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

Abhijit V. Lele, Sarah Wahlster, Bhunyawee Alunpipachathai, Meron Awraris Gebrewold, Sherry H.Y. Chou, Gretchen Crabtree, Shane English, Caroline Der-Nigoghossian, David J. Gagnon, May Kim-Tenser, Navaz Karanjia, Matthew A. Kirkman, Massimo Lamperti, Sarah L. Livesay, Jorge Mejia-Mantilla, Kara Melmed, Hemanshu Prabhakar, Leandro Tumino, Chethan P. Venkatasubba Rao, Andrew A. UdyWalter Videtta, Asma M. Moheet

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)209-220
Number of pages12
JournalJournal of Neurosurgical Anesthesiology
Volume34
Issue number2
DOIs
StatePublished - Apr 1 2022
Externally publishedYes

Keywords

  • COVID-19
  • SARS-Cov-2
  • care delivery
  • neurocritical care
  • pandemic
  • resources

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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