Consultations During COVID: Effects of a Pandemic on Neurosurgical Care

Abstract

COVID-19 has impacted Neurosurgical care around the world. But reports describing patient admission trends during the pandemic have provided limited time frames and diagnoses. The purpose of this paper was to analyze the impact of COVID-19 on Neurosurgical care provided to our Emergency Department during the outbreak. Patient admission data were collected based on a list of 35 ICD-10 codes, which were placed into one of four categories: head and spine trauma ("Trauma"), head and spine infection ("Infection"), degenerative spine ("Degenerative") and subarachnoid hemorrhage / brain tumor ("Control"). Emergency room consultations to the Neurosurgery Department were collected from March 2018 to March 2022, representing 2 years before COVID and 2 years of pandemic. We hypothesized that Control cases would remain stable throughout the two time periods while Trauma, and Infection would decrease. Because of widespread clinic restrictions we postulated Degenerative (spine) cases presenting to the ER would increase. During the first two years of the COVID pandemic, Neurosurgical Trauma and Degenerative ER patients decreased compared to pre-pandemic levels, while Cranial and Spinal infections increased, and continued to do so during the pandemic period studied. Brain tumors and sub-arachnoid hemorrhages ('control' cases) did not change in a significant way throughout the four-year analysis. The COVID pandemic significantly altered the demographics of our Neurosurgical Emergency Room patient population and continues to do so.