Türkiye'de covid-19 pandemisinin pediatrik nöroşirürji üzerine etkileri

Amaç: Koronavirüs hastalığı 2019 (COVID-19) pandemisi, dünya çapında milyonlarca insanı etkileyen ve geçmiş dünya düzenini her bakımdan değiştiren bir felakettir. Özellikle, nöroşirürji de dahil olmak üzere tüm tıbbi uzmanlık alanlarında prosedür değişiklikleri gerektiğinden sağlık kurumları büyük ölçüde etkilenmiştir. Bu yazıda kliniğimizde pediatrik nöroşirürji hasta yönetimi uygulamasını ve Türkiye'de COVID-19 pandemisi sırasında meydana gelen değişiklikleri anlatacağız. Gereç ve Yöntemler: Kliniğimizin pediatrik nöroşirürji bölümünde Kasım 2020 - Ocak 2021 ve Kasım 2021 - Ocak 2022 tarihleri arasında hasta hareketleri retrospektif olarak değerlendirildi. Bulgular: Kasım 2020 - Ocak 2021 ve Kasım 2021 - Ocak 2022 tarihleri arasında poliklinikte 1888 ve 2895 hasta incelendi ve sırasıyla 65 ve 156 ameliyat yapıldı. COVID-19 pandemisinin zirvesinde, ayakta tedavi ziyaretlerinin sayısı% 65.2, ameliyatların sayısı% 41.6 azaldı. Sonuç: Pandemi sırasında cerrahi işlemlerde ilk adım acil ve elektif olgular arasında ayrım yapmaktır. Bu bağlamda pediatrik nöroşirürjide şant disfonksiyonu, akut hidrosefali, meningomiyelosel ve klinik bozukluğa neden olan tümörlere öncelik verilmektedir. Özellikle, pediatrik hastalar her bakımdan daha savunmasızdır ve özellikle bu tür zamanlarında daha fazla bakıma ihtiyaç duyarlar

Anahtar Kelimeler:

Pediatri, Sağlık sistemi, SARS-CoV-2

Effects of the covid-19 pandemic on paediatric neurosurgery in turkey

Aim: The coronavirus disease 2019 (COVID-19) pandemic is a catastrophe that has affected millions worldwide and changed the past world order in all respects. In particular, health institutions have been greatly affected as procedural changes were required in all medical specialties, including neurosurgery. In this article, we describe the paediatric neurosurgery patient management practice in our clinic and changes in this procudure in Turkey during the COVID-19 pandemic. Material and Methods: Patient movements from November 2020 to January 2021 and November 2021 to January 2022 in the paediatric neurosurgery department of our clinic were retrospectively evaluated. Further, we performed a literature review. Results: From November 2020 to January 2021 and November 2021 to January 2022, 1888 and 2895 patients were examined at the outpatient clinic and 65 and 156 surgeries were performed, respectively. At the peak of the COVID-19 pandemic, the number outpatient visits decreased by 65.2% and that of surgeries decreased by 41.6%. Conclusion: During the pandemic, the first step in surgical procedures is to distinguish between emergency and elective cases. In this regard, shunt dysfunction, acute hydrocephalus, meningomyelocele and tumours that cause clinical impairment are prioritized in paediatric neurosurgery. Although the health care system is under great pressure due to the COVID-19 pandemic, it remains committed to prioristisin patients.. In particular, paediatric patients are more more vulnerable in all respects and require greater care, especially in such trying times.

Keywords:

children, health care system, SARS-CoV-2,

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1. Balestrino, A., Fiaschi, P., Melloni, I., Riccardi, N., Prior, A., & Zona, G. In Reply: The Coronavirus Disease 2019 Global Pandemic: A Neurosurgical Treatment Algorithm. Neurosurgery 2020; 87(2); E214 doi: 10.1093/neuros/nyaa177
2. Epidemiology of COVID-19 Among Children in China | Pediatrics | American Academy of Pediatrics. Available from: URL: https://publications.aap.org/pediatrics/article/145/6/e20200702/76952/Epidemiology-of-COVID-19-Among-Children-in-China (erişim 04 Mart 2022)
3. Adil, M. T., Rahman, R., Whitelaw, D., Jain, V., Al-Taan, O., Rashid, F., vd. SARS-CoV-2 and the pandemic of COVID-19. Postgraduate Medical Journal 2021; 97(1144); 110-6 doi: 10.1136/postgradmedj-2020-138386
4. Why COVID-19 is less frequent and severe in children: a narrative review - PubMed. Available from: URL: https://pubmed.ncbi.nlm.nih.gov/32978651/ (erişim 04 Mart 2022)
5. Clinical Issues and Guidance. American College of Surgeons. Available from: URL: http://www.facs.org/covid-19/clinical-guidance (erişim 04 Mart 2022)
6. Ceraudo, M., Balestrino, A., Cama, A., Macrina, G., Piatelli, G., & Consales, A. Pediatric Neurosurgery After the COVID-19 Pandemic: Management Strategies from a Single Pediatric Hospital in Italy. World Neurosurgery 2021; 146 e1079-82 doi: 10.1016/j.wneu.2020.11.088
7. Weiner, H. L., Adelson, P. D., Brockmeyer, D. L., Maher, C. O., Gupta, N., Smyth, M. D., vd. Editorial. Pediatric neurosurgery along with Children’s Hospitals’ innovations are rapid and uniform in response to the COVID-19 pandemic. Journal of Neurosurgery. Pediatrics 2020; 26(1); 3-5 doi: 10.3171/2020.4.PEDS20240
8. Hu, Y.-J., Zhang, J.-M., & Chen, Z.-P. Experiences of practicing surgical neuro-oncology during the COVID-19 pandemic. Journal of Neuro-Oncology 2020; 148(1); 199-200 doi: 10.1007/s11060-020-03489-6
9. Khazaei, M., Asgari, R., Zarei, E., Moharramzad, Y., Haghighatkhah, H., & Sanei Taheri, M. Incidentally Diagnosed COVID-19 Infection in Trauma Patients; a Clinical Experience. Archives of Academic Emergency Medicine 2020; 8(1); e31
10. Ruggiero, A., Romano, A., & Attinà, G. Covid-19 and children with cancer: are they at increased risk of infection?. Pediatric Research 2021; 89(3); 398 doi: 10.1038/s41390-020-0919-1
11. Boulad, F., Kamboj, M., Bouvier, N., Mauguen, A., & Kung, A. L. COVID-19 in Children With Cancer in New York City. JAMA oncology 2020; 6(9); 1459-60 doi: 10.1001/jamaoncol.2020.2028
12. Flores, L. E., Williams, D. L., Bell, B. A., O’Brien, M., & Ragab, A. H. Delay in the diagnosis of pediatric brain tumors. American Journal of Diseases of Children (1960) 1986; 140(7); 684-6 doi: 10.1001/archpedi.1986.02140210082031
13. Mohile, N. A., Blakeley, J. O., Gatson, N. T. N., Hottinger, A. F., Lassman, A. B., Ney, D. E., vd. Urgent Considerations for the Neuro-oncologic Treatment of Patients with Gliomas During the COVID-19 Pandemic. Neuro-Oncology 2020; noaa090 doi: 10.1093/neuonc/noaa090
14. Patel, P. D., Kelly, K. A., Reynolds, R. A., Turer, R. W., Salwi, S., Rosenbloom, S. T., vd. Tracking the Volume of Neurosurgical Care During the Coronavirus Disease 2019 Pandemic. World Neurosurgery 2020; 142 e183-94 doi: 10.1016/j.wneu.2020.06.176
15. Jean, W. C., Ironside, N. T., Sack, K. D., Felbaum, D. R., & Syed, H. R. The impact of COVID-19 on neurosurgeons and the strategy for triaging non-emergent operations: a global neurosurgery study. Acta Neurochirurgica 2020; 162(6); 1229-40 doi: 10.1007/s00701-020-04342-5