Impact of the COVID-19 Pandemic on Neurosurgical Practice in India: Results of an Anonymized National Survey

Venkataram, Tejas; Goyal, Neeraj Kumar; Dash, Chinmaya; Chandra, P Prarthana; Chaturvedi, Jitender; Raheja, Amol; Singla, Raghav; Sardhara, Jayesh; Singh, Bhoopendra; Gupta, Ravi

doi:10.4103/0028-3886.289004

Cited by 34 publications

(67 citation statements)

References 19 publications

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“…In a national survey conducted by the authors on neurosurgeons, there was a 70% decrease in the number of surgeries performed as well decrease in the proportion of elective surgeries from 72% to 42% during the COVID-19 era all over the country [6]. In our study, the proportion of elective surgeries performed has decreased to 11.3% during the COVID-19 pandemic as compared to 57.7% during the same time-frame in 2019.…”

Section: Discussionsupporting

confidence: 39%

“…Surgery for those who test positive for COVID-19 should be postponed until test results are negative, where possible. This is supported by evidence from a seminal article where it was shown that in patients with peri-operative COVID-19 infection, 30-day mortality of elective surgery was 23.8% and pulmonary complications were seen in 51.2% cases [6][7][8]. Once a patient tests negative for COVID-19, he is shifted to the non-COVID-19 area and undergoes surgery in the designated non-COVID-19 operation room.…”

Section: Discussionmentioning

confidence: 83%

“…Viral shedding has been found to be higher in the upper respiratory tract and, once aerosolized, virus particles remain airborne for more than 3 hours [28,29]. In the survey conducted by the authors, almost 80% neurosurgeons were against doing endo-nasal procedures during the COVID-19 pandemic [6]. At our centre, endonasal surgeries are being avoided largely.…”

Section: Discussionmentioning

confidence: 90%

“…Hospitals and medical institutions have had to adapt to the 'new normal' by doing widespread COVID-19 testing, switching from physical out-patient department (OPD) to telemedicine and rescheduling of 'non-emergent' surgeries [6]. However, there has been a concern amongst health-care workers for patients who had their surgeries cancelled/postponed due to the ongoing COVID-19 pandemic.…”

Section: Introductionmentioning

confidence: 99%

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Collateral damage caused by COVID-19: Change in volume and spectrum of neurosurgery patients

Goyal

Venkataram

Singh

et al. 2020

Journal of Clinical Neuroscience

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Background: There has been a dramatic change in the pattern of patients being seen in hospitals and surgeries performed during the ongoing COVID-19 pandemic. The objective of this study is to study the change in the volume and spectrum of surgeries performed during the ongoing COVID-19 pandemic compared to pre-COVID-19 era. Methods: Details of all patients who were operated under department of neurosurgery at our institute since the onset of COVID-19 pandemic in India were collected and compared to the same time period last year. The demographic profile, diagnosis, surgery performed, type of surgery (routine/emergency, cranial/ spinal and major/minor) in these two groups were compared. They were further categorized into various categories [neuro-oncology (brain and spine tumors), neuro-trauma (head injury and spinal trauma), congenital cases, degenerative spine, neuro-vascular, CSF diversion procedures, etc.] and compared between the two groups. Results: Our study showed a drastic fall (52.2%) in the number of surgeries performed during the pandemic compared to pre-COVID era. 11.3% of patients operated during COVID-19 pandemic were nonemergent surgeries compared to 57.7% earlier (p = 0.000). There was increase in proportion of minor cases from 28.8% to 41.5% (p = 0.106). The proportion of spinal cases decreased from 27.9% to 11.3% during the COVID-19 pandemic (p = 0.043). Conclusions: The drastic decrease in the number of surgeries performed will result in large backlog of patients waiting for 'elective' surgery. There is a risk of these patients presenting at a later stage with progressed disease and the best way forward would be to resume work with necessary precautions and universal effective COVID-19 testing.

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Section: Discussionsupporting

confidence: 39%

Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

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Collateral damage caused by COVID-19: Change in volume and spectrum of neurosurgery patients

Goyal

Venkataram

Singh

et al. 2020

Journal of Clinical Neuroscience

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“…[ 5 ] In a survey conducted by the authors between 7 and 23 May 2020, most neurosurgeons in the country felt that there was a shortage of PPE in their respective hospitals. [ 6 ] Ventilators were highly inadequate in numbers. [ 4 ] There were handful of laboratories with facilities to do COVID-19 testing.…”

Section: Introductionmentioning

confidence: 99%

Getting Neurosurgery Services Back on Its Feet: “Learning to Live” with COVID-19

et al. 2021

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Background: Cancellation/postponement of ” non-emergent ” surgeries during coronavirus disease of 2019 (COVID-19) pandemic has created a huge backlog of patients waiting for surgery and has put them at risk of disease progression. We share our institute's policy and our department's attempt to resume ” non-emergent ” surgeries. Materials and Methods: We collected details of all patients operated under department of neurosurgery since the onset of COVID-19 pandemic in India and categorized them into ” lockdown ” and ” unlock ” groups for comparison. COVID-19 tests done in these patients were also analyzed. We also compared our surgical volume with the number of COVID-19 cases in the state. Results: One hundred and forty-eight patients (97 males, 51 females) with mean age of 37.8 years (range-2 months-82 years) underwent surgery in our department during the study period. The operative volume per week increased by 37% during the ” unlock ” period as compared to ” lockdown ” period. The proportion of elective/” non-emergent ” surgeries increased from 11.3% during ” lockdown ” to 34.7% during the ” unlock ” period ( P = 0.0037). During ” lockdown ” period, number of surgeries declined steadily as the number of COVID-19 cases rose in the state (rs(8) = −0.914, P = 0.000). Whereas there was a trend toward increased number of cases done per week despite increase in the number of cases in the state during the “ unlock ” period. During the ” unlocking ” process, in-patient department admissions and surgeries performed per month increased ( P = 0.0000) and this increase was uniform across all specialties. COVID-19 test was done (preoperatively or postoperatively) for all surgeries during ” unlock ” period compared to 12 (22.6%) surgeries during ” lockdown ” period. Three neurosurgery patients who underwent surgery during the ” unlock ” period tested positive for COVID-19. Conclusions: Our experience shows that proper evidence-based protocols, setting up of adequate COVID-19 testing facilities and provision of ample personal protective equipments are instrumental in re-starting “nonemergent” surgeries.

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The Impact of the COVID-19 Pandemic on Neurosurgery Worldwide

Kalyvas

Bernstein

Baticulon

et al. 2022

Neurosurgery and Global Health

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Impact of the COVID-19 Pandemic on Neurosurgical Practice in India: Results of an Anonymized National Survey

Cited by 34 publications

References 19 publications

Collateral damage caused by COVID-19: Change in volume and spectrum of neurosurgery patients

Collateral damage caused by COVID-19: Change in volume and spectrum of neurosurgery patients

Getting Neurosurgery Services Back on Its Feet: “Learning to Live” with COVID-19

The Impact of the COVID-19 Pandemic on Neurosurgery Worldwide

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