key: cord-0045210-tbumj0ot
authors: D’Antona, Linda; Palasz, Joanna; Haq, Huzaifah; Usher, Inga; De-Saram, Sophia; Curtis, Carmel; Thorne, Lewis; Watkins, Laurence Dale; Toma, Ahmed Kassem
title: Risk of hospital-acquired COVID-19 infection during admission for semi-urgent neurosurgical procedures
date: 2020-06-11
journal: World Neurosurg
DOI: 10.1016/j.wneu.2020.06.034
sha: 74b264d0cc5453ab0d0424c17cb7cfbcad4da4f8
doc_id: 45210
cord_uid: tbumj0ot

nan

worldwide. 1-7 Moreover, it has been demonstrated that patients with perioperative diagnosis 12 of COVID-19 have higher risk of mortality when undergoing surgery (23.8%). 8 The next 13 challenge for neurosurgical practices will be to find a balance between the benefits of surgery 14 and the risk of nosocomial infection, to allow neurosurgical services to resume in a safe and 15 sustainable manner. Information on the risks of nosocomial acquisition of COVID-19 will be 16 essential in order to achieve this balance and to counsel surgical patients appropriately. 17

In this letter we report the risk of hospital-acquired COVID-19 infection in a group of 55 19 consecutive patients undergoing semi-urgent neurosurgical procedures at the National 20

Hospital for Neurology and Neurosurgery (London, UK) during the lockdown period 21 (23/03/2020 to 04/05/2020). Patients were retrospectively identified through screening the 22 theatre lists database. Data collection was performed through the hospital electronic records 23 and a short patient telephone survey. Patients who were discharged from hospital for at least 24 14 days (at the time of the study) were contacted for a short telephone survey including the 25 following two questions: (i) Have you had a diagnosis of COVID-19 in the 14 days following 26 your discharge from hospital? (ii) Have you experienced any of the following symptoms in 27 the 14 days following your discharge from hospital: Cough, shortness of breath/difficulty 28 breathing, fever, chills, muscle pain, headache, sore throat, loss of taste/smell? 9 A diagnosis 29 of COVID-19 was confirmed when a respiratory swab sample tested positive for SARS-CoV-30 2 by RT-qPCR, clinically suspected when the patient presented 2 out of the 8 previously 31

listed symptoms, and was excluded in patients with a negative COVID-19 swab test and 32 patients who did not present the typical symptoms. Table 1 provides information on the 33 reorganisation of the neurosurgical services in our centre. study period due to positive preoperative COVID-19 test results of the patients. Fifty-five 38 consecutive patients undergoing 56 neurosurgical procedures were included in the study. The 39 patients' baseline clinical characteristics are described in Table 2 Whitney test p<0.001). All neurosurgical sub-specialties were affected (Figure 1) . 

Impact of COVID-19 outbreak on spinal 99 pathology: single center first impression. Spinal Cord

Elective surgery cancellations 104 due to the COVID-19 pandemic: global predictive modelling to inform surgical 105 recovery plans

Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Pandemic: A Worldwide 108

Collateral Pandemic in Face of the Present

Pandemic: A Neurosurgical Perspective

COVID-19 Non-Essential Surgery Restrictions and Spine 112 Surgery: A German Experience

Coronavirus disease 2019 (COVID-19) in neurology and 114 neurosurgery: A scoping review of the early literature

Mortality and pulmonary complications in 117 patients undergoing surgery with perioperative SARS-CoV-2 infection: an 118 international cohort study. The Lancet. 2020. 119 9