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. 2022 Apr 1;34(2):209-220.
doi: 10.1097/ANA.0000000000000825.

Perceptions Regarding the SARS-CoV-2 Pandemic's Impact on Neurocritical Care Delivery: Results From a Global Survey

Abhijit V Lele  1 , Sarah Wahlster  2 , Bhunyawee Alunpipachathai  3 , Meron Awraris Gebrewold  4 , Sherry H-Y Chou  5 , Gretchen Crabtree  6 , Shane English  7 , Caroline Der-Nigoghossian  8 , David J Gagnon  9 , May Kim-Tenser  10 , Navaz Karanjia  11 , Matthew A Kirkman  12 , Massimo Lamperti  13 , Sarah L Livesay  14 , Jorge Mejia-Mantilla  15 , Kara Melmed  16 , Hemanshu Prabhakar  17 , Leandro Tumino  18 , Chethan P Venkatasubba Rao  19 , Andrew A Udy  20 , Walter Videtta  21 , Asma M Moheet  6 ; NCC-COVID Study Collaborators
Collaborators, Affiliations

Perceptions Regarding the SARS-CoV-2 Pandemic's Impact on Neurocritical Care Delivery: Results From a Global Survey

Abhijit V Lele et al. J Neurosurg Anesthesiol. .

Abstract

Background: The SARS-CoV-2 (COVID-19) pandemic has impacted many facets of critical care delivery.

Methods: An electronic survey was distributed to explore the pandemic's perceived impact on neurocritical care delivery between June 2020 and March 2021. Variables were stratified by World Bank country income level, presence of a dedicated neurocritical care unit (NCCU) and experiencing a COVID-19 patient surge.

Results: Respondents from 253 hospitals (78.3% response rate) from 47 countries (45.5% low/middle income countries; 54.5% with a dedicated NCCU; 78.6% experienced a first surge) participated in the study. Independent of country income level, NCCU and surge status, participants reported reductions in NCCU admissions (67%), critical care drug shortages (69%), reduction in ancillary services (43%) and routine diagnostic testing (61%), and temporary cancellation of didactic teaching (44%) and clinical/basic science research (70%). Respondents from low/middle income countries were more likely to report lack of surge preparedness (odds ratio [OR], 3.2; 95% confidence interval [CI], 1.8-5.8) and struggling to return to prepandemic standards of care (OR, 12.2; 95% CI, 4.4-34) compared with respondents from high-income countries. Respondents experiencing a surge were more likely to report conversion of NCCUs and general-mixed intensive care units (ICUs) to a COVID-ICU (OR 3.7; 95% CI, 1.9-7.3), conversion of non-ICU beds to ICU beds (OR, 3.4; 95% CI, 1.8-6.5), and deviations in critical care and pharmaceutical practices (OR, 4.2; 95% CI 2.1-8.2). Respondents from hospitals with a dedicated NCCU were less likely to report conversion to a COVID-ICU (OR, 0.5; 95% CI, 0.3-0.9) or conversion of non-ICU to ICU beds (OR, 0.5; 95% CI, 0.3-0.9).

Conclusion: This study reports the perceived impact of the COVID-19 pandemic on global neurocritical care delivery, and highlights shortcomings of health care infrastructures and the importance of pandemic preparedness.

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Conflict of interest statement

A.V.L. reports receiving research support from Aqueduct Critical Care and salary support from LifeCenter Northwest. D.J.G. receives research support from a Centers for Biomedical Research Excellence grant from the National Institute of General Medical Sciences (1P20GM139745-01). A.A.U. has received in-kind clinical trial support (study consumables) from Integra Lifesciences. S.H.-Y.C. reports research funding from the National Center for Advancing Translational Sciences (NCATS) UL1 TR001857, the National Institutes of Neurological Disorders and Stroke (NINDS) R21NS113037, and the University of Pittsburgh. S.L.L. reports receiving consulting fees from Lombardi-Hill/Stroke Challenges LLC. The remaining authors have no conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
World map showing the location of the 253 hospitals in 47 countries participating in the neurocritical care-COVID study.
FIGURE 2
FIGURE 2
Univariate analysis highlighting changes to neurocritical care delivery by country income level, dedicated neurocritical care unit and surge of COVID-19 patient status. gen-ICU indicates general/mixed critical care unit; ICU, intensive care unit; NCCU, dedicated neurocritical care unit.
FIGURE 3
FIGURE 3
Themes regarding the impact of the COVID-19 pandemic on neurocritical care delivery. ICU indicates intensive care unit; NCC, neurocritical care.
See this image and copyright information in PMC

References

    1. World Health Organization. Coronavirus disease (COVID-19), Situation Report-135. 2021. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situatio.... Accessed August 14, 2021.
    1. Guan WJ, Ni ZY, Hu Y, et al. . Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382:1708–1720. doi:10.1056/NEJMoa2002032 - DOI - PMC - PubMed
    1. Huang C, Wang Y, Li X, et al. . Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506. doi:10.1016/S0140-6736(20)30183-5 - DOI - PMC - PubMed
    1. Richardson S, Hirsch JS, Narasimhan M, et al. . Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City Area. JAMA. 2020;323:2052–2059. doi:10.1001/jama.2020.6775 - DOI - PMC - PubMed
    1. Bhatraju PK, Ghassemieh BJ, Nichols M, et al. . Covid-19 in critically ill patients in the Seattle region—case series. N Engl J Med. 2020;382:2012–2022. doi:10.1056/NEJMoa2004500 - DOI - PMC - PubMed