Article
Subarachnoid haemorrhage and symptomatic aneurysms – influence of the SARS-CoV2 pandemic on incidence and outcome in a neurovascular maximum provider
Subarachnoidalblutung und symptomatische Aneurysmen – Einfluss der SARS-CoV2-Pandemie auf Inzidenz und Outcome in einem neurovaskulären Maximalversorger
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Authors
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Konstantinos Lintas
- Klinikum Dortmund gGmbH, Neurochirurgie, Dortmund, Deutschland
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Oliver Müller
- Klinikum Dortmund gGmbH, Neurochirurgie, Dortmund, Deutschland
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Boris El Hamalawi
- Klinikum Dortmund gGmbH, Neurochirurgie, Dortmund, Deutschland
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Robert Sarge
- Klinikum Dortmund gGmbH, Neurochirurgie, Dortmund, Deutschland
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Stephan Rohde
- Klinikum Dortmund gGmbH, Radiologie und Neuroradiologie, Dortmund, Deutschland
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Gisa Ellrichmann
- Klinikum Dortmund gGmbH, Neurologie, Dortmund, Deutschland
| Published: | May 25, 2022 |
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Outline
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Objective: To assess the impact of the SARS-CoV2-pandemic on the incidence, the outcome and the course of treatment of subarachnoid hemorrhages and aneurysms at a tertiary medical center.
Methods: We performed a matched-case-study on neurovascular emergencies treated between March 16th 2020 and January 31st 2021, beginning of the first lock down to the near-end of the second lockdown in Germany. Cases were retrospectively analyzed with respect to incidence and outcome of the subarachnoid hemorrhage and the symptomatic, cerebral aneurysms, and finally compared to a matching cohort of cases between March 16th 2019 to January 31st 2020.
Study protocol was approved by the ethics committee of the associated medical faculty.
Results: A total of 764 neurosurgical emergencies were admitted to our hospital between March 16th 2019 and January 31st 2020 (the matched-case-control group). Of these, 39 cases were identified as symptomatic aneurysms and SAH.
During the period of the pandemic from March 16th 2020 to January 31st 2021, there were 905 neurosurgical emergencies (an increase of 18%) referred to our hospital. Of these, 47 symptomatic aneurysms and SAH were identified (+20%).
The number of severely affected cases (Hunt and Hess 5) increased significantly by 40%, and the number of patients with extensive bleeding in the computed tomographic diagnosis (Fischer 4) increased by 63%. Accordingly, the need for external ventricular drainage (EVD) systems increased by 6.3%. Symptomatic vasospasm occurred 1,6 times more frequently during the pandemic (19.5% vs. 12%).
Mortality rate increased dramatically by 83% in all during the pandemic during the pandemic
Conclusion: Unexpectedly, the number and severity of subarachnoid hemorrhages and symptomatic aneurysms increased during the pandemic. Overall, the course and outcome of SAB and symptomatic aneurysms seem to have become more complicated during the pandemic. The increase in the incidence and severity of the cases, as well as the increased occurrence of vasospasms - in patients who only tested negative - cannot be explained by central nervous involvement of the SARS-CoV2 infection. Rather, it must be assumed that the lockdown will result in an accumulation of cases in houses with maximum care. Our data show the need to maintain neurovascular competence in hospitals with maximum care even in extreme situations such as lockdown due to the corona pandemic.
