"Staying Home"-Early Changes in Patterns of Neurotrauma in New York City During the COVID-19 Pandemic

Abstract

Objective: New York City is the epicenter of the novel coronavirus disease 2019 (COVID-19) pandemic in the United States. Traumatic brain injury accounts for a significant proportion of admissions to our trauma center. We sought to characterize the effect of the pandemic on neurotraumas, given the cancellation of nonessential activities during the crisis.

Methods: Retrospective and prospective reviews were performed from November 2019 to April 2020. General demographics, clinical status, mechanism of trauma, diagnosis, and treatment instituted were recorded. We dichotomized the data between pre-COVID-19 (before 1 March) and COVID-19 periods and compared the differences between the 2 groups. We present the timeline of events since the beginning of the crisis in relation to the number of neurotraumas.

Results: A total of 150 patients composed our cohort with a mean age of 66.2 years (standard deviation ±18.9), and 66% were male. More males sustained neurotrauma in the COVID-19 period compared with the pre-COVID-19 (60.4% vs. 77.6%, P = 0.03). The most common mechanism of trauma was mechanical fall, but it was observed less frequently compared with the pre-COVID-19 period (61.4% vs. 40.8; P = 0.03). Subdural hematoma, traumatic subarachnoid hemorrhage, and intracerebral contusion accounted for the most common pathologies in both periods. Nonoperative management was selected for most patients (79.2 vs. 87.8%, P = 0.201) in both periods.

Conclusions: A decrease in the frequency of neurotraumas was observed during the COVID-19 crisis concomitant with the increase in COVID-19 patients in the city. This trend began after the cancellation of nonessential activities and implementation of social distancing recommendations.

Keywords: COVID-19; Coronavirus; Trauma; Traumatic brain injury.

Figure 1

Monthly frequency of neurotraumas during the study period.

Figure 2

Timeline of events during the coronavirus disease 2019 (COVID-19) crisis with the weekly incidences of the hospital's neurotrauma cases and the COVID-19 cases in New York City. The outbreak started in New York City on 3 March (dotted red line). The World Health Organization declared the infection as a pandemic on 11 March (dotted blue lines). A transient drop in the frequency of neurotraumas was observed concomitant with the increase in COVID-19 cases and the cancellation of nonessential activities by the Office of the Mayor on 16 March (blue line). The peak of newly diagnosed COVID-19 cases (6368) in a single day on 6 April (red line).