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Perioperative Complications of Patients with SARS-CoV-2 Infection in Neurosurgery

Ladina Greuter1, Christian Zweifel1,2,3, Raphael Guzman1,3

  • 1Department of Neurosurgery, University Hospital of Basel, 4031 Basel, Switzerland.

Journal of Clinical Medicine
|February 15, 2022
PubMed

Insights

COVID-19 patients undergoing neurosurgery face significantly higher risks of perioperative complications, including thrombotic and hemorrhagic events. This highlights increased mortality and complication rates in neurosurgical patients with SARS-CoV-2 infection.

Area of Science:

  • Neurosurgery
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • The COVID-19 pandemic has led to increased infections globally.
  • COVID-19 is associated with neurological and coagulopathic symptoms, including intracranial hemorrhages.
  • Limited data exists on postoperative complications in neurosurgical patients with COVID-19.

Purpose of the Study:

  • To investigate perioperative complications in neurosurgical patients with COVID-19.
  • To compare thrombotic and hemorrhagic complication rates in COVID-19-positive versus COVID-19-negative neurosurgical patients.

Main Methods:

  • Retrospective cohort study of neurosurgical patients from March 2020 to March 2021.
  • Inclusion of COVID-19-positive and propensity score-matched COVID-19-negative cohorts.
  • Primary outcome: hemorrhagic or thrombotic complication within 30 days post-surgery.

Main Results:

  • Ten COVID-19-positive patients (mean age 56) experienced 12 complications.
  • Higher rates of overall complications (60.0% vs 19.2%), thrombotic complications (30.0% vs 1.9%), and mortality (20.0% vs 0.0%) in COVID-19-positive patients.
  • Specific thrombotic events included cerebral sinus vein thromboses and pulmonary embolus.

Conclusions:

  • Patients with concomitant COVID-19 infection undergoing neurosurgery have elevated rates of perioperative complications.
  • Neurosurgical interventions in COVID-19 patients are associated with increased thrombotic and hemorrhagic risks.
  • Concomitant COVID-19 infection significantly increases the risk of adverse outcomes in neurosurgical patients.
Abstract

Keywords:
COVID-19SARS-CoV-2complicationsneurosurgery

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