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Urgent Neurosurgical Interventions in the COVID-19-Positive Pediatric Population.
Lang, Shih-Shan; Gajjar, Avi A; Tucker, Alexander M; Storm, Phillip B; Rahman, Raphia K; Madsen, Peter J; O'Brien, Aidan; Chiotos, Kathleen; Kilbaugh, Todd J; Huh, Jimmy W.
  • Lang SS; Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Department of Neurosurgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA. Electronic address: chens4@chop.edu.
  • Gajjar AA; Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Department of Chemistry, Union College, Schenectady, New York, USA.
  • Tucker AM; Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
  • Storm PB; Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Department of Neurosurgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
  • Rahman RK; Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA.
  • Madsen PJ; Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
  • O'Brien A; Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Department of Chemistry, Union College, Schenectady, New York, USA.
  • Chiotos K; Division of Infectious Disease, Children's Hospital of Philadelphia, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA; Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsyl
  • Kilbaugh TJ; Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
  • Huh JW; Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
World Neurosurg ; 158: e196-e205, 2022 02.
Article in English | MEDLINE | ID: covidwho-1525984
ABSTRACT

BACKGROUND:

Urgent neurosurgical interventions for pediatric patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are rare. These cases pose additional stress on a potentially vulnerable dysregulated inflammatory response that can place the child at risk of further clinical deterioration. Our aim was to describe the perioperative course of SARS-CoV-2-positive pediatric patients who had required an urgent neurosurgical intervention.

METHODS:

We retrospectively analyzed pediatric patients aged ≤18 years who had been admitted to a quaternary children's hospital with a positive polymerase chain reaction test result for SARS-CoV-2 virus from March 2020 to October 2021. The clinical characteristics, anesthetic and neurosurgical operative details, surgical outcomes, and non-neurological symptoms were collected and analyzed.

RESULTS:

We identified 8 SARS-CoV-2-positive patients with a mean age of 8.83 years (median, 8.5 years; range, 0.58-18 years). Of the 8 patients, 6 were male. All children had had mild or asymptomatic coronavirus disease 2109. The anesthetic and surgical courses for these patients were, overall, uncomplicated. All the patients had been admitted to a specialized isolation unit in the pediatric intensive care unit for cardiopulmonary and neurological monitoring. The use of increased protective personal equipment during anesthesia and surgery did not impede a successful neurosurgical operation.

CONCLUSIONS:

SARS-CoV-2-positive pediatric patients with minimal coronavirus disease 2019-related symptoms who require urgent neurosurgical interventions face unique challenges regarding their anesthetic status, operative delays due to SARS-CoV-2 polymerase chain reaction testing, and requirements for additional protective personal equipment. Despite these clinical challenges, the patients in our study had not experienced adverse postoperative consequences, and no healthcare professional involved in their care had contracted the virus.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Neurosurgical Procedures / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Limits: Child / Female / Humans / Male Language: English Journal: World Neurosurg Journal subject: Neurosurgery Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Neurosurgical Procedures / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Limits: Child / Female / Humans / Male Language: English Journal: World Neurosurg Journal subject: Neurosurgery Year: 2022 Document Type: Article