Tracking the Volume of Neurosurgical Care During the Coronavirus Disease 2019 Pandemic

Patel, Pious D.; Kelly, Katherine A.; Reynolds, Rebecca A.; Turer, Robert W; Salwi, Sanjana; Rosenbloom, S. Trent; Bonfield, Christopher M.; Naftel, Robert P.

doi:10.1016/j.wneu.2020.06.176

Cited by 49 publications

(49 citation statements)

References 20 publications

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“…Although the COVID period included in this study was longer than the pre-COVID period by 41 days, there was a notable decline of 52.16% in presentations to the outpatient urology clinics in 12 different centers. In line with this finding, a study conducted during the COVID-19 pandemic period showed a 47% decline in presentation to the outpatient neurosurgical clinics and another study found a decline of approximately 56% in presentation to the outpatient orthopedic clinics during COVID-19 pandemic period [8,9]. In a survey with 60 urologists, approximately 96% of the respondents reported a decline in presentation to the outpatient clinics during the COVID-19 pandemic period at varying degrees [10].…”

Section: Discussionmentioning

confidence: 71%

Variations in the Number of Patients Presenting With Andrological Problems During the Coronavirus Disease 2019 Pandemic and the Possible Reasons for These Variations: A Multicenter Study

et al. 2020

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Introduction COVID-19 pandemic caused unprecedented restrictions in outpatient services and surgical practices in urology as in other medical branches as well as in all areas of life. Aim To investigate whether there have been variations in the presentations of male patients with sexual and reproductive health problems to the outpatient urology clinics during the COVID-19 pandemic and to understand the underlying factors for these variations, if any. Methods Male patients aged ≥18 years who presented to the outpatient urology clinics in 12 centers across Turkey from February 1, 2020 to June 1, 2020 were retrospectively evaluated. The patients were divided into two groups: those who presented to the outpatient clinic from February 1, 2020 to March 11, 2020 comprised the “pre-COVID-19 pandemic period” group, whereas those who presented to the outpatient clinic from March 12, 2020 to June 1, 2020 comprised the “COVID-19 pandemic period” group and compared with each other. Main Outcome Measures Number and diagnose of patients presented to urology outpatient clinics Results Andrological problems were detected in 721 of 4,955 male patients included in the study. During the COVID-19 pandemic period, there was a significant increase in andrological diagnosis in these patients compared with the pre-COVID-19 pandemic period [n=293 (17%) vs. n=428 (13.2%), p<0.001, respectively]. Similarly, there was a statistically significant increase in the number of patients diagnosed with male reproductive or sexual health problems during the COVID-19 pandemic period [n=107 (6.2%) vs. n=149 (4.6%), p=0.016 and n=186 (10.8%) vs. n=279 (8.6%), p=0.013, respectively]. The number of patients diagnosed with erectile dysfunction during the pandemic was also significantly higher than the pre-COVID-19 pandemic period [n=150 (8.7%) vs. n=214 (6.6%), p=0.008]. Conclusion Presentations to the outpatient urology clinics due to andrological problems markedly increased during the pandemic period. Although these problems are of multifactorial origin, psychogenic factors are also considered to significantly trigger these problems.

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Section: Discussionmentioning

confidence: 71%

Variations in the Number of Patients Presenting With Andrological Problems During the Coronavirus Disease 2019 Pandemic and the Possible Reasons for These Variations: A Multicenter Study

et al. 2020

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“…The impact of patient volumes related to COVID-19 across the United States and abroad has been tremendous and continues to evolve. This impact extends beyond any single specialty and has not been limited to the specialty of chronic pain [ 13 , 14 ]. During the height of the pandemic, some ambulatory pain clinics were either completely shut down or severely limited in outpatient services.…”

Section: Impact Of Covid On Apcsmentioning

confidence: 99%

Telemedicine and current clinical practice trends in the COVID-19 pandemic

Wahezi

Kohan

Spektor

et al. 2021

Best Practice & Research Clinical Anaesthesiology

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Telemedicine is the medical practice of caring for and treating patients remotely. With the advent of the COVID-19 pandemic, telemedicine has become increasingly prevalent. Although telemedicine was already in practice before the 2020 pandemic, the internet, smartphones, computers and video-conferencing tools have made telemedicine easily accessible and available to almost everyone. However, there are also new challenges that health care providers may not be prepared for, including treating and diagnosing patients without physical contact. We review current trends involving telemedicine, how pandemics such as COVID-19 affect the remote treatment of patients, and key concepts important to health care providers who practice telemedicine.

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“…To avoid delays of necessary treatment in the future, we advocate adequate education of the public and digitalization of medical consultations. We, as well as other authors [ 4 , 20 , 21 ], suppose that such interventions may help oncological and neurosurgical patients in making an informed decision during the pandemic.…”

Section: Discussionmentioning

confidence: 99%

The Demand for Elective Neurosurgery at a German University Hospital during the First Wave of COVID-19

et al. 2020

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Background: Patients’ fear of the coronavirus disease 2019 (COVID-19) may delay inevitable treatment, putting potential benefits at risk. This single-center retrospective study aims to analyze temporal relationships of the first wave of the COVID-19 pandemic in Germany with the number of patients who sought and received elective neurosurgical treatment at a German university hospital. Methods: Daily outpatient numbers (ON) and elective procedures (EP) were recorded at our department between 1 January 2020 and 30 June 2020 (baseline: between 1 January 2019 and 30 June 2019). In patients who received EP, we recorded indication, outcome, and length of stay (LOS). Moving averages of ON (MAON) and of EP were calculated. Data on governmental action taken in response to the pandemic and on coronavirus-positive cases in Germany (CPCG) were superimposed. Exponential and arc tangent curves (ATC) were fitted to the absolute numbers of CPCG. Phase shifts were estimated, and Spearman’s rank correlation coefficient, rho, was calculated between the 2020 MAON and the derivative function of the fitted ATC (DFATC). Wilcoxon rank sum served as statistical test. Significance was assumed with p values of less than 0.05. Results: ON were significantly decreased in April 2020 as compared to April 2019 (p = 0.010). A phase shift between the German lockdown, the DFATC, and the decrease in MAON was not detected, while a phase shift of 10 days between the DFATC and the subsequent increase in MAON was detected. The DFATC was significantly negatively correlated (rho = −0.92, p < 0.0001) to the MAON until 31 March 2020, and, when shifted by 10 days, the DFATC was significantly negatively correlated (rho = −0.87, p < 0.0001) to the MAON from 01 April 2020. EP (p = 0.023), including the subset of non-oncological EP (p = 0.032), were significantly less performed in the first half of 2020 as compared to the first half of 2019. In March and April 2020, we conducted significantly more EP due to motor deficits (p = 0.0267, and less), visual disturbances (p = 0.0488), and spinal instability (p = 0.0012), and significantly less EP due to radicular pain (p = 0.0489), as compared to March and April 2019. LOS ranked significantly higher in patients who received cranial or spinal EP in March and April 2020 as compared to March and April 2019 (p = 0.0497). Significant differences in outcome were not observed. Conclusion: The beginning of the COVID-19 pandemic was correlated to an immediate and significant decrease in ON, and to a significant decrease in the number of EP performed. The subsequent increase in ON was delayed. Adequate measures to promote timely discharge of patients may become increasingly relevant as the pandemic proceeds. Although we observed a shift in the range of indications towards significantly more EP in patients with neurological deficiencies, care should be taken to avoid potentially deleterious delays of necessary elective treatment in future pandemic situations.

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Tracking the Volume of Neurosurgical Care During the Coronavirus Disease 2019 Pandemic

Cited by 49 publications

References 20 publications

Variations in the Number of Patients Presenting With Andrological Problems During the Coronavirus Disease 2019 Pandemic and the Possible Reasons for These Variations: A Multicenter Study

Variations in the Number of Patients Presenting With Andrological Problems During the Coronavirus Disease 2019 Pandemic and the Possible Reasons for These Variations: A Multicenter Study

Telemedicine and current clinical practice trends in the COVID-19 pandemic

The Demand for Elective Neurosurgery at a German University Hospital during the First Wave of COVID-19

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