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      Coronavirus disease-19 is associated with decreased treatment access and worsened outcomes in malignant brain tumor patients

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background:

          The global coronavirus disease-19 (COVID-19) pandemic has resulted in procedural delays around the world; however, timely and aggressive surgical resection for malignant brain tumor patients is essential for outcome optimization. To investigate the association between COVID-19 and outcomes of these patients, we queried the 2020 National Inpatient Sample (NIS) for differences in rates of surgical resection, time to surgery, mortality, and discharge disposition between patients with and without confirmed COVID-19 infection.

          Methods:

          Patient data were taken from the NIS from April 2020 to December 2020. COVID-19 diagnosis was determined with the International Classification of Diseases, Tenth Revision, Clinical Modification code U07.1.

          Results:

          A total of 30,671 malignant brain tumor patients met inclusion criteria and 738 (2.4%) patients had a confirmed COVID-19 diagnosis. COVID-19-positive patients had lower likelihood of receiving surgery (Odds ratio [OR] 0.43, 95% confidence interval [CI] 0.29–0.63, P < 0.0001), increased likelihood of mortality (OR 2.18, 95% CI 1.78–2.66, P < 0.0001), and increased likelihood of non-routine discharge (OR 1.25, 95% CI 1.13–1.39, P < 0.0001). Notably, COVID patients receiving surgery were not associated with surgical delay ( P = 0.17).

          Conclusion:

          COVID-19 infection was associated with worse patient outcome in malignant brain tumor patients, including decreased likelihood of receiving surgery, increased likelihood of mortality, and increased likelihood of non-routine discharge. Our study highlights the need to balance the risks and benefits of delaying surgery for malignant brain tumor patients with COVID-19. Although the COVID-19 pandemic is no longer a public health emergency, understanding the pandemic’s impact on outcome provides important insight in effective triage for these patients in the situations where resources are limited.

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          Most cited references38

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          Elective surgery cancellations due to the COVID ‐19 pandemic: global predictive modelling to inform surgical recovery plans

          Dmitri Nepogodiev, Aneel Bhangu, Savino Spadaro … (2020)
          Background The COVID‐19 pandemic has disrupted routine hospital services globally. This study estimated the total number of adult elective operations that would be cancelled worldwide during the 12 weeks of peak disruption due to COVID‐19. Methods A global expert‐response study was conducted to elicit projections for the proportion of elective surgery that would be cancelled or postponed during the 12 weeks of peak disruption. A Bayesian beta‐regression model was used to estimate 12‐week cancellation rates for 190 countries. Elective surgical case‐mix data, stratified by specialty and indication (cancer versus benign surgery), was determined. This case‐mix was applied to country‐level surgical volumes. The 12‐week cancellation rates were then applied to these figures to calculate total cancelled operations. Results The best estimate was that 28,404,603 operations would be cancelled or postponed during the peak 12 weeks of disruption due to COVID‐19 (2,367,050 operations per week). Most would be operations for benign disease (90.2%, 25,638,922/28,404,603). The overall 12‐week cancellation rate would be 72.3%. Globally, 81.7% (25,638,921/31,378,062) of benign surgery, 37.7% (2,324,069/6,162,311) of cancer surgery, and 25.4% (441,611/1,735,483) of elective Caesarean sections would be cancelled or postponed. If countries increase their normal surgical volume by 20% post‐pandemic, it would take a median 45 weeks to clear the backlog of operations resulting from COVID‐19 disruption. Conclusions A very large number of operations will be cancelled or postponed due to disruption caused by COVID‐19. Governments should mitigate against this major burden on patients by developing recovery plans and implementing strategies to safely restore surgical activity. This article is protected by copyright. All rights reserved.
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            The Disproportionate Impact of COVID-19 on Racial and Ethnic Minorities in the United States

            Don Bambino Geno Tai, Aditya Shah, Chyke Doubeni … (2020)
            Abstract The COVID-19 pandemic has disproportionately affected racial and ethnic minority groups, with high rates of death in African American, Native American, and LatinX communities. While the mechanisms of these disparities are being investigated, they can be conceived as arising from biomedical factors as well as social determinants of health. Minority groups are disproportionately affected by chronic medical conditions and lower access to healthcare that may portend worse COVID-19 outcomes. Furthermore, minority communities are more likely to experience living and working conditions that predispose them to worse outcomes. Underpinning these disparities are long-standing structural and societal factors that the COVID-19 pandemic has exposed. Clinicians can partner with patients and communities to reduce the short-term impact of COVID-19 disparities while advocating for structural change.
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              Racial and Ethnic Disparities in COVID-19–Related Infections, Hospitalizations, and Deaths

              Katherine R.M. Mackey, Chelsea K. Ayers, Karli K Kondo … (2020)
              Data suggest that impacts of COVID-19 differ among U.S. racial/ethnic groups. This systematic review evaluates racial/ethnic disparities in SARS-CoV-2 infection rates and COVID-19 outcomes, factors contributing to disparities, and interventions to reduce them.
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                Author and article information

                Contributors
                Kristie Qwan-Ting Liu
                Jonathan Dallas
                Talia A. Wenger: https://orcid.org/0000-0001-6616-2780
                Hunter Richards: https://orcid.org/0000-0002-3218-6087
                Li Ding
                Frances Elaine Chow: https://orcid.org/0000-0001-5402-2473
                Gabriel Zada
                William J. Mack
                Frank J. Attenello
                Journal
                Journal ID (nlm-ta): Surg Neurol Int
                Journal ID (iso-abbrev): Surg Neurol Int
                Title: Surgical Neurology International
                Publisher: Scientific Scholar (USA )
                ISSN (Print): 2229-5097
                ISSN (Electronic): 2152-7806
                Publication date Collection: 2023
                Publication date (Electronic): 18 August 2023
                Volume: 14
                Electronic Location Identifier: 292
                Affiliations
                [1 ]Department of Neurological Surgery, Keck School of Medicine of University of Southern California, Los Angeles, California, United States
                [2 ]Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, United States
                [3 ]Department of Preventive Medicine, Keck School of Medicine of University of Southern California, Los Angeles, California, United States.
                Author notes
                [* ] Corresponding author: Kristie Qwan-Ting Liu, Department of Neurological Surgery, Keck School of Medicine of USC, Los Angeles, California, United States. kqliu@ 123456usc.edu
                Article
                Publisher ID: 10.25259/SNI_440_2023
                DOI: 10.25259/SNI_440_2023
                PMC ID: 10481862
                PubMed ID: 37680935
                SO-VID: ed6c212b-6e10-467c-9ff1-2c238193a281
                Copyright © Copyright: © 2023 Surgical Neurology International
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                Date received : 22 May 2023
                Date accepted : 23 July 2023
                Categories
                Subject: Original Article

                ScienceOpen disciplines: Surgery
                Keywords: brain tumor,coronavirus,coronavirus disease-19,malignant,national inpatient sample
                Data availability:
                ScienceOpen disciplines: Surgery
                Keywords: brain tumor, coronavirus, coronavirus disease-19, malignant, national inpatient sample

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