Objective
We present the unique administrative issues as well as specific patient and surgeon related challenges and solutions implemented while treating neurosurgical cases during the COVID pandemic vis-à-vis the pre COVID times at our tertiary care center.
Methods
This is a retrospective study comparing the outcome of the neurosurgical patients treated from the beginning of lockdown in India on 25 March 2020 to 30 November 2020 with that of same period in the previous year, 2019.
Results
We had a total of 687 admissions under neurosurgery this year during the study period as compared to 2550 admissions in 2019. The total number of surgeries done under neurosurgery also showed a similar trend with only 654 surgeries in 2020 compared to 3165 surgeries in 2019. During COVID-19 times, a total of 474 patients were operated including both trauma and non-trauma cases. Out of the 50 COVID-19 suspect/ indeterminate patients who were operated upon, 5 patients turned out to be positive for COVID-19. Significant differences were seen in the mortality (p<0.01) and morbidity (p<0.01) among trauma patients on comparing COVID and pre-COVID periods. Similarly, a significant difference was observed in the mortality (p<0.001) and morbidity (p<0.001) in non-trauma patients.
Conclusions
A higher mortality and morbidity during the COVID times is primarily attributable to poorer baseline clinical status. Our experience in this COVID period might not only help us in tackling subsequent waves but also help other institutions in developing world to be better prepared for the same.