Impact of COVID-19 on neurosurgical service: A one-year experience from a provincial countryside hospital in a rural area in north Egypt.

ABSTRACT

BACKGROUND: Globally, there is a shooting pandemic that affected many healthcare systems. Healthcare facilities had to set up strategies to avoid exhaustion while facing a catastrophic health problem. Vaccines or perfect therapies were not available over a long pandemic time and also no certified immunity against that disease is guaranteed. Therefore, it is probable that healthcare systems will face it for an exceptionally long period. That already had a grave effect on the strategy of daily practice of different specialties' services at healthcare centers. METHODS: We tried simply to share a countryside hospital's expertise in managing neurosurgical cases amid a dreadful health crisis. Healthcare workers' safety and patient safety were typical priorities for neurosurgical service at Damietta Specialized Hospital. We expose the lines of management, triaging cases, the methods of handling confirmed and suspected neurosurgical patients, and strategies for discharging and following up patients. We identified hospital admission and discharge records starting from February 2020 till February 2021 to track the neurosurgical case burden, the state of service offered and the rate of infection among healthcare workers who participated in surgeries. RESULTS: At the peak time of the COVID­19 pandemic in Egypt starting from February 2020 till February 2021, we have admitted about 500 neurosurgical patients. About 400 (80%) of them did surgeries according to the triaging protocol of the hospital. About 150 (30%) of those who did surgeries were urgent and the rest were borderline or semi­urgent. About 20 (4%) were tested COVID-19 positive and six of them died due to acute respiratory distress syndrome. Only two mortality cases were reported due to post-operative complications and not related to SARS­CoV­2 infection. The rest of the cases (97.6%) were discharged for follow­up without complications. No neurosurgeons but three anesthesia staff were infected with SARS­CoV­2. A successful undisturbed neurosurgical care was available for patients during COVID-19 time. CONCLUSIONS: Following the suggested strategies, a rural area-serving hospital managed to provide uninterrupted neurosurgical care amid COVID-19 pandemic in Egypt. Rural areas in developing countries are in need of strategies to deal with pandemics in the future without dismantling the normal health system, especially for life­saving cases in a critical specialty as neurosurgery.