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Global survey on disruption and mitigation of neurological services during COVID-19: the perspective of global international neurological patients and scientific associations.
Triki, Chahnez Charfi; Leonardi, Matilde; Mallouli, Salma Zouari; Cacciatore, Martina; Karlshoej, Kimberly Coard; Magnani, Francesca Giulia; Newton, Charles R; Pilotto, Andrea; Saylor, Deanna; Westenberg, Erica; Walsh, Donna; Winkler, Andrea Sylvia; Thakur, Kiran T; Okubadejo, Njideka U; Garcia-Azorin, David.
  • Triki CC; Child Neurology Department, Hédi Chaker Hospital, LR19ES15, Sfax University, Sfax, Tunisia.
  • Leonardi M; Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy. Matilde.leonardi@istituto-besta.it.
  • Mallouli SZ; Child Neurology Department, Hédi Chaker Hospital, LR19ES15, Sfax University, Sfax, Tunisia.
  • Cacciatore M; Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
  • Karlshoej KC; World Federation of Neurology, Cqhester House, Fulham Green, 81-83 Fulham High Street, London, SW6 3JA, UK.
  • Magnani FG; Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
  • Newton CR; Department of Psychiatry, University of Oxford, Oxford, UK.
  • Pilotto A; Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
  • Saylor D; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
  • Westenberg E; Department of Neurology, Center for Global Health, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
  • Walsh D; European Federation of Neurological Associations, Brussels, Belgium.
  • Winkler AS; Department of Neurology, Center for Global Health, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
  • Thakur KT; Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway.
  • Okubadejo NU; Department of Neurology, Columbia-Irving University Medical Center/New York Presbyterian Hospital, New York, USA.
  • Garcia-Azorin D; Neurology Unit, Department of Neurology, College of Medicine, University of Lagos, Lagos, Nigeria.
J Neurol ; 269(1): 26-38, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1265495
ABSTRACT

BACKGROUND:

The COVID-19 pandemic outbreak has dramatically disrupted healthcare systems. Two rapid WHO pulse surveys studied disruptions in mental health services, but did not particularly focus on neurology. Here, a global survey was conducted and addresses the impact of the pandemic on neurology services.

METHODS:

A cross-sectional study was carried out in which 34 international neurological associations were asked to distribute the survey to national associations. The responses represented the national situation, in November-December 2020, with regard to the main disrupted neurological services, reasons and the mitigation strategies implemented as well as the disruption on training of residents and on neurological research. A comparison with the situation in February-April 2020, first pandemic wave, was also requested.

FINDINGS:

54 completed surveys came from 43 countries covering all the 6 WHO regions. Overall, neurological services disruption was reported as mild by 26%, moderate by 30%, complete by 13% of associations. The most affected services were cross-sectoral neurological services (57%) and neurorehabilitation (56%). The second wave of the pandemic, however, was associated with the improvement of service provision for diagnostics services (44%) and for neurorehabilitation (41%). Governmental directives were the major cause of services' disruption (56%). Mitigation strategies were mostly established through telemedicine (48%). Almost half of respondents reported a significant impact on neurological research (48%) and educational activities (60%). Most associations (67%) were not involved in decision making for neurological patients' issues by their national government.

INTERPRETATION:

The COVID-19 pandemic affects neurological services and raises the universal need for the development of neurological health care at the policy, systems and services levels. A global national plan on mitigation strategies for disruption of neurological services during pandemic situations should be established and neurological scientific and patients associations should get involved in decision making.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Observational study / Randomized controlled trials Limits: Humans Language: English Journal: J Neurol Year: 2022 Document Type: Article Affiliation country: S00415-021-10641-3

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Observational study / Randomized controlled trials Limits: Humans Language: English Journal: J Neurol Year: 2022 Document Type: Article Affiliation country: S00415-021-10641-3