Greuter Ladina, Zweifel Christian, Guzman Raphael, Soleman Jehuda
Department of Neurosurgery, University Hospital of Basel, 4031 Basel, Switzerland.
Department of Neurosurgery, Cantonal Hospital Graubünden, 7000 Chur, Switzerland.
J Clin Med. 2022 Jan 27;11(3):657. doi: 10.3390/jcm11030657.
The outbreak of coronavirus disease 2019 (COVID-19) has been rapidly evolving, resulting in a pandemic, with 270,031,622 infections according to the World Health Organization. Patients suffering from COVID-19 have also been described to suffer from neurologic and coagulopathic symptoms apart from the better-known flu-like symptoms. Some studies showed that patients suffering from COVID-19 were likely to developed intracranial hemorrhages. To our knowledge, only a few studies have investigated postoperative complications in COVID-19-positive neurosurgical patients and investigated the perioperative complications, either thrombotic or hemorrhagic, in patients with SARS-CoV-2 undergoing a neurosurgical intervention.
We conducted a retrospective cohort study including patients from March 2020 to March 2021 undergoing neurosurgical interventions and suffering from COVID-19. Our primary outcome parameter was a hemorrhagic or thrombotic complication within 30 days after surgery. These outcomes were compared to those for a COVID-19-negative cohort of patients using propensity score matching.
We included ten COVID-19-positive patients with a mean age of 56.00 (±14.91) years. Twelve postoperative complications occurred in five patients. Three thrombotic complications (30%) were observed, with two cerebral sinus vein thromboses and one pulmonary embolus. Two patients suffered from a postoperative hemorrhagic complication (20%). The mean postoperative GCS was 14.30 (±1.57). COVID-19-positive patients showed a significantly higher rate of overall postoperative complications ((6 (60.0%) vs. 10 (19.2%), = 0.021), thrombotic complications (3 (30.0%) vs. 1 (1.9%), = 0.009), and mortality (2 (20.0%) vs. 0 (0.0%), = 0.021) compared to the matched cohort of COVID-19-negative patients, treated at our institute before the SARS-CoV-2 pandemic.
Patients undergoing neurosurgical operations with concomitant COVID-19 infection have higher rates of perioperative complications.
2019年冠状病毒病（COVID-19）疫情迅速演变，导致全球大流行，据世界卫生组织统计，感染人数达270,031,622例。除了众所周知的流感样症状外，COVID-19患者还出现了神经和凝血方面的症状。一些研究表明，COVID-19患者可能会发生颅内出血。据我们所知，只有少数研究调查了COVID-19阳性神经外科患者的术后并发症，以及接受神经外科手术的SARS-CoV-2患者围手术期的血栓形成或出血等并发症。
我们进行了一项回顾性队列研究，纳入了2020年3月至2021年3月期间接受神经外科手术且患有COVID-19的患者。我们的主要结局参数是术后30天内的出血或血栓形成并发症。使用倾向评分匹配法将这些结局与COVID-19阴性患者队列的结局进行比较。
我们纳入了10例COVID-19阳性患者，平均年龄为56.00（±14.91）岁。5例患者出现了12例术后并发症。观察到3例血栓形成并发症（30%），其中2例为脑静脉窦血栓形成，1例为肺栓塞。2例患者出现术后出血并发症（20%）。术后平均格拉斯哥昏迷评分（GCS）为14.30（±1.57）。与我们研究所SARS-CoV-2大流行之前治疗的匹配COVID-19阴性患者队列相比，COVID-19阳性患者的总体术后并发症发生率（6例（60.0%）对10例（19.2%），P = 0.021）、血栓形成并发症发生率（3例（30.0%）对1例（1.9%），P = 0.009）和死亡率（2例（20.0%）对0例（0.0%），P = 0.021）显著更高。
合并COVID-19感染接受神经外科手术的患者围手术期并发症发生率更高。
