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COVID-19 Impact on Neurosurgical Practice: Lockdown Attitude and Experience of a European Academic Center.
Lubansu, Alphonse; Assamadi, Mouhssine; Barrit, Sami; Dembour, Victoria; Yao, Gedeon; El Hadwe, Salim; De Witte, Olivier.
  • Lubansu A; Department of Neurosurgery, Erasme Hospital, Université Libre de Bruxelles, Belgium. Electronic address: alphonse.lubansu@erasme.ulb.ac.be.
  • Assamadi M; Department of Neurosurgery, Erasme Hospital, Université Libre de Bruxelles, Belgium; Department of Neurosurgery, Ibn Tofail Hospital, Université Cadi Ayyad, CHU Mohammed Sixth, Marrakech, Morocco.
  • Barrit S; Department of Neurosurgery, Erasme Hospital, Université Libre de Bruxelles, Belgium.
  • Dembour V; Department of Neurosurgery, Delta Hospital, CHIREC, Brussels, Belgium.
  • Yao G; Department of Neurosurgery, Erasme Hospital, Université Libre de Bruxelles, Belgium; Department of Neurosurgery, Hospital University of Yopougon, Abidjan, Ivory Coast.
  • El Hadwe S; Department of Neurosurgery, Erasme Hospital, Université Libre de Bruxelles, Belgium.
  • De Witte O; Department of Neurosurgery, Erasme Hospital, Université Libre de Bruxelles, Belgium.
World Neurosurg ; 144: e380-e388, 2020 12.
Article in English | MEDLINE | ID: covidwho-741539
ABSTRACT

BACKGROUND:

The coronavirus disease 2019 (COVID-19) pandemic is an unprecedented challenge. Different models of reorganization have been described aiming to preserve resources and ensure optimal medical care. Limited clinical neurosurgical experience with patients with COVID-19 has been reported. We share organizational experience, attitudes, and preliminary data of patients treated at our institution.

METHODS:

Institutional guidelines and patient workflow are described and visualized. A cohort of all neurosurgical patients managed during the lockdown period is presented and analyzed, assessing suspected nosocomial infection risk factors. A comparative surgical subcohort from the previous year was used to investigate the impact on surgical activity.

RESULTS:

A total of 176 patients were admitted in 66 days, 20 of whom tested positive for COVID-19. Patients initially admitted to the neurosurgical ward were less likely to be suspected for a COVID-19 infection compared with patients admitted for critical emergencies, particularly with neurovascular and stroke-related diseases. The mortality of patients with COVID-19 was remarkably high (45%), and even higher in patients who underwent surgical intervention (77%). In addition to the expected decrease in surgical activity (-53%), a decrease in traumatic emergencies was noted.

CONCLUSIONS:

By applying infection prevention and resource-sparing logistics measures shared by the international medical community, we were able to maintain essential neurosurgical care in a pandemic with controlled nosocomial infection risk. Special consideration should be given to medical management and surgical indications in patients infected with severe acute respiratory syndrome coronavirus 2, because they seem to show a problematic hemostatic profile that might result in an unfavorable clinical and surgical outcome.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Central Nervous System Diseases / Cross Infection / Organizational Policy / Academic Medical Centers / Workflow / COVID-19 / Neurosurgery Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Country/Region as subject: Europa Language: English Journal: World Neurosurg Journal subject: Neurosurgery Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Central Nervous System Diseases / Cross Infection / Organizational Policy / Academic Medical Centers / Workflow / COVID-19 / Neurosurgery Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Country/Region as subject: Europa Language: English Journal: World Neurosurg Journal subject: Neurosurgery Year: 2020 Document Type: Article