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Vianna FSL, Neves LL, Testa R, Nassar AP, Peres JHF, da Silva RÁJ, de Paula Sales F, Raglione D, Del Bianco Madureira B, Dalfior L, Malbouisson LMS, Ribeiro U, da Silva JM. Impact of the COVID-19 Pandemic on the Outcomes of Patients Undergoing Oncological Surgeries: CORONAL Study. Ann Surg Oncol 2024:10.1245/s10434-024-15152-9. [PMID: 38530529 DOI: 10.1245/s10434-024-15152-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 02/20/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND The impact of coronavirus disease 2019 (COVID-19) on postoperative recovery from oncology surgeries should be understood for the clinical decision-making. Therefore, this study was designed to evaluate the postoperative cumulative 28-day mortality and the morbidity of surgical oncology patients during the COVID-19 pandemic. METHODS This retrospective cohort study included patients consecutively admitted to intensive care units (ICU) of three centres for postoperative care of oncologic surgeries between March to June 2019 (first phase) and March to June 2020 (second phase). The primary outcome was cumulative 28-day postoperative mortality. Secondary outcomes were postoperative organic dysfunction and the incidence of clinical complications. Because of the possibility of imbalance between groups, adjusted analyses were performed: Cox proportional hazards model (primary outcome) and multiple logistic regression model (secondary outcomes). RESULTS After screening 328 patients, 291 were included. The proportional hazard of cumulative 28-day mortality was higher in the second phase than that in the first phase in the Cox model, with the adjusted hazard ratio of 4.35 (95% confidence interval [CI] 2.15-8.82). The adjusted incidences of respiratory complications (odds ratio [OR] 5.35; 95% CI 1.42-20.11) and pulmonary infections (OR 1.53; 95% CI 1.08-2.17) were higher in the second phase. However, the adjusted incidence of other infections was lower in the second phase (OR 0.78; 95% CI 0.67-0.91). CONCLUSIONS Surgical oncology patients who underwent postoperative care in the intensive care unit during the COVID-19 pandemic had higher hazard of 28-day mortality. Furthermore, these patients had higher odds of respiratory complications and pulmonary infections. Trials registration The study is registered in the Brazilian Registry of Clinical Trials under the code RBR-8ygjpqm, UTN code U1111-1293-5414.
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Affiliation(s)
- Felipe Souza Lima Vianna
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
- Departamento de Pacientes Graves, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | | | - Renato Testa
- Fundação Antonio Prudente- A C Camargo Cancer Center, São Paulo, SP, Brazil
| | | | | | | | | | - Dante Raglione
- Instituto do Câncer do Estado de São Paulo, São Paulo, SP, Brazil
| | | | - Luiz Dalfior
- Instituto do Câncer do Estado de São Paulo, São Paulo, SP, Brazil
| | - Luiz Marcelo Sá Malbouisson
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
- Instituto do Câncer do Estado de São Paulo, São Paulo, SP, Brazil
| | - Ulysses Ribeiro
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
- Instituto do Câncer do Estado de São Paulo, São Paulo, SP, Brazil
| | - João Manoel da Silva
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
- Hospital do Câncer de Barretos- Fundação Pio XII, Barretos, SP, Brazil
- Instituto do Câncer do Estado de São Paulo, São Paulo, SP, Brazil
- Departamento de Pacientes Graves, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
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Teng H, Wang Z, Yang X, Wu X, Chen Z, Wang Z, Chen G. The impact of COVID-19 on clinical outcomes in people undergoing neurosurgery: a systematic review and meta-analysis. Syst Rev 2023; 12:137. [PMID: 37550713 PMCID: PMC10405503 DOI: 10.1186/s13643-023-02291-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 07/17/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND The coronavirus disease-2019 (COVID-19) pandemic has created a global crisis unique to the healthcare system around the world. It also had a profound impact on the management of neurosurgical patients. In our research, we investigated the effect of the COVID-19 pandemic on clinical outcomes in people undergoing neurosurgery, particularly vascular and oncological neurosurgery. METHOD Two investigators independently and systematically searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrail.Gov, and Web of Science to identify relevant studies respecting the criteria for inclusion and exclusion published up to June 30, 2022. The outcomes of our research included mortality rate, length of stay, modified Rankin Score, delay in care, Glasgow outcome scale, and major complications. The risk of bias was assessed using the Methodological Index for Non-randomized Studies (MINORS) checklist. RESULTS Two investigators independently and systematically searched 1378 results from MEDLINE, EMBASE, Cochrane database, ClinicalTrail.Gov, and Web of Science and extracted the detailed data from 13 studies that met the review's eligibility criteria. Two articles reported on patients with intracerebral hemorrhages, five on patients with subarachnoid hemorrhages, four on patients undergoing surgery for neuro-oncology, and in two studies the patients' conditions were unspecified. A total of 26,831 patients were included in our research. The number who died was significantly increased in the COVID-19 pandemic group (OR 1.52, 95% CI 1.36-1.69, P < 0.001). No significant difference was found between the two groups in terms of length of stay (SMD - 0.88, 95% CI - 0.18-0.02, P = 0.111), but it differed between regions, according to our subgroup analysis. CONCLUSION Compared to the pre-pandemic group, the number who died was significantly increased in the COVID-19 pandemic group. Meanwhile, the effect of the pandemic on clinical outcomes in people undergoing neurosurgery might differ in different regions, according to our subgroup analysis.
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Affiliation(s)
- Haiying Teng
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu Province, China
- Suzhou Medical College of Soochow University, Suzhou, 215002, Jiangsu Province, China
| | - Zilan Wang
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu Province, China
| | - Xingyu Yang
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu Province, China
| | - Xiaoxiao Wu
- Suzhou Medical College of Soochow University, Suzhou, 215002, Jiangsu Province, China
| | - Zhouqing Chen
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu Province, China.
| | - Zhong Wang
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu Province, China.
| | - Gang Chen
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu Province, China
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Hughes L, Murphy O, Lenihan M, Mhuircheartaigh RN, Wall TP. Impact of the COVID-19 pandemic on anaesthesia specialty training: a single-centre quantitative analysis. BJA Open 2023; 5:100117. [PMID: 36505902 PMCID: PMC9721281 DOI: 10.1016/j.bjao.2022.100117] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
Background The COVID-19 pandemic disrupted healthcare services worldwide, with a consequent impact on the delivery of medical education and training in all acute care specialties. Anaesthesia training has been challenged by a combination of reduced elective theatre activity, redeployment of trainees to critical care units, and changes in standard anaesthetic practices. Methods The aim of this study was to quantify the impact of COVID-19 on specialist anaesthesia training at a tertiary level teaching hospital in Ireland via a retrospective analysis of data captured by electronic anaesthesia records. The anaesthetic caseloads of trainees in periods before and during the pandemic were analysed along with airway management practices, core procedural skills performed, and critical care rostering. Data relating to 145 anaesthesia trainees were captured during the study periods: pre-pandemic (January 2018 to January 2020) and pandemic (January 2020 to January 2022). Results The mean number of theatre cases logged per trainee in a 6-month period reduced from 156.8 pre-pandemic to 119.2 during the pandemic (23.9% reduction; P<0.0001). Although theatre caseload was reduced, trainees gained additional critical care experience with a significant increase in overall days spent staffing critical care wards. In the theatre setting, the number of arterial lines, central lines, neuraxial blocks, and peripheral nerve blocks performed were significantly reduced during the pandemic. Conclusions Although the COVID-19 pandemic significantly reduced anaesthesia training exposure and increased critical care exposure over an extended period, the overall long-term significance of this alteration in the anaesthesia training experience remains uncertain.
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Affiliation(s)
- Lauren Hughes
- Department of Anaesthesia, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Orla Murphy
- Department of Anaesthesia, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Martin Lenihan
- Department of Anaesthesia, Mater Misericordiae University Hospital, Dublin, Ireland
| | | | - Thomas P. Wall
- Department of Anaesthesia, Mater Misericordiae University Hospital, Dublin, Ireland,University College Dublin, Dublin, Ireland,Corresponding author. Department of Anaesthesia, Mater Misericordiae University Hospital, Dublin, Ireland
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Probert AC, McKinnon LS, Jiang E, Gray RJ, Sivakumar BS, Symes MJ. The impact of COVID-19 on spinal cord injuries and trauma at a tertiary referral centre in Sydney. J Spine Surg 2022; 8:418-425. [PMID: 36605996 PMCID: PMC9808099 DOI: 10.21037/jss-22-46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 09/23/2022] [Indexed: 11/05/2022]
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has yielded far-reaching consequences for individual health systems as well as society. Although several studies have investigated epidemiological trends due to the pandemic-associated restrictions in patients requiring surgery for general surgical, trauma and orthopaedic aetiologies, there has been no assessment of the impact on spinal trauma and surgery in Australia. Thus, the aim of this study was to examine these changes at an Australian level one tertiary referral spinal cord injury (SCI) centre. Methods We performed a retrospective cohort study of patients presenting to this institution with spinal injuries requiring surgery, from two time periods [one prior to the pandemic, and one during]. We analysed demographics, injury mechanism and characteristics, and surgical factors to identify significant differences between the cohorts. Results There were 7.3% fewer spinal operations performed in the COVID-19 affected period. Although patient demographics were unchanged, the total number of emergency operations performed for injuries sustained in a motor vehicle accident decreased by 44% compared to the pre-COVID cohort (P=0.049). The median number of spinal levels affected by injury decreased, and there was a 30% decrease in American Spinal Injury Association (ASIA) type A injuries during the pandemic (P=0.006), with a corresponding increase in ASIA B injuries (P=0.032). Conclusions The pandemic (and its associated social restrictions) has influenced the patterns of spinal injuries treated at this tertiary level institute during this time. We observed an overall reduction in the volume of emergency procedures performed during the pandemic. There was no change in the proportion of spinal cord injuries when compared to the pre-pandemic period; however, the severity of spinal cord injuries was diminished during the pandemic.
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Affiliation(s)
- Annabel C. Probert
- Department of Orthopaedics and Trauma Surgery, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Luke S. McKinnon
- Department of Orthopaedics and Trauma Surgery, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Eric Jiang
- Department of Orthopaedics and Trauma Surgery, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Randolph J. Gray
- Department of Orthopaedics and Trauma Surgery, Royal North Shore Hospital, St Leonards, NSW, Australia;,Department of Orthopaedics and Spinal surgery, Westmead Hospital, Sydney, NSW, Australia
| | - Brahman S. Sivakumar
- Department of Orthopaedics and Trauma Surgery, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Michael J. Symes
- Department of Orthopaedics and Trauma Surgery, Royal North Shore Hospital, St Leonards, NSW, Australia
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Lau VI, Dhanoa S, Cheema H, Lewis K, Geeraert P, Lu D, Merrick B, Vander Leek A, Sebastianski M, Kula B, Chaudhuri D, Agarwal A, Niven DJ, Fiest KM, Stelfox HT, Zuege DJ, Rewa OG, Bagshaw SM. Non-COVID outcomes associated with the coronavirus disease-2019 (COVID-19) pandemic effects study (COPES): A systematic review and meta-analysis. PLoS One 2022; 17:e0269871. [PMID: 35749400 PMCID: PMC9231780 DOI: 10.1371/journal.pone.0269871] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 05/29/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND As the Coronavirus Disease-2019 (COVID-19) pandemic continues, healthcare providers struggle to manage both COVID-19 and non-COVID patients while still providing high-quality care. We conducted a systematic review/meta-analysis to describe the effects of the COVID-19 pandemic on patients with non-COVID illness and on healthcare systems compared to non-pandemic epochs. METHODS We searched Ovid MEDLINE/EMBASE/Cochrane Database of Systematic Reviews/CENTRAL/CINAHL (inception to December 31, 2020). All study types with COVID-pandemic time period (after December 31, 2019) with comparative non-pandemic time periods (prior to December 31, 2019). Data regarding study characteristics/case-mix/interventions/comparators/ outcomes (primary: mortality; secondary: morbidity/hospitalizations/disruptions-to-care. Paired reviewers conducted screening and abstraction, with conflicts resolved by discussion. Effect sizes for specific therapies were pooled using random-effects models. Risk of bias was assessed by Newcastle-Ottawa Scale, with evidence rating using GRADE methodology. RESULTS Of 11,581 citations, 167 studies met eligibility. Our meta-analysis showed an increased mortality of 16% during the COVID pandemic for non-COVID illness compared with 11% mortality during the pre-pandemic period (RR 1.38, 95% CI: 1.28-1.50; absolute risk difference: 5% [95% CI: 4-6%], p<0.00001, very low certainty evidence). Twenty-eight studies (17%) reported significant changes in morbidity (where 93% reported increases), while 30 studies (18%) reported no significant change (very low certainty). Thirty-nine studies (23%) reported significant changes in hospitalizations (97% reporting decreases), while 111 studies (66%) reported no significant change (very low certainty). Sixty-two studies (37%) reported significant disruptions in standards-to-care (73% reporting increases), while 62 studies (37%) reported no significant change (very low certainty). CONCLUSIONS There was a significant increase in mortality during the COVID pandemic compared to pre-pandemic times for non-COVID illnesses. When significant changes were reported, there was increased morbidity, decreased hospitalizations and increased disruptions in standards-of-care. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020201256 (Sept 2, 2020).
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Affiliation(s)
- Vincent Issac Lau
- Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Alberta, Canada
| | - Sumeet Dhanoa
- Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Alberta, Canada
| | - Harleen Cheema
- Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Alberta, Canada
| | - Kimberley Lewis
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
- Division of Critical Care Medicine, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Patrick Geeraert
- Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Alberta, Canada
| | - David Lu
- Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Alberta, Canada
| | - Benjamin Merrick
- Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Alberta, Canada
| | - Aaron Vander Leek
- Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Alberta, Canada
| | - Meghan Sebastianski
- Alberta Strategy for Patient-Orientated Research Knowledge Translation Platform, University of Alberta, Edmonton, Alberta, Canada
| | - Brittany Kula
- Division of Infectious Disease, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Alberta, Canada
| | - Dipayan Chaudhuri
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
- Division of Critical Care Medicine, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Arnav Agarwal
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, General Internal Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Daniel J Niven
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, and Alberta Health Services, Calgary, Alberta, Canada
- Critical Care Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada
| | - Kirsten M Fiest
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, and Alberta Health Services, Calgary, Alberta, Canada
- Critical Care Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada
| | - Henry T Stelfox
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, and Alberta Health Services, Calgary, Alberta, Canada
- Critical Care Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada
- O'Brien Institute of Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Danny J Zuege
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, and Alberta Health Services, Calgary, Alberta, Canada
- Critical Care Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada
| | - Oleksa G Rewa
- Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Alberta, Canada
- Critical Care Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Sean M Bagshaw
- Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Alberta, Canada
- Critical Care Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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Jäntti S, Ponkilainen V, Mäntymäki H, Uimonen M, Kuitunen I, Mattila VM. Trends in emergency department visits due to back pain and spine surgeries during the COVID-19 pandemic in Finland. Medicine (Baltimore) 2022; 101:e29496. [PMID: 35687783 PMCID: PMC9276135 DOI: 10.1097/md.0000000000029496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 05/05/2022] [Indexed: 01/04/2023] Open
Abstract
We aim to report the incidences of ED visits due to back pain, hospitalizations, and urgent spine surgeries during the first and second waves of COVID-19 in Finland. The number of emergency department visits and hospitalizations due to back pain as well as urgent spine surgeries in the adult population was collected from hospital discharge registers for the years 2017 through 2019 (reference years) and 2020.This study was conducted at three large Finnish hospitals. The monthly incidence with 95% confidence intervals (CI) of emergency department visits and hospitalizations due to back pain and spine surgeries in the three participating hospitals were calculated and compared by incidence rate ratios (IRR).Visits to ED due to back pain decreased during the pandemic. The incidence of ED visits due to back pain was similar in February (IRR 0.95, CI: 0.82-1.10), but a decrease was seen after lockdown began (March IRR 0.67, CI: 0.57-0.78; April IRR 0.65, CI: 0.56-0.76) compared to the reference years. A second decrease in visits was seen after regional restrictions were implemented in October (IRR 0.88, CI: 0.76-1.02). The most common diagnoses were non-specific back pain, lumbar disk herniation, and back contusion. Incidence of non-specific back pain decreased during the lockdown (March IRR 0.65, CI: 0.55-0.78) and regional restrictions (October IRR 0.83, CI: 0.70-0.98), whereas the rates of other diagnoses remained unchanged, and incidences of hospitalizations and urgent spine surgeries remained stable.A clear decrease in ED visits due to back pain was seen during the first and second waves of the pandemic. This decrease was mainly the result of patients with non-specific back pain avoiding visits to the ED. The incidence of specific back pain, hospitalizations, and urgent spine surgeries remained unchanged during the pandemic.
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Affiliation(s)
- Saara Jäntti
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Ville Ponkilainen
- Department of Surgery, Central Finland Hospital Nova, Hoitajantie 3, Jyväskylä, Finland
| | - Heikki Mäntymäki
- Department of Orthopaedics and Traumatology, Tampere University Hospital, Teiskontie 35, PL2000, Tampere, Finland
| | - Mikko Uimonen
- Department of Surgery, Central Finland Hospital Nova, Hoitajantie 3, Jyväskylä, Finland
| | - Ilari Kuitunen
- Mikkeli Central Hospital, Porrassalmenkatu 35-37, Mikkeli, Finland
- University of Eastern Finland, School of Medicine, Yliopistonranta 1, Kuopio, Finland
| | - Ville M. Mattila
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Orthopaedics and Traumatology, Tampere University Hospital, Teiskontie 35, PL2000, Tampere, Finland
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Damara FA, Muchamad GR, Anton A, Ramdhani AN, Channel IC, Faried A. Epidemiological Pattern of Traumatic Brain Injury in the COVID-19 Pandemic: A Systematic Review and Meta-Analysis. World Neurosurg 2022; 161:e698-e709. [PMID: 35227924 PMCID: PMC8881220 DOI: 10.1016/j.wneu.2022.02.081] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/17/2022] [Accepted: 02/18/2022] [Indexed: 12/12/2022]
Abstract
Background Although the incidence of traumatic brain injury (TBI) has decreased since the beginning of the coronavirus disease 2019 (COVID-19) pandemic and severe acute respiratory syndrome coronavirus 2 is still evolving, the number of TBI cases has still greatly increased in multiple countries. In the present systematic review and meta-analysis, we evaluated the epidemiological characteristics of patients with TBI before and during the COVID-19 pandemic. Methods We conducted a systematic literature search of original studies, short reports, and research letters from databases on studies that contained data about the severity, mortality, presence of neurological deficits, radiological diagnosis, cause of injury, and type of management of TBI during a specified period within the pandemic compared with before the pandemic. Results A total of 18,490 subjects from 13 studies were included in the present study. The results of the meta-analysis showed a higher TBI mortality rate during the COVID-19 pandemic in the low-to-middle income countries (odds ratio, 1.65; 95% confidence interval, 1.12–2.41; P < 0.05; I2 = 40.8%; P = 0.18). The proportion of subdural hemorrhage was decreased, and the proportion of subarachnoid hemorrhage was increased in low- to middle-income and high-income countries, respectively. The proportion of assaults as the cause of TBI had increased during the pandemic (odds ratio, 1.40; 95% confidence interval, 1.06–1.86; P = 0.02; I2 = 20.8%; P = 0.28). We did not find any significant differences in the incidence of surgical intervention for TBI during the pandemic. Conclusions Our results have indicated that during the COVID-19 pandemic, the TBI mortality rate had increased in low- to middle-income countries. The rate of assault as the cause of TBI had also increased during the pandemic.
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Affiliation(s)
- Fachreza Aryo Damara
- Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Galih Ricci Muchamad
- Department of Medicine, Faculty of Medicine, Universitas Diponegoro - Kariadi General Hospital, Semarang, Indonesia
| | - Anton Anton
- Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Alfya Nandika Ramdhani
- Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Ivan Christian Channel
- Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Ahmad Faried
- Department of Neurosurgery, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, Indonesia.
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Zhang JK, Del Valle A, Ivankovic S, Patel N, Alexopoulos G, Khan M, Durrani S, Patel M, Tecle NE, Sujijantarat N, Jenson AV, Zammar SG, Huntoon K, Goulart CR, Wilkinson BM, Bhimireddy S, Britz GW, DiLuna M, Prevedello DM, Dinh DH, Mattei TA. Educational impact of early COVID-19 operating room restrictions on neurosurgery resident training in the United States: A multicenter study. N Am Spine Soc J 2022; 9:100104. [PMID: 35224520 PMCID: PMC8856749 DOI: 10.1016/j.xnsj.2022.100104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 02/14/2022] [Accepted: 02/14/2022] [Indexed: 12/19/2022]
Abstract
Background The coronavirus (COVID-19) pandemic has caused unprecedented suspensions of neurosurgical elective surgeries, a large proportion of which involve spine procedures. The goal of this study is to report granular data on the impact of early COVID-19 pandemic operating room restrictions upon neurosurgical case volume in academic institutions, with attention to its secondary impact upon neurosurgery resident training. This is the first multicenter quantitative study examining these early effects upon neurosurgery residents caseloads. Methods A retrospective review of neurosurgical caseloads among seven residency programs between March 2019 and April 2020 was conducted. Cases were grouped by ACGME Neurosurgery Case Categories, subspecialty, and urgency (elective vs. emergent). Residents caseloads were stratified into junior (PGY1-3) and senior (PGY4-7) levels. Descriptive statistics are reported for individual programs and pooled across institutions. Results When pooling across programs, the 2019 monthly mean (SD) case volume was 214 (123) cases compared to 217 (129) in January 2020, 210 (115) in February 2020, 157 (81), in March 2020 and 82 (39) cases April 2020. There was a 60% reduction in caseload between April 2019 (207 [101]) and April 2020 (82 [39]). Adult spine cases were impacted the most in the pooled analysis, with a 66% decrease in the mean number of cases between March 2020 and April 2020. Both junior and senior residents experienced a similar steady decrease in caseloads, with the largest decreases occurring between March and April 2020 (48% downtrend). Conclusions Results from our multicenter study reveal considerable decreases in caseloads in the neurosurgical specialty with elective adult spine cases experiencing the most severe decline. Both junior and senior neurosurgical residents experienced dramatic decreases in case volumes during this period. With the steep decline in elective spine cases, it is possible that fellowship directors may see a disproportionate increase in spine fellowships in the coming years. In the face of the emerging Delta and Omicron variants, programs should pay attention toward identifying institution-specific deficiencies and developing plans to mitigate the negative educational effects secondary to such caseloads reduction.
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Affiliation(s)
- Justin K Zhang
- Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, 63104, US
| | - Armando Del Valle
- Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, 63104, US
| | - Sven Ivankovic
- Department of Neurological Surgery, University of Illinois College of Medicine Peoria, Peoria, Illinois, 61605, US
| | - Niel Patel
- Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, 63104, US
| | - Georgios Alexopoulos
- Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, 63104, US
| | - Maheen Khan
- Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, 63104, US
| | - Sulaman Durrani
- Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, 63104, US
| | - Mayur Patel
- Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, 63104, US
| | - Najib El Tecle
- Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, 63104, US
| | | | - Amanda V Jenson
- Department of Neurosurgery, Houston Methodist Neurological Institute, Houston, Texas, 77030, US
| | - Samer G Zammar
- Department of Neurosurgery, Penn State College of Medicine, Hershey, Pennsylvania, 17033, US
| | - Kristin Huntoon
- Department of Neurosurgery, The Ohio State University, Columbus, Ohio, 43210, USA
| | - Carlos R Goulart
- Department of Neurosurgery, SUNY Upstate Medical University, Syracuse, New York, 13210, US
| | - Brandon M Wilkinson
- Department of Neurosurgery, SUNY Upstate Medical University, Syracuse, New York, 13210, US
| | - Sujit Bhimireddy
- Department of Neurological Surgery, University of Illinois College of Medicine Peoria, Peoria, Illinois, 61605, US
| | - Gavin W Britz
- Department of Neurosurgery, Houston Methodist Neurological Institute, Houston, Texas, 77030, US
| | - Michael DiLuna
- Department of Neurosurgery, Yale University, New Haven, Connecticut, 06510, USA
| | - Daniel M Prevedello
- Department of Neurosurgery, The Ohio State University, Columbus, Ohio, 43210, USA
| | - Dzung H Dinh
- Department of Neurological Surgery, University of Illinois College of Medicine Peoria, Peoria, Illinois, 61605, US
| | - Tobias A Mattei
- Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, 63104, US
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9
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Ferry AM, Dibbs RP, Ward A, Velez V, Ringold SL, Archer NM, Winebar JM, Andropoulos DB, Hollier Jr LH. Operational Effect of COVID-19 on Surgical Care at a Tertiary Pediatric Hospital. AORN J 2022; 115:147-155. [PMID: 35084769 PMCID: PMC9011624 DOI: 10.1002/aorn.13604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/17/2021] [Accepted: 04/12/2021] [Indexed: 11/12/2022]
Abstract
The detrimental effects of the coronavirus disease 2019 (COVID‐19) pandemic have profoundly disrupted surgical care at health care facilities worldwide. At our tertiary pediatric hospital, we made substantial adjustments to surgical suite utilization and staff member scheduling to account for reductions in surgical volume, increased demand for staff members in other sectors of the hospital, and the highly infectious properties of the virus. Perioperative leaders took advantage of the pandemic’s disruption to clinical activities to design and implement a new procedure‐scheduling process to rectify the inefficiencies that had accumulated as the previous system evolved. The implementation of said directives was largely facilitated by establishing communication with all involved parties for their input and feedback throughout the process. Although COVID‐19 has had varying effects on procedural operations across pediatric health care facilities, we believe our institutional response to the disruptive forces of COVID‐19 is of benefit to pediatric hospitals worldwide.
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Saeedi R, Bajunaid K, Sabbagh AJ, Alomar S, Alyousef M, Baeesa SS. Pattern of neurosurgical practice at a university hospital in KSA during COVID-19 pandemic. J Taibah Univ Med Sci 2021; 17:448-453. [PMID: 34924921 PMCID: PMC8669889 DOI: 10.1016/j.jtumed.2021.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/26/2021] [Accepted: 10/28/2021] [Indexed: 11/20/2022] Open
Abstract
Objective The coronavirus disease 2019 (COVID-19) pandemic affected both medical services as well as hospital admissions. Scholars have attempted to study the effect of the pandemic on the services of multiple specialities. In this study, we aim to examine the pandemic's impact on the neurosurgical service provided at the King Abdulaziz University Hospital in Jeddah over an eight-month period. Methods In this retrospective, single-centre case series study, we included all the consecutive neurosurgical patients who underwent a surgical intervention in the 8-month period starting on 3rd March, 2020 and ending on 3rd November, 2020. The demographics, diagnosis, surgery type, priority category, and mortality data of the patients were collected. Results A total of 147 patients underwent surgery during the study period. The mean age was 30.8 years. Forty-nine percent of the study population were men. Oncology (31.3%) and hydrocephalus (23.8%) recorded the highest number of cases. More than half of the cases were Priority 1 (immediate and within 24 h). The mortality rate was 4.1% among all the performed cases. Conclusion By describing this local neurosurgical experience during the COVID-19 pandemic, we hope to bring out some of the difficulties we encountered and improve what we learned during the pandemic.
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Affiliation(s)
- Rothaina Saeedi
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, KSA
| | - Khalid Bajunaid
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of Jeddah, Jeddah, KSA
| | - Abdulrahman J. Sabbagh
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, KSA
| | - Soha Alomar
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, KSA
| | - Mohammed Alyousef
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, KSA
| | - Saleh S. Baeesa
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, KSA
- Corresponding address: Division of Neurosurgery, Faculty of Medicine, King Abdulaziz University, P.O. Box 80215, Jeddah 21589, KSA.
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11
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Mehl SC, Loera JM, Shah SR, Vogel AM, Fallon SC, Glover CD, Monson LA, Enochs JA, Hollier LH, Lopez ME. Favorable postoperative outcomes for children with COVID-19 infection undergoing surgical intervention: Experience at a free-standing children's hospital. J Pediatr Surg 2021; 56:2078-2085. [PMID: 33581882 PMCID: PMC7838581 DOI: 10.1016/j.jpedsurg.2021.01.033] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 01/13/2021] [Accepted: 01/23/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Current literature has shown that adult patients with perioperative Coronavirus Disease-2019 (COVID-19) have increased rates of postoperative morbidity and mortality. We hypothesized that children with COVID-19 have favorable postoperative outcomes compared to the reported adult experience. METHODS We performed a retrospective cohort study for children with a confirmed preoperative COVID-19 diagnosis from April 1st, 2020 to August 15th, 2020 at a free-standing children's hospital. Primary outcomes evaluated were postoperative complications, readmissions, reoperations, and mortality within 30 days of operation. Secondary outcomes included hospital resource utilization, hospital length of stay, and postoperative oxygen support. RESULTS A total of 66 children with preoperative confirmed COVID-19 were evaluated with median age of 9.5 years (interquartile range (IQR) 5-14) with 65% male and 70% Hispanic White. Sixty-five percent of patients had no comorbidities, with abdominal pain identified as the most common preoperative symptom (65%). Twenty-three percent of patients presented with no COVID-19 related symptoms. Eighty-two percent of patients had no preoperative chest imaging and 98% of patients did not receive preoperative oxygen support. General pediatric surgeons performed the majority of procedures (68%) with the most common diagnosis appendicitis (47%). Forty-one percent of patients were discharged the same day as surgery with 9% of patients utilizing postoperative intensive care unit resources and only 5% receiving postoperative invasive mechanical ventilation. Postoperative complications (7%), readmission (6%), and reoperation (6%) were infrequent, with no mortality. CONCLUSION COVID-19+ children requiring surgery have a favorable postoperative course and short-term outcomes compared to the reported adult experience. TYPE OF STUDY Prognosis Study. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Steven C. Mehl
- Department of Surgery, Baylor College of Medicine, Houston, TX, United States,Michael E. DeBakey Department of Surgery, Division of Pediatric Surgery, Baylor College of Medicine, Texas Children's Hospital, 6701 Fannin Street, Suite 1210, Houston, TX 77030, United States
| | - Jackquelin M. Loera
- Department of Surgery, Baylor College of Medicine, Houston, TX, United States
| | - Sohail R. Shah
- Department of Surgery, Baylor College of Medicine, Houston, TX, United States,Michael E. DeBakey Department of Surgery, Division of Pediatric Surgery, Baylor College of Medicine, Texas Children's Hospital, 6701 Fannin Street, Suite 1210, Houston, TX 77030, United States
| | - Adam M. Vogel
- Department of Surgery, Baylor College of Medicine, Houston, TX, United States,Michael E. DeBakey Department of Surgery, Division of Pediatric Surgery, Baylor College of Medicine, Texas Children's Hospital, 6701 Fannin Street, Suite 1210, Houston, TX 77030, United States
| | - Sara C. Fallon
- Department of Surgery, Baylor College of Medicine, Houston, TX, United States,Michael E. DeBakey Department of Surgery, Division of Pediatric Surgery, Baylor College of Medicine, Texas Children's Hospital, 6701 Fannin Street, Suite 1210, Houston, TX 77030, United States
| | - Chris D. Glover
- Department of Pediatric Anesthesiology, Texas Children's Hospital, Houston, TX, United States
| | - Laura A. Monson
- Department of Surgery, Division of Plastic Surgery, Texas Children's Hospital, Houston, TX, United States
| | - Joyce A. Enochs
- Department of Surgery, Perioperative Services, Texas Children's Hospital, Houston, TX, United States
| | - Larry H. Hollier
- Department of Surgery, Division of Plastic Surgery, Texas Children's Hospital, Houston, TX, United States
| | - Monica E. Lopez
- Michael E. DeBakey Department of Surgery, Division of Pediatric Surgery, Baylor College of Medicine, Texas Children's Hospital, 6701 Fannin Street, Suite 1210, Houston, TX 77030, United States,Corresponding author
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de Macêdo Filho LJ, Aragão ACA, dos Santos VTD, Galvão LB, Shlobin NA, De Biase G, Suarez-Meade P, Almeida JPC, Quinones-Hinojosa A, de Albuquerque LA. Impact of COVID-19 on Neurosurgery in Brazil's Health System: The Reality of a Developing Country Affected by the Pandemic. World Neurosurg 2021; 155:e142-e149. [PMID: 34400327 PMCID: PMC8548285 DOI: 10.1016/j.wneu.2021.08.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/05/2021] [Accepted: 08/06/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND The coronavirus disease identified in 2019 (COVID-19) pandemic changed neurosurgery protocols to provide ongoing care for patients while ensuring the safety of health care workers. In Brazil, the rapid spread of the disease led to new challenges in the health system. Neurooncology practice was one of the most affected by the pandemic due to restricted elective procedures and new triage protocols. We aim to characterize the impact of the pandemic on neurosurgery in Brazil. METHODS We analyzed 112 different types of neurosurgical procedures, with special detail in 11 neurooncology procedures, listed in the Brazilian Hospital Information System records in the DATASUS database between February and July 2019 and the same period in 2020. Linear regression and paired t-test analyses were performed and considered statistically significant at P < 0.05. RESULTS There was an overall decrease of 21.5% (28,858 cases) in all neurosurgical procedures, impacting patients needing elective procedures (-42.46%) more than emergency surgery (-5.93%). Neurooncology procedures decreased by 14.89%. Nonetheless, the mortality rate during hospitalization increased by 21.26%. Linear regression analysis in hospitalizations (Slope = 0.9912 ± 0.07431; CI [95%] = 0.8231-1.159) and total cost (Slope = 1.03 ± 0.03501; CI [95%] = 0.9511-1.109) in the 11 different types of neurooncology procedures showed a P < 0.0001. The mean cost per type of procedure showed an 11.59% increase (P = 0.0172) between 2019 and 2020. CONCLUSIONS The COVID-19 pandemic has increased mortality, decreased hospitalizations, and therefore decreased overall costs, despite increased costs per procedure for a variety of neurosurgical procedures. Our study serves as a stark example of the effect of the pandemic on neurosurgical care in settings of limited resources and access to care.
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Affiliation(s)
- Leonardo J.M. de Macêdo Filho
- Department of Neurological Surgery, Mayo Clinic, Jacksonville, Florida, USA,Health Science Center, University of Fortaleza, Fortaleza, Ceará, Brazil,To whom correspondence should be addressed: Leonardo J.M. de Macêdo Filho, M.D
| | | | | | - Lívia B.A. Galvão
- Health Science Center, University of Fortaleza, Fortaleza, Ceará, Brazil
| | - Nathan A. Shlobin
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Gaetano De Biase
- Department of Neurological Surgery, Mayo Clinic, Jacksonville, Florida, USA
| | - Paola Suarez-Meade
- Department of Neurological Surgery, Mayo Clinic, Jacksonville, Florida, USA
| | - Joao Paulo C. Almeida
- Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
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AlMutiri AM, Alsulaimani S, Sabbagh AJ, Bajunaid KM, Tashkandi WA, Baeesa SS. Cervical Spinal Cord Injury During Prone Position Ventilation in the COVID-19 Pandemic. Cureus 2021; 13:e18958. [PMID: 34707947 PMCID: PMC8531578 DOI: 10.7759/cureus.18958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2021] [Indexed: 11/30/2022] Open
Abstract
The prone positioning of patients experiencing acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been proven effective in optimizing oxygenation and lung function. However, such patients may be at risk of developing complications due to the prolonged prone position in intensive critical care. A 45-year-old COVID-19 female, not known with cervical spine disease, presented with progressive severe COVID-19-related hypoxemia that required intensive care unit admission for pulmonary care. She was positioned prone and ventilated for several weeks. She developed a rapidly advanced decreased level of consciousness and flaccid quadriparesis. CT and MRI scans of the cervical spine revealed C4/C5 fracture-dislocation with spinal cord compression in asymptomatic ankylosing spondylitis and focal ossification of a posterior longitudinal ligament. In addition, the patient had severe ARDS-SARS-CoV-2 hemodynamic instability. Surgery was not performed due to her critical condition, and the patient died from multi-organ failure. Patients with underlying cervical spine disease or deformity can be subjected to hyperextension and develop fatigue (stress) spinal fracture, leading to spinal cord compression. To our knowledge, this is the first case of spontaneous cervical spine fracture dislocation in a COVID-19 patient after several weeks in prone position ventilation in ICU. Hence, our case report raises the awareness of the possibility of devastating spinal cord injuries in prone position ventilation during the COVID-19 pandemic and the need for early screening using plain X-rays of these patients for cervical spine disease.
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Affiliation(s)
| | | | | | | | - Wail A Tashkandi
- Critical Care Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Saleh S Baeesa
- Surgery, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
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14
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Bajunaid K, Baeesa S. In Reply to the Letter to the Editor Regarding "Perception of Neurosurgery Residents and Attendings on Online Webinars During COVID-19 Pandemic and Implications on Future Education". World Neurosurg 2021; 154:191. [PMID: 34583485 PMCID: PMC8461639 DOI: 10.1016/j.wneu.2021.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 07/03/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Khalid Bajunaid
- Department of Surgery, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Saleh Baeesa
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
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15
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Naskar R, Baryeh KW, Pavuluri S, Rajagopal T. The changing pattern of acute spinal referrals during primary and secondary waves of the COVID-19 pandemic. Musculoskeletal Care 2021; 20:316-320. [PMID: 34516029 PMCID: PMC8661871 DOI: 10.1002/msc.1589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 08/21/2021] [Indexed: 11/09/2022]
Abstract
INTRODUCTION The COVID-19 pandemic has had a devastating effect on health systems globally. This led to changes in patient access to healthcare particularly spinal services. This study investigates the impact of the pandemic on the volume of patients being referred to and accessing spinal services during both the first and second waves. METHODS All emergency spinal referrals and related hospital attendances to the emergency department in a busy district general hospital were analysed. The data were evaluated at three time points each covering a 3-month period. Data collected included patient demographics, duration and nature of symptoms, reason for referral, clinical and MRI findings, length of stay in hospital, any interventions performed and the follow-up plan. RESULTS There were a total of 316 emergency referrals across the three time periods. The number of referrals fell by 15% between the pre-COVID-19 period and the first wave. Comparing the first and second waves, the number of referrals was increased by 58%. Comparing the second wave to the pre-COVID-19 period, referrals were 34% greater in the second wave (p < 0.005). CONCLUSION We highlight an increase in referrals to our spinal service during the secondary wave, having fallen during the first wave. We hypothesise that the increase in referrals, despite similar restrictions to the first wave, is a result of changing patterns of behaviour due to the fear of contracting COVID during the first wave and difficulty in accessing primary care services in the second wave.
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Affiliation(s)
- Rajib Naskar
- Department of Trauma and Orthopaedics, Royal Berkshire Hospital, Reading, UK
| | - Kwaku W Baryeh
- Department of Trauma and Orthopaedics, Royal Berkshire Hospital, Reading, UK
| | - Sindhu Pavuluri
- Department of Trauma and Orthopaedics, Royal Berkshire Hospital, Reading, UK
| | - Trichy Rajagopal
- Department of Trauma and Orthopaedics, Royal Berkshire Hospital, Reading, UK
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Gandía-González ML, Viñuela-Prieto JM, Barrios L, Alarcón C, Arikan F, Arráez C, Domínguez CJ, Alén JF, Gutiérrez-González R, Horcajadas A, Muñoz Hernández F, Narváez A, Paredes I, Pérez-Alfayate R, Rodríguez de Lope A, Ruiz-Juretschke F, Salge Arrieta FJ, Tejada S, Tamarit M, Topczewski T, Lafuente J. Neurosurgical emergency management during the lockdown period in health care regions in Spain with different COVID-19 impact: lessons learned to improve outcomes on the future waves. Eur J Trauma Emerg Surg 2021. [PMID: 34401937 DOI: 10.1007/s00068-021-01767-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 07/18/2021] [Indexed: 12/02/2022]
Abstract
Background COVID-19 has overloaded health care systems, testing the capacity and response in every European region. Concerns were raised regarding the impact of resources’ reorganization on certain emergency pathology management. The aim of the present study was to assess the impact of the outbreak (in terms of reduction of neurosurgical emergencies) during lockdown in different regions of Spain. Methods We analyzed the impact of the outbreak in four different affected regions by descriptive statistics and univariate comparison with same period of two previous years. These regions differed in their incidence level (high/low) and in the time of excess mortality with respect to lockdown declaration. That allowed us to analyze their influence on the characteristics of neurosurgical emergencies registered for every region. Results 1185 patients from 18 neurosurgical centers were included. Neurosurgical emergencies that underwent surgery dropped 24.41% and 28.15% in 2020 when compared with 2019 and 2018, respectively. A higher reduction was reported for the most affected regions by COVID-19. Non-traumatic spine experienced the most significant decrease in number of cases. Life-threatening conditions did not suffer a reduction in any health care region. Conclusions COVID-19 affected dramatically the neurosurgical emergency management. The most significant reduction in neurosurgical emergencies occurred on those regions that were hit unexpectedly by the pandemic, as resources were focused on fighting the virus. As a consequence, life-threating and non-life-threatening conditions’ mortality raised. Results in regions who had time to prepare for the hit were congruent with an organized and sensible neurosurgical decision-making.
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Tavanaei R, Ahmadi P, Yazdani KO, Zali A, Oraee-Yazdani S. The Impact of the Coronavirus Disease 2019 Pandemic on Neurosurgical Practice and Feasibility of Safe Resumption of Elective Procedures During this Era in a Large Referral Center in Tehran, Iran: An Unmatched Case-Control Study. World Neurosurg 2021; 154:e370-e381. [PMID: 34284156 PMCID: PMC8285939 DOI: 10.1016/j.wneu.2021.07.047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 07/09/2021] [Indexed: 12/23/2022]
Abstract
Objective The coronavirus disease 2019 (COVID-19) pandemic has considerably affected surgical practice. The present study aimed to investigate the effects of the pandemic on neurosurgical practice and the safety of the resumption of elective procedures through implementing screening protocols in a high-volume academic public center in Iran, as one of the countries severely affected by the pandemic. Methods This unmatched case-control study compared 2 populations of patients who underwent neurosurgical procedures between June 1, 2019 and September 1, 2019 and the same period in 2020. In the prospective part of the study, patients who underwent elective procedures were tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection postoperatively to evaluate the viability of our screening protocol. Results Elective and emergency procedures showed significant reduction during the pandemic (59.4%, n = 168 vs. 71.3%, n = 380) and increase (28.7%, n = 153 vs. 40.6%, n = 115, respectively; P = 0.003). The proportional distribution of neurosurgical categories remained unchanged during the pandemic. Poisson regression showed that the reduction in total daily admissions and some categories, including spine, trauma, oncology, and infection were significantly correlated with the pandemic. Among patients who underwent elective procedures, 0 (0.0%) and 26 (16.25%) had positive test results on days 30 and 60 postoperatively, respectively. Overall mortality was comparable between the pre–COVID-19 and COVID-19 periods, yet patients with concurrent SARS-CoV-2 infection showed substantially higher mortality (65%). Conclusions By implementing safety and screening protocols with proper resource allocation, the emergency care capacity can be maintained and the risk minimized of hospital-acquired SARS-CoV-2 infection, complications, and mortality among neurosurgical patients during the pandemic. Similarly, for elective procedures, according to available resources, hospital beds can be allocated for patients with a higher risk of delayed hospitalization and those who are concerned about the risk of hospital-acquired infection can be reassured.
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Affiliation(s)
- Roozbeh Tavanaei
- Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pooria Ahmadi
- Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kaveh Oraii Yazdani
- Department of Cardiovascular Diseases, Zahedan University of Medical Science, Zahedan, Iran
| | - Alireza Zali
- Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Oraee-Yazdani
- Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Kattan AE, Mortada H, Alzaidi S, Gelidan AG. Perceptions of Saudi Plastic Surgery Residents and Attendings of Online Education during the COVID-19 Pandemic. Plast Reconstr Surg Glob Open 2021; 9:e3658. [PMID: 34168946 PMCID: PMC8219255 DOI: 10.1097/gox.0000000000003658] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/29/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND The world has faced an unprecedented challenge in controlling the spread of COVID-19-a rapid reshaping of the healthcare system and education was inevitable. Consequently, residency programs adopted e-learning as a social distancing tool for the continuity of the learning process. In this study, we explore the opinions and perspectives of plastic surgery attending doctors and residents on the implications of e-learning. METHODS After obtaining ethical approval, this cross-sectional study was conducted electronically between October and December 2020 among plastic surgery residents and board-certified plastic surgeons in Saudi Arabia. Participants completed a validated, anonymous, self-administered questionnaire. The questionnaire gathered participants' demographic data, perceptions of online webinars, and audiovisual evaluations. Finally, we compared traditional (in-person) teaching with online webinars. The analysis was performed at a 95% confidence interval using the Statistical Package for Social Sciences (SPSS), version 23.0 (IBM, Armonk, N.Y.). RESULTS A total of 61 responses were included in this study. The majority of respondents (78.7%) were comfortable during webinars, with 38 (62.3%) believing they should supplement traditional teaching methods. Overall, 50.8% were satisfied with the webinars. However, 37.7% were neutral. Most believed that the webinars increased their clinical (67.2%) and surgical skills (67.2%) to reasonable levels. CONCLUSIONS Online education provided an excellent educational tool as a viable option to supplement traditional face-to-face training, with most residents being satisfied, supporting the use of this educational tool. More objective research is required to refine existing online plastic surgery teaching methods while creating novel distance e-learning approaches for the future.
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Affiliation(s)
- Abdullah E. Kattan
- From the Division of Plastic Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Hatan Mortada
- Division of Plastic Surgery, Department of Surgery, King Saud University Medical City, King Saud University and Department of Plastic Surgery & Burn Unit, King Saud Medical City, Riyadh, Saudi Arabia
| | - Salman Alzaidi
- Plastic and Reconstructive Surgery, King Faisal Medical Complex, Taif, Saudi Arabia
| | - Adnan G. Gelidan
- From the Division of Plastic Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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19
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Goyal N, Gupta K, Chaturvedi J, Swain SK, Tomy A. Getting Neurosurgery Services Back on Its Feet: "Learning to Live" with COVID-19. Asian J Neurosurg 2021; 16:340-348. [PMID: 34268162 PMCID: PMC8244690 DOI: 10.4103/ajns.ajns_497_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/23/2021] [Accepted: 02/24/2021] [Indexed: 12/12/2022] Open
Abstract
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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Affiliation(s)
- Nishant Goyal
- Departments of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Kanav Gupta
- Department of Nursing, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Jitender Chaturvedi
- Department of Nursing, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Srikant Kumar Swain
- Department of Nursing, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Akhil Tomy
- Department of Nursing, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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20
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Azab MA, Azzam AY. Impact of COVID-19 pandemic on the management of glioma patients around the world. An evidence-based review. Brain Disord 2021; 2:100012. [PMID: 33997826 PMCID: PMC8106822 DOI: 10.1016/j.dscb.2021.100012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 05/08/2021] [Indexed: 02/06/2023] Open
Abstract
Background The coronavirus pandemic has affected many health care services worldwide since the emergence of the first case in Wuhan. Surgical neuro-oncology care is a fundamental part of hospital services, making it susceptible to strategic changes amid the COVID-19 pandemic. Methods An electronic search on several databases (PubMed/Medline, Scopus, and Google Scholar) from the beginning of the pandemic to the end of 2020, each paper was reviewed independently. The publication inclusion and exclusion criteria were done using Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Results Eight studies were found to be eligible for our meta-analysis. Most of the studies were on a retrospective basis, except one which was retrospective and prospective. An overall of 951 glioma patients’ were included for surgical admission from the beginning of the pandemic until 2020. Seventy-four patients' had mortality outcomes, and 250 patients had complications for both surgical admitted and non-surgical admitted purposes. Conclusions To our knowledge, we made the first systematic review and meta-analysis regarding the management of glioma patients’ during the pandemic of COVID-19. Our main findings are that the number of surgical admissions for glioma patients’ did not significantly differ between COVID-19 negative and COVD-19 positive cases; however, surprisingly, we found that both overall complications and mortality outcomes were more significant COVID-19 negative patients’ from the reported studies.
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Affiliation(s)
- Mohammed A Azab
- Department of Neurosurgery, Cairo University Faculty of Medicine, Cairo, Egypt
| | - Ahmed Y Azzam
- October 6 University Faculty of Medicine, Giza, Egypt
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21
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Kilgore MD, Scullen T, Mathkour M, Dindial R, Carr C, Zeoli T, Werner C, Kahn L, Bui CJ, Keen JR, Maulucci CM, Dumont AS. Effects of the COVID-19 Pandemic on Operative Volume and Residency Training at Two Academic Neurosurgery Centers in New Orleans. World Neurosurg 2021; 151:e68-e77. [PMID: 33812067 DOI: 10.1016/j.wneu.2021.03.122] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/23/2021] [Accepted: 03/24/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Medical subspecialties including neurosurgery have seen a dramatic shift in operative volume in the wake of the coronavirus disease 2019 (COVID-19) pandemic. The goal of this study was to quantify the effects of the COVID-19 pandemic on operative volume at 2 academic neurosurgery centers in New Orleans, Louisiana, USA from equivalent periods before and during the COVID-19 pandemic. METHODS A retrospective review was conducted analyzing neurosurgical case records for 2 tertiary academic centers from March to June 2020 and March to June 2019. The records were reviewed for variables including institution and physician coverage, operative volume by month and year, cases per subspecialty, patient demographics, mortality, and morbidity. RESULTS Comparison of groups showed a 34% reduction in monthly neurosurgical volume per institution during the pandemic compared with earlier time points, including a 77% decrease during April 2020. There was no change in mortality and morbidity across institutions during the pandemic. CONCLUSIONS The COVID-19 pandemic has had a significant impact on neurosurgical practice and will likely continue to have long-term effects on patients at a time when global gross domestic products decrease and relative health expenditures increase. Clinicians must anticipate and actively prepare for these impacts in the future.
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Affiliation(s)
- Mitchell D Kilgore
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA
| | - Tyler Scullen
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA; Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA
| | - Mansour Mathkour
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA; Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA; Neurosurgery Division, Department of Surgery, Jazan University, Jazan, Kingdom of Saudi Arabia.
| | - Rishawn Dindial
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA
| | - Christopher Carr
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA
| | - Tyler Zeoli
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA
| | - Cassidy Werner
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA
| | - Lora Kahn
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA; Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA
| | - Cuong J Bui
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA; Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA
| | - Joseph R Keen
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA; Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA
| | - Christopher M Maulucci
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA; Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA
| | - Aaron S Dumont
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA; Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA
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22
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Goyal N, Chandra PP, Raheja A, Sardhara J. Letter to the Editor Regarding "Early Effects of COVID-19 Pandemic on Neurosurgical Training in the United States: A Case Volume Analysis of 8 Programs". World Neurosurg 2021; 146:411-3. [PMID: 33607741 DOI: 10.1016/j.wneu.2020.10.162] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 10/29/2020] [Indexed: 12/23/2022]
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23
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Goyal N, Venkataram T, Dash C, Chandra PP. Letter to the Editor Regarding "Impact of COVID-19 on Neurosurgical Training in Southeast Asia". World Neurosurg 2021; 146:424-426. [PMID: 33607746 PMCID: PMC7884233 DOI: 10.1016/j.wneu.2020.10.043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 10/07/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Nishant Goyal
- Department of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, India.
| | - Tejas Venkataram
- Department of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, India
| | - Chinmaya Dash
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhubaneshwar, India
| | - P Prarthana Chandra
- Department of Neurosurgery, Hamdard Institute of Medical Sciences & Research, New Delhi, India
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Goyal N, Swain SK, Sardhara J, Raheja A. Letter to the Editor Regarding "'Staying Home'-Early Changes in Patterns of Neurotrauma in New York City During the COVID-19 Pandemic". World Neurosurg 2021; 146:407-9. [PMID: 33607739 DOI: 10.1016/j.wneu.2020.10.165] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 10/30/2020] [Indexed: 12/23/2022]
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25
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Goyal N, Chaturvedi J, Chandra PP, Raheja A. Letter to the Editor Regarding "Neurosurgery Services in Dr. Sardjito General Hospital, Yogyakarta, Indonesia, During the COVID-19 Pandemic: Experience from a Developing Country". World Neurosurg 2021; 146:415-416. [PMID: 33607743 PMCID: PMC7884255 DOI: 10.1016/j.wneu.2020.10.117] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 10/23/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Nishant Goyal
- Department of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, India.
| | - Jitender Chaturvedi
- Department of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, India
| | - P Prarthana Chandra
- Department of Neurosurgery, Hamdard Institute of Medical Sciences & Research, New Delhi, India
| | - Amol Raheja
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
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Abd-Alrazaq A, Schneider J, Mifsud B, Alam T, Househ M, Hamdi M, Shah Z. A Comprehensive Overview of the COVID-19 Literature: Machine Learning-Based Bibliometric Analysis. J Med Internet Res 2021; 23:e23703. [PMID: 33600346 PMCID: PMC7942394 DOI: 10.2196/23703] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/14/2020] [Accepted: 11/24/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Shortly after the emergence of COVID-19, researchers rapidly mobilized to study numerous aspects of the disease such as its evolution, clinical manifestations, effects, treatments, and vaccinations. This led to a rapid increase in the number of COVID-19-related publications. Identifying trends and areas of interest using traditional review methods (eg, scoping and systematic reviews) for such a large domain area is challenging. OBJECTIVE We aimed to conduct an extensive bibliometric analysis to provide a comprehensive overview of the COVID-19 literature. METHODS We used the COVID-19 Open Research Dataset (CORD-19) that consists of a large number of research articles related to all coronaviruses. We used a machine learning-based method to analyze the most relevant COVID-19-related articles and extracted the most prominent topics. Specifically, we used a clustering algorithm to group published articles based on the similarity of their abstracts to identify research hotspots and current research directions. We have made our software accessible to the community via GitHub. RESULTS Of the 196,630 publications retrieved from the database, we included 28,904 in our analysis. The mean number of weekly publications was 990 (SD 789.3). The country that published the highest number of COVID-19-related articles was China (2950/17,270, 17.08%). The highest number of articles were published in bioRxiv. Lei Liu affiliated with the Southern University of Science and Technology in China published the highest number of articles (n=46). Based on titles and abstracts alone, we were able to identify 1515 surveys, 733 systematic reviews, 512 cohort studies, 480 meta-analyses, and 362 randomized control trials. We identified 19 different topics covered among the publications reviewed. The most dominant topic was public health response, followed by clinical care practices during the COVID-19 pandemic, clinical characteristics and risk factors, and epidemic models for its spread. CONCLUSIONS We provide an overview of the COVID-19 literature and have identified current hotspots and research directions. Our findings can be useful for the research community to help prioritize research needs and recognize leading COVID-19 researchers, institutes, countries, and publishers. Our study shows that an AI-based bibliometric analysis has the potential to rapidly explore a large corpus of academic publications during a public health crisis. We believe that this work can be used to analyze other eHealth-related literature to help clinicians, administrators, and policy makers to obtain a holistic view of the literature and be able to categorize different topics of the existing research for further analyses. It can be further scaled (for instance, in time) to clinical summary documentation. Publishers should avoid noise in the data by developing a way to trace the evolution of individual publications and unique authors.
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Affiliation(s)
- Alaa Abd-Alrazaq
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Jens Schneider
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Borbala Mifsud
- College of Health and Life Sciences, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Tanvir Alam
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Mowafa Househ
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Mounir Hamdi
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Zubair Shah
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
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Hameed NUF, Ma Y, Zhen Z, Wu S, Feng R, Li W, Huang G, Wu J, Chen Z. Impact of a pandemic on surgical neuro-oncology-maintaining functionality in the early phase of crisis. BMC Surg 2021; 21:40. [PMID: 33461509 PMCID: PMC7812331 DOI: 10.1186/s12893-021-01055-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 01/07/2021] [Indexed: 02/06/2023] Open
Abstract
Background The Coronavirus disease 2019 (COVID-19) pandemic has extraordinarily impacted global healthcare. Neuro-oncological surgery units have peculiar features that make them highly relevant in the strategic reaction to the pandemic. In this Chinese Society of Neuro-Oncology (CSNO) initiated survey, we appraise the changes implemented in neuro-oncological surgery hospitals across different Asian countries and provide expert recommendations for responses at different stages of the pandemic. Methods We performed a 42-question survey of the early experience of neuro-oncological surgery practice in hospitals across different Asian countries on April 1, 2020, with responses closed on April 18, 2020. Results 144 hospitals completed the questionnaire. Most were in WHO post-peak phase of the pandemic and reported a median reduction in neuro-oncological surgery volume of 25–50%. Most (67.4%) resumed elective surgery in only COVID-19 negative patients;11.1% performed only emergency cases irrespective of COVID-19 status;2.1% suspended all surgical activity. Ninety-one (63.2%) relocated personnel from neurosurgery to other departments. Fifty-two (36.1%) hospitals suspended post-operative adjuvant therapy and 94 (65.2%) instituted different measures to administer post-operative adjuvant therapy. Majority (59.0%) of the hospitals suspended research activity. Most (70%) respondents anticipate that current neurosurgery restrictions will continue to remain for > 1 month. Conclusions Majority of the respondents to our survey reported reduced neuro-oncological surgery activity, policy modification, personnel reallocation, and curtailment of educational/research activities in response to the COVID-19 pandemic. The persistent widespread interruption of surgical neuro-oncology in even post-peak phases of the pandemic raises serious concerns about the long-term impact of the pandemic on neuro-oncological patients and highlights the essence of timely measures for pandemic preparedness, patient triage, and workforce protection.
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Affiliation(s)
- N U Farrukh Hameed
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, 201206, China
| | - Yixin Ma
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, 201206, China
| | - Zili Zhen
- Department of General Surgery, Jinshan Hospital, Fudan University, Shanghai, 201206, China
| | - Shuai Wu
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, 201206, China
| | - Rui Feng
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, 201206, China
| | - Weiping Li
- Department of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518035, China
| | - Guodong Huang
- Department of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518035, China
| | - Jinsong Wu
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, 201206, China
| | - Zhongping Chen
- Department of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518035, China.
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28
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Goyal N, Swain SK, Gupta K, Chaturvedi J, Arora RK, Sharma SK. "Locked up inside home" - Head injury patterns during coronavirus disease of 2019 pandemic. Surg Neurol Int 2020; 11:395. [PMID: 33274111 PMCID: PMC7708961 DOI: 10.25259/sni_675_2020] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 10/30/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND As citizens have been forced to stay home during coronavirus disease of 2019 (COVID-19) pandemic, the crisis created unique trends in the neurotrauma patterns with changes in mode, severity, and outcome of head injured patients. METHODS Details of neurotrauma admissions under the neurosurgery department at our institute since the onset of COVID-19 pandemic in the country were collected retrospectively and compared to the same period last year in terms of demographic profile, mode of injury, GCS at admission, severity of head injury, radiological diagnosis, management (surgical/conservative), and outcome. The patients were studied according to which phase of pandemic they were admitted in - "lockdown" period (March 25 to May 31, 2020) or "unlock" period (June 1 to September 15, 2020). RESULTS The number of head injuries decreased by 16.8% during the COVID-19 pandemic. Furthermore, during the lockdown period, the number of admissions was 2.7/week while it was 6.8/week during the "unlock" period. RTA was the mode of injury in 29.6% patients during the lockdown, while during the unlock period, it was 56.9% (P = 0.000). Mild and moderate head injuries decreased by 41% and severe head injuries increased by 156.25% during the COVID-19 pandemic (P = 0.000). The mortality among neurotrauma patients increased from 12.4% to 22.5% during the COVID-19 era (P = 0.009). CONCLUSION We observed a decline in the number of head injury admissions during the pandemic, especially during the lockdown. At the same time, there was increase in the severity of head injuries and associated injuries, resulting in significantly higher mortality in our patients during the ongoing COVID-19 pandemic.
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Affiliation(s)
- Nishant Goyal
- Department of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Srikant Kumar Swain
- Department of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Kanav Gupta
- Department of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Jitender Chaturvedi
- Department of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Rajnish Kumar Arora
- Department of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Suresh K. Sharma
- College of Nursing, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Goyal N, Chaturvedi J, Chandra PP, Raheja A. Letter to the Editor Regarding "Early Changes to Neurosurgery Resident Training During the COVID-19 Pandemic at a Large United States Academic Medical Center". World Neurosurg 2020; 146:420-422. [PMID: 33229250 PMCID: PMC7666569 DOI: 10.1016/j.wneu.2020.10.085] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 10/17/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Nishant Goyal
- Department of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, India.
| | - Jitender Chaturvedi
- Department of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, India
| | | | - Amol Raheja
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
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30
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Al-Ahmari AN, Ajlan AM, Bajunaid K, Alotaibi NM, Al-Habib H, Sabbagh AJ, Al-Habib AF, Baeesa SS. Perception of Neurosurgery Residents and Attendings on Online Webinars During COVID-19 Pandemic and Implications on Future Education. World Neurosurg 2020; 146:e811-e816. [PMID: 33181378 DOI: 10.1016/j.wneu.2020.11.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 11/04/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Online education has provided an important tool to continue medical education during the COVID-19 pandemic. Our study aimed to evaluate trainee and attending perceptions of online webinars as an educational tool in neurosurgery. METHODS We conducted a cross-sectional survey study. A web-based 19-question survey was distributed to the people who attended the webinar series that was carried out by the Saudi Association of Neurological Surgery from March 29, 2020 to May 31, 2020. Candidates were identified through their registration e-mails. The survey was distributed June 5-8, 2020. RESULTS A total of 156 responses were received (survey response rate: 60%). The overall satisfaction rate among residents and attendings (board-certified neurosurgeons) was similar (>80%). However, only 56.4% of attendings reported they were comfortable with online webinars compared with 81.2% of residents (P value <0.0001). Seventy-five percent of residents found online lectures more useful than traditional in-person lectures compared with 52% of attendings (P value = 0.01). CONCLUSIONS Online educational webinars provide an educational value that can be considered as an adjunct to traditional (in-person) education methods. Among trainees, the satisfaction of neurosurgery webinars was encouraging to consider as an education method. More objective research and progress are required to adopt and refine existing online didactic and neurosurgical teaching tools while creating more engaging future distant learning models.
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Affiliation(s)
- Ahmed N Al-Ahmari
- Division of Neurosurgery, Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia
| | - Abdulrazag M Ajlan
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Khalid Bajunaid
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of Jeddah, Jeddah, Kingdom of Saudi Arabia
| | - Naif M Alotaibi
- Department of Neurosurgery, National Neurosciences Institute, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia; Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Husam Al-Habib
- Department of Spine Surgery, Dr. Sulaiman Al-Habib Medical Group, Al-Khobar, Kingdom of Saudi Arabia
| | - Abdulrahman J Sabbagh
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia; Research and Development Unit, Clinical Skills and Simulation Center, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Amro F Al-Habib
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Saleh S Baeesa
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
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Bajunaid K, Alatar A, Alqurashi A, Alkutbi M, Alzahrani AH, Sabbagh AJ, Alobaid A, Barnawi A, Alferayan AA, Alkhani AM, Bin Salamah A, Sheikh BY, Alotaibi FE, Alabbas F, Farrash F, Al-Jehani HM, Alhabib H, Alnaami I, Altweijri I, Khoja I, Taha M, Alzahrani M, Bafaquh MS, Binmahfoodh M, Algahtany MA, Al-Rashed S, Raza SM, Elwatidy S, Alomar SA, Al-Issawi W, Khormi YH, Ammar A, Al-Habib A, Baeesa SS, Ajlan A. The longitudinal impact of COVID-19 pandemic on neurosurgical practice. Clin Neurol Neurosurg 2020; 198:106237. [PMID: 33002677 DOI: 10.1016/j.clineuro.2020.106237] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/21/2020] [Accepted: 09/12/2020] [Indexed: 11/25/2022]
Abstract
All neurosurgical procedures decreased in number during the COVID-19 pandemic. Surgical complication rates remained within the acceptable range. Emergency procedures numbers remained the same throughout the study period. Neurosurgical oncology cases were the highest in frequency. There is a decline in hospital length of stay as we progressed during the study period.
Objective This observational cross-sectional multicenter study aimed to evaluate the longitudinal impact of the coronavirus disease 2019 (COVID-19) pandemic on neurosurgical practice. Methods We included 29 participating neurosurgeons in centers from all geographical regions in the Kingdom of Saudi Arabia. The study period, which was between March 5, 2020 and May 20, 2020, was divided into three equal periods to determine the longitudinal effect of COVID-19 measures on neurosurgical practice over time. Results During the 11-week study period, 474 neurosurgical interventions were performed. The median number of neurosurgical procedures per day was 5.5 (interquartile range [IQR]: 3.5–8). The number of cases declined from 72 in the first week and plateaued at the 30′s range in subsequent weeks. The most and least number of performed procedures were oncology (129 [27.2 %]) and functional procedures (6 [1.3 %]), respectively. Emergency (Priority 1) cases were more frequent than non-urgent (Priority 4) cases (178 [37.6 %] vs. 74 [15.6 %], respectively). In our series, there were three positive COVID-19 cases. There was a significant among-period difference in the length of hospital stay, which dropped from a median stay of 7 days (IQR: 4–18) to 6 (IQR: 3–13) to 5 days (IQR: 2–8). There was no significant among-period difference with respect to institution type, complications, or mortality. Conclusion Our study demonstrated that the COVID-19 pandemic decreased the number of procedures performed in neurosurgery practice. The load of emergency neurosurgery procedures did not change throughout the three periods, which reflects the need to designate ample resources to cover emergencies. Notably, with strict screening for COVID -19 infections, neurosurgical procedures could be safely performed during the early pandemic phase. We recommend to restart performing neurosurgical procedures once the pandemic gets stabilized to avoid possible post pandemic health-care system intolerable overload.
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Abd-alrazaq A, Schneider J, Mifsud B, Alam T, Househ M, Hamdi M, Shah Z. A Comprehensive Overview of the COVID-19 Literature: Machine Learning–Based Bibliometric Analysis (Preprint).. [DOI: 10.2196/preprints.23703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
BACKGROUND
Shortly after the emergence of COVID-19, researchers rapidly mobilized to study numerous aspects of the disease such as its evolution, clinical manifestations, effects, treatments, and vaccinations. This led to a rapid increase in the number of COVID-19–related publications. Identifying trends and areas of interest using traditional review methods (eg, scoping and systematic reviews) for such a large domain area is challenging.
OBJECTIVE
We aimed to conduct an extensive bibliometric analysis to provide a comprehensive overview of the COVID-19 literature.
METHODS
We used the COVID-19 Open Research Dataset (CORD-19) that consists of a large number of research articles related to all coronaviruses. We used a machine learning–based method to analyze the most relevant COVID-19–related articles and extracted the most prominent topics. Specifically, we used a clustering algorithm to group published articles based on the similarity of their abstracts to identify research hotspots and current research directions. We have made our software accessible to the community via GitHub.
RESULTS
Of the 196,630 publications retrieved from the database, we included 28,904 in our analysis. The mean number of weekly publications was 990 (SD 789.3). The country that published the highest number of COVID-19–related articles was China (2950/17,270, 17.08%). The highest number of articles were published in bioRxiv. Lei Liu affiliated with the Southern University of Science and Technology in China published the highest number of articles (n=46). Based on titles and abstracts alone, we were able to identify 1515 surveys, 733 systematic reviews, 512 cohort studies, 480 meta-analyses, and 362 randomized control trials. We identified 19 different topics covered among the publications reviewed. The most dominant topic was public health response, followed by clinical care practices during the COVID-19 pandemic, clinical characteristics and risk factors, and epidemic models for its spread.
CONCLUSIONS
We provide an overview of the COVID-19 literature and have identified current hotspots and research directions. Our findings can be useful for the research community to help prioritize research needs and recognize leading COVID-19 researchers, institutes, countries, and publishers. Our study shows that an AI-based bibliometric analysis has the potential to rapidly explore a large corpus of academic publications during a public health crisis. We believe that this work can be used to analyze other eHealth-related literature to help clinicians, administrators, and policy makers to obtain a holistic view of the literature and be able to categorize different topics of the existing research for further analyses. It can be further scaled (for instance, in time) to clinical summary documentation. Publishers should avoid noise in the data by developing a way to trace the evolution of individual publications and unique authors.
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