Disruptions of neurological services, its causes and mitigation strategies during COVID-19: a global review

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Disruptions of neurological services, its causes and mitigation strategies during COVID-19: a global review


JournalJournal of Neurology
Article typeJournal research article – Clinical research
Publication date – Jun – 2021
Authors – David García-Azorín, Katrin M. Seeher, Charles R. Newton, Njideka U. Okubadejo, Andrea Pilotto, Deanna Saylor, Andrea Sylvia Winkler, Chahnez Charfi Triki , Matilde Leonardi
Keywordscovid-19, Health services administration, Nervous system diseases, Neurology, telemedicine
Open access – Yes
SpecialityHealth policy, Neurosurgery
World region Global

Language – English
Submitted to the One Surgery Index on June 1, 2021 at 3:08 am
Abstract:

Background
The COVID-19 pandemic leads to disruptions of health services worldwide. To evaluate the particular impact on neurological services a rapid review was conducted.

Methods
Studies reporting the provision of neurological services during the pandemic and/or adopted mitigation strategies were included in this review. PubMed and World Health Organization’s (WHO) COVID-19 database were searched. Data extraction followed categories used by WHO COVID-19 pulse surveys and operational guidelines on maintaining essential health services during COVID-19.

Findings
The search yielded 1101 articles, of which 369 fulfilled eligibility criteria, describing data from 210,419 participants, being adults (81%), children (11.4%) or both (7.3%). Included articles reported data from 105 countries and territories covering all WHO regions and World Bank income levels (low income: 1.9%, lower middle: 24.7%, upper middle: 29.5% and high income; 44.8%). Cross-sectoral services for neurological disorders were most frequently disrupted (62.9%), followed by emergency/acute care (47.1%). The degree of disruption was at least moderate for 75% of studies. Travel restrictions due to lockdowns (81.7%) and regulatory closure of services (65.4%) were the most commonly reported causes of disruption. Authors most frequently described telemedicine (82.1%) and novel dispensing approaches for medicines (51.8%) as mitigation strategies. Evidence for the effectiveness of these measures is largely missing.

Interpretation
The COVID-19 pandemic affects all aspects of neurological care. Given the worldwide prevalence of neurological disorders and the potential long-term neurological consequences of COVID-19, service disruptions are devastating. Different strategies such as telemedicine might mitigate the negative effects of the pandemic, but their efficacy and acceptability remain to be seen.

OSI Number – 21114

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