Tondo Giacomo, Aprile Davide, Tesser Fabiana, Comi Cristoforo
Neurology Unit, S. Andrea Hospital, Department of Translational Medicine, University of Piemonte Orientale, Corso Abbiate 21, 13100 Vercelli, Italy.
School of Psychology, Vita-Salute San Raffaele University, 20132 Milan, Italy.
J Clin Med. 2021 Nov 4;10(21):5169. doi: 10.3390/jcm10215169.
The novel coronavirus disease of 2019 (COVID-19) outbreak provoked a profound healthcare system reorganization. This study aimed to compare the reasons for requesting a non-deferrable neurological evaluation before the COVID-19 pandemic and during the lockdown.
Retrospective observational study including non-deferrable neurological outpatients before the pandemic (pre-COVID-19 group, = 223) and during the Italian second wave of the COVID-19 pandemic (LOCKDOWN group, = 318).
The number of patients sent for cerebrovascular disorders, headache, and vertigo significantly dropped between the pre-COVID-19 era and the lockdown period. While in the pre-COVID-19 group, the most frequent diagnosis was cerebrovascular disorder; neuropsychiatric disorders ranked first in the LOCKDOWN group. Moreover, the percentage of appropriate non-deferrable neurological evaluations significantly increased in the LOCKDOWN group compared with the pre-COVID-19 group.
Our study shows a significant increase of neuropsychiatric disorders in non-deferrable neurologic evaluations during the Italian second wave of the COVID-19. Overall, cases were more severe and required a more complex management during the lockdown compared with the pre-COVID era. These findings confirm that a careful approach to prevent the psychological consequences of the pandemic is needed, and long-term rearrangements of the healthcare system are desirable to guarantee appropriate management.
2019年新型冠状病毒病(COVID-19)疫情引发了医疗保健系统的深刻重组。本研究旨在比较COVID-19大流行之前和封锁期间要求进行不可推迟的神经学评估的原因。
回顾性观察研究,纳入大流行之前(COVID-19前组,n = 223)和意大利第二波COVID-19大流行期间(封锁组,n = 318)的不可推迟的神经科门诊患者。
在COVID-19前时代和封锁期间,因脑血管疾病、头痛和眩晕就诊的患者数量显著下降。在COVID-19前组中,最常见的诊断是脑血管疾病;在封锁组中,神经精神疾病排名第一。此外,与COVID-19前组相比,封锁组中适当的不可推迟的神经学评估的百分比显著增加。
我们的研究表明,在意大利第二波COVID-19期间,不可推迟的神经学评估中神经精神疾病显著增加。总体而言,与COVID-19前时代相比,封锁期间的病例更严重,需要更复杂的管理。这些发现证实,需要采取谨慎的方法来预防大流行的心理后果,并且需要对医疗保健系统进行长期重新安排以确保适当的管理。