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. Udy; Walter Videtta; Asma M. Moheet

doi:10.1097/ANA.0000000000000825

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

^*Corresponding author for this work

Neurology

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

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 language	English (US)
Pages (from-to)	209-220
Number of pages	12
Journal	Journal of Neurosurgical Anesthesiology
Volume	34
Issue number	2
DOIs	https://doi.org/10.1097/ANA.0000000000000825
State	Published - Apr 1 2022

Funding

A.V.L. reports receiving research support from Aqueduct Critical Care and salary support from LifeCenter Northwest. D.J.G. receives research support from a Centers for Biomedical Research Excellence grant from the National Institute of General Medical Sciences (1P20GM139745-01). A.A.U. has received in-kind clinical trial support (study consumables) from Integra Lifesciences. S.H.-Y.C. reports research funding from the National Center for Advancing Translational Sciences (NCATS) UL1 TR001857, the National Institutes of Neurological Disorders and Stroke (NINDS) R21NS113037, and the University of Pittsburgh. S.L.L. reports receiving consulting fees from Lombardi-Hill/Stroke Challenges LLC. The remaining authors have no conflicts of interest to declare.

Keywords

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

ASJC Scopus subject areas

Clinical Neurology
Anesthesiology and Pain Medicine
Surgery

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10.1097/ANA.0000000000000825

Cite this

Lele, A. V., Wahlster, S., Alunpipachathai, B., Awraris Gebrewold, M., Chou, S. H. Y., Crabtree, G., English, S., Der-Nigoghossian, C., Gagnon, D. J., Kim-Tenser, M., Karanjia, N., Kirkman, M. A., Lamperti, M., Livesay, S. L., Mejia-Mantilla, J., Melmed, K., Prabhakar, H., Tumino, L., Venkatasubba Rao, C. P., ... Moheet, A. M. (2022). Perceptions Regarding the SARS-CoV-2 Pandemic's Impact on Neurocritical Care Delivery: Results From a Global Survey. Journal of Neurosurgical Anesthesiology, 34(2), 209-220. https://doi.org/10.1097/ANA.0000000000000825

@article{7207875f41944cc19b253b3ca481f233,

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

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.",

keywords = "COVID-19, SARS-Cov-2, care delivery, neurocritical care, pandemic, resources",

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

note = "Funding Information: A.V.L. reports receiving research support from Aqueduct Critical Care and salary support from LifeCenter Northwest. D.J.G. receives research support from a Centers for Biomedical Research Excellence grant from the National Institute of General Medical Sciences (1P20GM139745-01). A.A.U. has received in-kind clinical trial support (study consumables) from Integra Lifesciences. S.H.-Y.C. reports research funding from the National Center for Advancing Translational Sciences (NCATS) UL1 TR001857, the National Institutes of Neurological Disorders and Stroke (NINDS) R21NS113037, and the University of Pittsburgh. S.L.L. reports receiving consulting fees from Lombardi-Hill/Stroke Challenges LLC. The remaining authors have no conflicts of interest to declare. Publisher Copyright: {\textcopyright} 2022 Lippincott Williams and Wilkins. All rights reserved.",

year = "2022",

month = apr,

day = "1",

doi = "10.1097/ANA.0000000000000825",

language = "English (US)",

volume = "34",

pages = "209--220",

journal = "Journal of Neurosurgical Anesthesiology",

issn = "0898-4921",

publisher = "Lippincott Williams and Wilkins",

number = "2",

}

Lele, AV, Wahlster, S, Alunpipachathai, B, Awraris Gebrewold, M, Chou, SHY, Crabtree, G, English, S, Der-Nigoghossian, C, Gagnon, DJ, Kim-Tenser, M, Karanjia, N, Kirkman, MA, Lamperti, M, Livesay, SL, Mejia-Mantilla, J, Melmed, K, Prabhakar, H, Tumino, L, Venkatasubba Rao, CP, Udy, AA, Videtta, W & Moheet, AM 2022, 'Perceptions Regarding the SARS-CoV-2 Pandemic's Impact on Neurocritical Care Delivery: Results From a Global Survey', Journal of Neurosurgical Anesthesiology, vol. 34, no. 2, pp. 209-220. https://doi.org/10.1097/ANA.0000000000000825

TY - JOUR

T1 - Perceptions Regarding the SARS-CoV-2 Pandemic's Impact on Neurocritical Care Delivery

T2 - Results From a Global Survey

AU - Lele, Abhijit V.

AU - Wahlster, Sarah

AU - Alunpipachathai, Bhunyawee

AU - Awraris Gebrewold, Meron

AU - Chou, Sherry H.Y.

AU - Crabtree, Gretchen

AU - English, Shane

AU - Der-Nigoghossian, Caroline

AU - Gagnon, David J.

AU - Kim-Tenser, May

AU - Karanjia, Navaz

AU - Kirkman, Matthew A.

AU - Lamperti, Massimo

AU - Livesay, Sarah L.

AU - Mejia-Mantilla, Jorge

AU - Melmed, Kara

AU - Prabhakar, Hemanshu

AU - Tumino, Leandro

AU - Venkatasubba Rao, Chethan P.

AU - Udy, Andrew A.

AU - Videtta, Walter

AU - Moheet, Asma M.

N1 - Funding Information: A.V.L. reports receiving research support from Aqueduct Critical Care and salary support from LifeCenter Northwest. D.J.G. receives research support from a Centers for Biomedical Research Excellence grant from the National Institute of General Medical Sciences (1P20GM139745-01). A.A.U. has received in-kind clinical trial support (study consumables) from Integra Lifesciences. S.H.-Y.C. reports research funding from the National Center for Advancing Translational Sciences (NCATS) UL1 TR001857, the National Institutes of Neurological Disorders and Stroke (NINDS) R21NS113037, and the University of Pittsburgh. S.L.L. reports receiving consulting fees from Lombardi-Hill/Stroke Challenges LLC. The remaining authors have no conflicts of interest to declare. Publisher Copyright: © 2022 Lippincott Williams and Wilkins. All rights reserved.

PY - 2022/4/1

Y1 - 2022/4/1

N2 - 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.

AB - 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.

KW - COVID-19

KW - SARS-Cov-2

KW - care delivery

KW - neurocritical care

KW - pandemic

KW - resources

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

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