• Ehsan Dowlati, Tianzan Zhou, Kwadwo Sarpong, Gnel Pivazyan, Jessica Briscoe, Islam Fayed, William Mualem, Jordan Black, Christopher G Kalhorn, Mani N Nair, and Daniel R Felbaum.
• Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, District of Columbia, USA. Electronic address: edowlati@gmail.com.
• World Neurosurg. 2020 Nov 1; 143: e550e560e550-e560.

ObjectiveThe true incidence of perioperative coronavirus disease 2019 (COVID-19) has not been well elucidated in neurosurgical studies. We reviewed the effects of the pandemic on the neurosurgical case volume to study the incidence of COVID-19 in patients undergoing these procedures during the perioperative period and compared the characteristics and outcomes of this group to those of patients without COVID-19.MethodsThe neurosurgical and neurointerventional procedures at 2 tertiary care centers during the pandemic were reviewed. The case volume, type, and acuity were compared to those during the same period in 2019. The perioperative COVID-19 tests and results were evaluated to obtain the incidence. The baseline characteristics, including a modified Medically Necessary Time Sensitive (mMeNTS) score, and outcome measures were compared between those with and without COVID-19.ResultsA total of 405 cases were reviewed, and a significant decrease was found in total spine, cervical spine, lumbar spine, and functional/pain cases. No significant differences were found in the number of cranial or neurointerventional cases. Of the 334 patients tested, 18 (5.4%) had tested positive for COVID-19. Five of these patients were diagnosed postoperatively. The mMeNTS score, complications, and case acuity were significantly different between the patients with and without COVID-19.ConclusionA small, but real, risk exists of perioperative COVID-19 in neurosurgical patients, and those patients have tended to have a greater complication rate. Use of the mMeNTS score might play a role in decision making for scheduling elective cases. Further studies are warranted to develop risk stratification and validate the incidence.Copyright © 2020 Elsevier Inc. All rights reserved.

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