Outcomes and Surgical Considerations for Neurosurgical Patients Hospitalized with COVID-19–A Multicenter Case Series

Lina Marenco-Hillembrand, Young Erben, Paola Suarez-Meade, Camila Franco-Mesa, Wendy Sherman, Benjamin H. Eidelman, David A. Miller, Nancy L. O'Keefe, Bernard R. Bendok, Robert J. Spinner, Kaisorn L. Chaichana, James F. Meschia, Alfredo Quiñones-Hinojosa

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Neurosurgical patients are at a higher risk of having a severe course of coronavirus disease 2019 (COVID-19). The objective of this study was to determine morbidity, hospital course, and mortality of neurosurgical patients during the coronavirus disease 2019 (COVID-19) pandemic in a multicenter health care system. Methods: A retrospective observational study was conducted to identify all hospitalized neurosurgical patients positive for COVID-19 from March 11, 2020 to November 2, 2020 at Mayo Clinic and the Mayo Clinic Health System. Results: Eleven hospitalized neurosurgical patients (0.68%) were positive for COVID-19. Four patients (36.6%) were men and 7 (63.3%) were women. The mean age was 65.7 years (range, 35–81 years). All patients had comorbidities. The mean length of stay was 13.4 days (range, 4–30 days). Seven patients had a central nervous system malignancy (4 metastases, 1 meningioma, 1 glioblastoma, and 1 schwannoma). Three patients presented with cerebrovascular complications, comprising 2 spontaneous intraparenchymal hemorrhages and 1 ischemic large-vessel stroke. One patient presented with an unstable traumatic spinal burst fracture. Four patients underwent neurosurgical/neuroendovascular interventions. Discharge disposition was to home in 5 patients, rehabilitation facility in 3, and hospice in 3. Five patients had died at follow-up, 3 within 30 days from COVID-19 complications and 2 from progression of their metastatic cancer. Conclusions: COVID-19 is rare among the inpatient neurosurgical population. In all cases, patients had multiple comorbidities. All symptomatic patients from the respiratory standpoint had complications during their hospitalization. Deaths of 3 patients who died within 30 days of hospitalization were all related to COVID-19 complications. Neurosurgical procedures were performed only if deemed emergent.

Original languageEnglish (US)
Pages (from-to)e118-e129
JournalWorld neurosurgery
Volume154
DOIs
StatePublished - Oct 2021

Keywords

  • COVID
  • Coronavirus
  • Neurosurgery
  • Neurosurgical

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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