicoradiological diagnosed [group-CR]) underwent neurosurgery and were compared with 50 matched non-COVID-19 patients. Preoperatively, clinicoradiological diagnosed COVID-19 patients had higher American Society of Anesthesiologists (ASA) grade ( p = 0.01), lower Glasgow Coma Scale (GCS) score ( p < 0.001), and more pulmonary involvement ( p = 0.004). The duration of intensive care unit stay was significantly longer in laboratory confirmed patients ( p = 0.03). Poor clinical outcome (in-hospital mortality or discharge motor-GCS <= 5) did not differ significantly between the groups ( p = 0.28). On univariate analysis, younger age, higher ASA grade, lower preoperative GCS, and motor-GCS, higher intraoperative blood and fluid administration and traumatic brain injury diagnosis were associated with poor outcome. On multivariable logistic regression. only lower preoperative motor-GCS remained the predictor of poor outcome. Conclusions The concomitant presence of COVID-19 infection did not translate into poor outcome in patients undergoing neurosurgery. Preoperative motor-GCS predicted neurological outcome in both COVID-19 and non-COVID-19 neurosurgical patients.

medrxiv; 2020.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2020.10.02.20204578


Objective: To evaluate if the number of admitted extremely preterm (EP) infants (born before 28weeks of gestational age) has changed in the neonatal intensive care units (NICUs) of the SafeBoosC-III consortium during the global lockdown when compared to the corresponding time period in 2019. Design: This is a retrospective, observational study. Forty-six out of 79 NICUs (58%) from 17 countries participated. Principal investigators were asked to report the following information: 1) Total number of EP infant admissions to their NICU in the three months where the lockdown restrictions were most rigorous during the first phase of the COVID-19 pandemic, 2) Similar EP infant admissions in the corresponding three months of 2019, 3) the level of local restrictions during the lockdown period and 4) the local impact of the COVID-19 lockdown on the everyday life of a pregnant woman. Results: There was no significant difference between the number of EP infant admissions during the three most rigorous lockdown months of the COVID-19 pandemic compared to the corresponding three months in 2019 (n=428 versus n=457 respectively, p=0.33). There were no significant changes within individual geographic regions and no significant association between the level of lockdown restrictions and change in the number of EP infant admissions (p=0.334). Conclusion: This larger ad hoc study did not confirm previous studies report of a major reduction in the number of extremely preterm births during the first phase of the COVID-19 pandemic.