Letter to the Editor Management of Neurosurgical Patients During the COVID-19 Pandemic

Spina, Alfio; Boari, Nicola; Gagliardi, Filippo; Bailo, Michele; F, Calvanese; Mortini, Pietro

doi:10.1016/j.wneu.2020.04.161

Cited by 6 publications

(7 citation statements)

References 25 publications

(60 reference statements)

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“…Facial and neurosurgical trauma cases posed significant risk of COVID-19 transmission. 31 , 32 Thus, a clinical pathway for teleconsultation by the Oral/Maxillofacial Surgery, Ophthalmology, Otorhinolaryngology, and Neurosurgical services was developed by one center and relayed to the other participating sites. This approach listed indications for required in-person assessment while all other consults could be performed remotely.…”

Section: Resultsmentioning

confidence: 99%

Trauma center activity and surge response during the early phase of the COVID-19 pandemic—the Philadelphia story

Qasim

Sjoholm

Volgraf

et al. 2020

J Trauma Acute Care Surg

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Section: Resultsmentioning

confidence: 99%

Trauma center activity and surge response during the early phase of the COVID-19 pandemic—the Philadelphia story

Qasim

Sjoholm

Volgraf

et al. 2020

J Trauma Acute Care Surg

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“…The Motor Rehabilitation Unit consisted of 21 beds, with 4 physiatrists, 5 physiotherapists, 1 psychologist, 1 nutritionist, and 1 occupational therapist. All medical, physiotherapy, and nursing staff were equipped with adequate PPE for each shift (4).…”

Section: Resultsmentioning

confidence: 99%

“…Advanced age and pre-existing conditions are risk factors for this functional decline (1,2,8). COVID-19 rehabilitation units can help to increase the number of hospital beds for post-acute care, and thus free up acute beds in intensive or semi-intensive care units for the treatment of COVID-19 or non-COVID-19 patients (in the descending phase of the infection) (3,4,8).…”

mentioning

confidence: 99%

“…Rehabilitation of infectious patients who are still positive for COVID-19 requires complex management regarding hospital facilities, the configuration of medical and nursing staff, together with the availability of personal protective equipment (PPE) (3)(4)(5)(6)(7)(8)(9)(10)(11). Since the beginning of the clinical emergency, the functional rehabilitation of COVID-19 patients, especially those admitted to the ICU, has shown the need for a very high level of clinical assistance.…”

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confidence: 99%

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COVID-19 rehabilitation units are twice as expensive as regular rehabilitation units

et al. 2020

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Many patients admitted to hospitals for Coronavirus Disease 2019 (COVID-19) can suffer from various disabilities, such as cardiorespiratory, motor, cognitive, psychological or neurological. These patients need to benefit from rehabilitation during their hospital stay, even when they are still presenting clinical signs of the infection. It is thus of high importance to setup specialized rehabilitative units for COVID-19 patients. The San Raffaele Hospital of Milan (Italy) created a Unit for rehabilitation of infectious COVID-19 patients. Here, we described the organization needs and costs of such Unit and compared it with the organization and costs of two other rehabilitation Units, already previously in place in the hospital: the Cardiologic and the Motor Rehabilitation Units. We showed that the COVID-19 Rehabilitation Unit had as many care beds as the other units but required twice the amount of workers and equipment, leading to a cost twice superior to the other Units. Objective: The COVID-19 pandemic has caused significant motor, cognitive, psychological, neurological and cardiological disabilities in many infected patients. Functional rehabilitation of infectious CO-VID-19 patients has been implemented in the acute care wards and in appropriate, ad hoc, multidisciplinary COVID-19 rehabilitation units. However, because COVID-19 rehabilitation units are a clinical novelty, clinical and organizational benchmarks are not yet available. The aim of this study is to describe the organizational needs and operational costs of such a unit, by comparing its activity, organization, and costs with 2 other functional rehabilitation units, in San Raffaele Hospital, Milan, Italy. Methods: The 2-month activity of the COVID-19 Rehabilitation Unit at San Raffaele Hospital, Milan, Italy, which was created in response to the emergency need for rehabilitation of COVID-19 patients, was compared with the previous year's activity of the Cardiac Rehabilitation and Motor Rehabilitation Units of the same institute. Results: The COVID-19 Rehabilitation Unit had the same number of care beds as the other units, but required twice the amount of staff and instrumental equipment, leading to a deficit in costs. Discussion: The COVID-19 Rehabilitation Unit was twice as expensive as the 2 other units studied. World health systems are organizing to respond to the pandemic by expanding capacity in acute intensive care and sub-intensive care units. This study shows that COVID-19 rehabilitation units must be organized and equiped according to the clinical and rehabilitative needs of patients, following specific measures to prevent the spread of infection amongs patients and workers.

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“…Worldwide, the practice of neurosurgery has not been immune to the disruption in health care systems caused by the coronavirus disease 2019 (COVID-19) pandemic: elective surgeries have been cancelled, outpatient clinics closed, international meetings postponed, and in many areas, neurosurgeons called on to augment the workforce of clinical departments that cared for patients with COVID-19. 1 , 2 , 3 , 4 , 5 , 6 Several letters to the editor and research articles have previously enumerated changes in neurosurgical education in North America, Europe, and Africa. 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 These data are lacking for Southeast Asian countries.…”

Section: Introductionmentioning

confidence: 99%

Impact of COVID-19 on Neurosurgical Training in Southeast Asia

et al. 2020

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Objective Neurosurgery departments worldwide have been forced to restructure their training programs because of the coronavirus disease 2019 (COVID-19) pandemic. In this study, we describe the impact of COVID-19 on neurosurgical training in Southeast Asia. Methods We conducted an online survey among neurosurgery residents in Indonesia, Malaysia, Philippines, Singapore, and Thailand from May 22 to 31, 2020 using Google Forms. The 33-item questionnaire collected data on elective and emergency neurosurgical operations, ongoing learning activities, and health worker safety. Results A total of 298 of 470 neurosurgery residents completed the survey, equivalent to a 63% response rate. The decrease in elective neurosurgical operations in Indonesia and in the Philippines (median, 100% for both) was significantly greater compared with other countries ( P < 0.001). For emergency operations, trainees in Indonesia and Malaysia had a significantly greater reduction in their caseload (median, 80% and 70%, respectively) compared with trainees in Singapore and Thailand (median, 20% and 50%, respectively; P < 0.001). Neurosurgery residents were most concerned about the decrease in their hands-on surgical experience, uncertainty in their career advancement, and occupational safety in the workplace. Most of the residents ( n = 221, 74%) believed that the COVID-19 crisis will have a negative impact on their neurosurgical training overall. Conclusions An effective national strategy to control COVID-19 is crucial to sustain neurosurgical training and to provide essential neurosurgical services. Training programs in Southeast Asia should consider developing online learning modules and setting up simulation laboratories to allow trainees to systematically acquire knowledge and develop practical skills during these challenging times.

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Letter to the Editor Management of Neurosurgical Patients During the COVID-19 Pandemic

Cited by 6 publications

References 25 publications

Trauma center activity and surge response during the early phase of the COVID-19 pandemic—the Philadelphia story

Trauma center activity and surge response during the early phase of the COVID-19 pandemic—the Philadelphia story

COVID-19 rehabilitation units are twice as expensive as regular rehabilitation units

Impact of COVID-19 on Neurosurgical Training in Southeast Asia

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