The Effect of the COVID-19 Pandemic and Lockdown on Operative Traumatic Brain Injury in Northern Virginia

Abstract

Introduction: COVID-19 is a disease that causes flu-like symptoms and difficulty breathing. Emerging in 2019, the COVID-19 pandemic has affected the entire world through restrictions and lockdowns. Multiple studies have compared the effects of COVID-19 on different types of head trauma, with each one producing different results. The goal of this study was to use state and hospital data to determine whether the COVID-19 pandemic had a significant impact on surgeries for traumatic brain injury (TBI).

Methods: Public state data on COVID-19 incidence, sourced from the Virginia Department of Health, was compared to hospital data of 352 patients receiving surgeries for TBI from a single major level-one trauma hospital in Northern Virginia. We used data from the three years before COVID-19 and the two years during the pandemic, using t-tests and Pearson correlation to analyze the data. This is a retrospective case review study on the number and age of patients receiving TBI surgery from March 2017 through February 2022 at Inova Fairfax Hospital in Northern Virginia to determine the impact of the COVID-19 pandemic on these factors.

Results: When comparing the data, there was a 60% reduction in cases of operative TBI during the peak months of COVID-19 compared to the same months in previous years (p<0.005). Comparing data on the number of Virginia and Northern Virginia COVID-19 cases and data on the age of individuals undergoing TBI surgery four weeks later showed a statistically significant negative correlation (p<0.05) in which the average age of individuals undergoing TBI surgery was lower in the four-week block following a four-week block of increased COVID-19 incidence.

Conclusion: Our findings indicate a correlation between the period of decreased activity from COVID-19 restrictions in Virginia and a decline in both the number of TBI surgeries and the age of individuals undergoing these surgeries.

Keywords: covid-19; elderly; lockdown; pandemic; surgery; tbi.

Figure 1. Average number of TBI surgeries performed each month during the three years prior to the COVID-19 pandemic compared to the two years following its start (p>0.05). P-values less than 0.05 were considered statistically significant

TBI: traumatic brain injury

Figure 2. Average number of TBI surgeries performed during the four-month period of increased lockdown restrictions compared to the same four-month period in the prior three years (p<0.005). P-values less than 0.05 were considered statistically significant

TBI: traumatic brain injury

Figure 3. Mean age of patients receiving TBI surgery during the two years after the start of the COVID-19 pandemic compared to the three years prior (p>0.05). P-values less than 0.05 were considered statistically significant

Figure 4. Mean age of patients receiving TBI surgery during the four-month period of increased COVID-19 lockdown restrictions compared to the same four months in the three years prior (p=0.073). P values less than 0.05 were considered statistically significant.

Figure 5. Number of new COVID-19 cases for each four-week period in Virginia compared to the number of TBI surgeries performed four weeks later during the first two years of the COVID-19 pandemic (p>0.05). P-values less than 0.05 were considered statistically significant

TBI: traumatic brain injury

Figure 6. Number of new COVID-19 cases for each four-week period in Northern Virginia compared to the number of TBI surgeries performed four weeks later during the first two years of the COVID-19 pandemic (p>0.05). P-values less than 0.05 were considered statistically significant

TBI: traumatic brain injury

Figure 7. New COVID-19 cases of each four-week period in Virginia compared to the average age of patients receiving TBI surgery four weeks later during the first two years of the COVID-19 pandemic (p<0.05). P-values less than 0.05 were considered statistically significant

Figure 8. New COVID-19 cases of each four-week period in Northern Virginia compared to the average age of patients receiving TBI surgery four weeks later during the first two years of the COVID-19 pandemic (p<0.05). P-values less than 0.05 were considered statistically significant