A snapshot of European neurosurgery December 2019 vs. March 2020: just before and during the Covid-19 pandemic.
Identifieur interne : 001803 ( Main/Exploration ); précédent : 001802; suivant : 001804A snapshot of European neurosurgery December 2019 vs. March 2020: just before and during the Covid-19 pandemic.
Auteurs : T. Mathiesen [Danemark, Suède] ; M. Arraez [Espagne] ; T. Asser [Estonie] ; N. Balak [Turquie] ; S. Barazi [Royaume-Uni] ; C. Bernucci [Italie] ; C. Bolger [Irlande (pays)] ; M L D. Broekman [Pays-Bas, États-Unis] ; A K Demetriades [Royaume-Uni] ; Z. Feldman [Israël] ; M M Fontanella [Italie] ; N. Foroglou [Grèce] ; J. Lafuente [Espagne] ; A D Maier [Danemark] ; B. Meyer [Allemagne] ; M. Niemel [Finlande] ; P H Roche [France] ; F. Sala [Italie] ; N. Sampr N [Espagne] ; U. Sandvik [Suède] ; K. Schaller [Suisse] ; C. Thome [Autriche] ; M. Thys [Belgique] ; M. Tisell [Suède] ; P. Vajkoczy [Allemagne] ; M. Visocchi [Italie]Source :
- Acta neurochirurgica [ 0942-0940 ] ; 2020.
Descripteurs français
- KwdFr :
- Besoins et demandes de services de santé (statistiques et données numériques), Département hospitalier de chirurgie (ressources et distribution), Enquêtes et questionnaires (MeSH), Europe (MeSH), Humains (MeSH), Infections à coronavirus (épidémiologie), Pandémies (MeSH), Pneumopathie virale (épidémiologie), Procédures de neurochirurgie (statistiques et données numériques), Ressources en santé (ressources et distribution), Unités de soins intensifs (ressources et distribution).
- MESH :
- ressources et distribution : Département hospitalier de chirurgie, Ressources en santé, Unités de soins intensifs.
- statistiques et données numériques : Besoins et demandes de services de santé, Procédures de neurochirurgie.
- épidémiologie : Infections à coronavirus, Pneumopathie virale.
- Enquêtes et questionnaires, Europe, Humains, Pandémies.
English descriptors
- KwdEn :
- Coronavirus Infections (epidemiology), Europe (MeSH), Health Resources (supply & distribution), Health Services Needs and Demand (statistics & numerical data), Humans (MeSH), Intensive Care Units (supply & distribution), Neurosurgical Procedures (statistics & numerical data), Pandemics (MeSH), Pneumonia, Viral (epidemiology), Surgery Department, Hospital (supply & distribution), Surveys and Questionnaires (MeSH).
- MESH :
- geographic : Europe.
- epidemiology : Coronavirus Infections, Pneumonia, Viral.
- statistics & numerical data : Health Services Needs and Demand, Neurosurgical Procedures.
- supply & distribution : Health Resources, Intensive Care Units, Surgery Department, Hospital.
- Humans, Pandemics, Surveys and Questionnaires.
Abstract
BACKGROUND
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or Covid-19), which began as an epidemic in China and spread globally as a pandemic, has necessitated resource management to meet emergency needs of Covid-19 patients and other emergent cases. We have conducted a survey to analyze caseload and measures to adapt indications for a perception of crisis.
METHODS
We constructed a questionnaire to survey a snapshot of neurosurgical activity, resources, and indications during 1 week with usual activity in December 2019 and 1 week during SARS-CoV-2 pandemic in March 2020. The questionnaire was sent to 34 neurosurgical departments in Europe; 25 departments returned responses within 5 days.
RESULTS
We found unexpectedly large differences in resources and indications already before the pandemic. Differences were also large in how much practice and resources changed during the pandemic. Neurosurgical beds and neuro-intensive care beds were significantly decreased from December 2019 to March 2020. The utilization of resources decreased via less demand for care of brain injuries and subarachnoid hemorrhage, postponing surgery and changed surgical indications as a method of rationing resources. Twenty departments (80%) reduced activity extensively, and the same proportion stated that they were no longer able to provide care according to legitimate medical needs.
CONCLUSION
Neurosurgical centers responded swiftly and effectively to a sudden decrease of neurosurgical capacity due to relocation of resources to pandemic care. The pandemic led to rationing of neurosurgical care in 80% of responding centers. We saw a relation between resources before the pandemic and ability to uphold neurosurgical services. The observation of extensive differences of available beds provided an opportunity to show how resources that had been restricted already under normal conditions translated to rationing of care that may not be acceptable to the public of seemingly affluent European countries.
DOI: 10.1007/s00701-020-04482-8
PubMed: 32642834
PubMed Central: PMC7343382
Affiliations:
- Allemagne, Autriche, Belgique, Danemark, Espagne, Estonie, Finlande, France, Grèce, Irlande (pays), Israël, Italie, Pays-Bas, Royaume-Uni, Suisse, Suède, Turquie, États-Unis
- Angleterre, Bavière, Berlin, Catalogne, District de Haute-Bavière, Grand Londres, Hovedstaden, Latium, Massachusetts, Provence-Alpes-Côte d'Azur, Svealand, Écosse
- Barcelone, Berlin, Copenhague, Londres, Marseille, Munich, Rome, Stockholm, Édimbourg
- Université Louis-et-Maximilien de Munich, Université d'Aix-Marseille
Links toward previous steps (curation, corpus...)
Le document en format XML
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Tiit.illimar.mathiesen@regionh.dk.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Clinical Medicine, University of Copenhagen, Copenhagen</wicri:regionArea><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation><affiliation wicri:level="3"><nlm:affiliation>Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. Tiit.illimar.mathiesen@regionh.dk.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Clinical Neuroscience, Karolinska Institutet, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Arraez, M" sort="Arraez, M" uniqKey="Arraez M" first="M" last="Arraez">M. 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Balak</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurosurgery, Istanbul Medeniyet University, Göztepe Education and Research Hospital, Istanbul, Turkey.</nlm:affiliation><country xml:lang="fr">Turquie</country><wicri:regionArea>Department of Neurosurgery, Istanbul Medeniyet University, Göztepe Education and Research Hospital, Istanbul</wicri:regionArea><wicri:noRegion>Istanbul</wicri:noRegion></affiliation></author><author><name sortKey="Barazi, S" sort="Barazi, S" uniqKey="Barazi S" first="S" last="Barazi">S. Barazi</name><affiliation wicri:level="3"><nlm:affiliation>King's College Hospital, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>King's College Hospital, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Bernucci, C" sort="Bernucci, C" uniqKey="Bernucci C" first="C" last="Bernucci">C. Bernucci</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neuroscience and Surgery of the Nervous System, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Neuroscience and Surgery of the Nervous System, ASST Papa Giovanni XXIII Hospital, Bergamo</wicri:regionArea><wicri:noRegion>Bergamo</wicri:noRegion></affiliation></author><author><name sortKey="Bolger, C" sort="Bolger, C" uniqKey="Bolger C" first="C" last="Bolger">C. Bolger</name><affiliation wicri:level="1"><nlm:affiliation>National Centre for Neurosurgery, Beaumont Hospital, Dublin, Ireland.</nlm:affiliation><country xml:lang="fr">Irlande (pays)</country><wicri:regionArea>National Centre for Neurosurgery, Beaumont Hospital, Dublin</wicri:regionArea><wicri:noRegion>Dublin</wicri:noRegion></affiliation></author><author><name sortKey="Broekman, M L D" sort="Broekman, M L D" uniqKey="Broekman M" first="M L D" last="Broekman">M L D. Broekman</name><affiliation wicri:level="1"><nlm:affiliation>Departments of Neurosurgery, Haaglanden Medical Center and Leiden University Medical Center, Leiden University, Leiden, Zuid-Holland, the Netherlands.</nlm:affiliation><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Departments of Neurosurgery, Haaglanden Medical Center and Leiden University Medical Center, Leiden University, Leiden, Zuid-Holland</wicri:regionArea><wicri:noRegion>Zuid-Holland</wicri:noRegion></affiliation><affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Neurology, Massachusetts General Hospital, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Demetriades, A K" sort="Demetriades, A K" uniqKey="Demetriades A" first="A K" last="Demetriades">A K Demetriades</name><affiliation wicri:level="3"><nlm:affiliation>Department of Neurosurgery, Western General Hospital, Edinburgh, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Neurosurgery, Western General Hospital, Edinburgh</wicri:regionArea><placeName><settlement type="city">Édimbourg</settlement><region type="country">Écosse</region></placeName></affiliation></author><author><name sortKey="Feldman, Z" sort="Feldman, Z" uniqKey="Feldman Z" first="Z" last="Feldman">Z. Feldman</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel.</nlm:affiliation><country xml:lang="fr">Israël</country><wicri:regionArea>Department of Neurosurgery, Sheba Medical Center, Ramat Gan</wicri:regionArea><wicri:noRegion>Ramat Gan</wicri:noRegion></affiliation></author><author><name sortKey="Fontanella, M M" sort="Fontanella, M M" uniqKey="Fontanella M" first="M M" last="Fontanella">M M Fontanella</name><affiliation wicri:level="1"><nlm:affiliation>Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Spedali Civili di Brescia, Brescia, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Spedali Civili di Brescia, Brescia</wicri:regionArea><wicri:noRegion>Brescia</wicri:noRegion></affiliation></author><author><name sortKey="Foroglou, N" sort="Foroglou, N" uniqKey="Foroglou N" first="N" last="Foroglou">N. Foroglou</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurosurgery, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece.</nlm:affiliation><country xml:lang="fr">Grèce</country><wicri:regionArea>Department of Neurosurgery, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki</wicri:regionArea><wicri:noRegion>Thessaloniki</wicri:noRegion></affiliation></author><author><name sortKey="Lafuente, J" sort="Lafuente, J" uniqKey="Lafuente J" first="J" last="Lafuente">J. Lafuente</name><affiliation wicri:level="3"><nlm:affiliation>Neurosurgery, Hospital Del Mar, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Neurosurgery, Hospital Del Mar, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Maier, A D" sort="Maier, A D" uniqKey="Maier A" first="A D" last="Maier">A D Maier</name><affiliation wicri:level="3"><nlm:affiliation>Department of Neurosurgery, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Neurosurgery, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen</wicri:regionArea><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation><affiliation wicri:level="3"><nlm:affiliation>Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Clinical Medicine, University of Copenhagen, Copenhagen</wicri:regionArea><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author><author><name sortKey="Meyer, B" sort="Meyer, B" uniqKey="Meyer B" first="B" last="Meyer">B. Meyer</name><affiliation wicri:level="4"><nlm:affiliation>Department of Neurosurgery, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurosurgery, Technical University of Munich, Klinikum rechts der Isar, Munich</wicri:regionArea><placeName><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Haute-Bavière</region><settlement type="city">Munich</settlement></placeName><orgName type="university">Université Louis-et-Maximilien de Munich</orgName></affiliation></author><author><name sortKey="Niemel, M" sort="Niemel, M" uniqKey="Niemel M" first="M" last="Niemel">M. Niemel</name><affiliation wicri:level="1"><nlm:affiliation>Helsinki University and Helsinki University Hospital, Helsinki, Finland.</nlm:affiliation><country xml:lang="fr">Finlande</country><wicri:regionArea>Helsinki University and Helsinki University Hospital, Helsinki</wicri:regionArea><wicri:noRegion>Helsinki</wicri:noRegion></affiliation></author><author><name sortKey="Roche, P H" sort="Roche, P H" uniqKey="Roche P" first="P H" last="Roche">P H Roche</name><affiliation wicri:level="4"><nlm:affiliation>Department of Neurosurgery, Hôpital Nord, Assistance Publique - Hôpitaux de Marseille, Aix Marseille Université, Marseille, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Neurosurgery, Hôpital Nord, Assistance Publique - Hôpitaux de Marseille, Aix Marseille Université, Marseille</wicri:regionArea><placeName><region type="region">Provence-Alpes-Côte d'Azur</region><region type="old region">Provence-Alpes-Côte d'Azur</region><settlement type="city">Marseille</settlement></placeName><orgName type="university">Université d'Aix-Marseille</orgName></affiliation></author><author><name sortKey="Sala, F" sort="Sala, F" uniqKey="Sala F" first="F" last="Sala">F. Sala</name><affiliation wicri:level="1"><nlm:affiliation>Section of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University Hospital, Verona, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Section of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University Hospital, Verona</wicri:regionArea><wicri:noRegion>Verona</wicri:noRegion></affiliation></author><author><name sortKey="Sampr N, N" sort="Sampr N, N" uniqKey="Sampr N N" first="N" last="Sampr N">N. Sampr N</name><affiliation wicri:level="1"><nlm:affiliation>Servicio de Neurocirugía, Hospital Universitario Donostia, San Sebastián, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Servicio de Neurocirugía, Hospital Universitario Donostia, San Sebastián</wicri:regionArea><wicri:noRegion>San Sebastián</wicri:noRegion></affiliation></author><author><name sortKey="Sandvik, U" sort="Sandvik, U" uniqKey="Sandvik U" first="U" last="Sandvik">U. Sandvik</name><affiliation wicri:level="3"><nlm:affiliation>Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Clinical Neuroscience, Karolinska Institutet, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation><affiliation wicri:level="1"><nlm:affiliation>Department of Neurosurgery, Karolinska University Hospital, Solna, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Neurosurgery, Karolinska University Hospital, Solna</wicri:regionArea><wicri:noRegion>Solna</wicri:noRegion></affiliation></author><author><name sortKey="Schaller, K" sort="Schaller, K" uniqKey="Schaller K" first="K" last="Schaller">K. Schaller</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurosurgery, Geneva University Medical Center & Faculty of Medicine, Geneva, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Neurosurgery, Geneva University Medical Center & Faculty of Medicine, Geneva</wicri:regionArea><wicri:noRegion>Geneva</wicri:noRegion></affiliation></author><author><name sortKey="Thome, C" sort="Thome, C" uniqKey="Thome C" first="C" last="Thome">C. Thome</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurosurgery, Medical University Innsbruck, Innsbruck, Austria.</nlm:affiliation><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Neurosurgery, Medical University Innsbruck, Innsbruck</wicri:regionArea><wicri:noRegion>Innsbruck</wicri:noRegion></affiliation></author><author><name sortKey="Thys, M" sort="Thys, M" uniqKey="Thys M" first="M" last="Thys">M. Thys</name><affiliation wicri:level="1"><nlm:affiliation>Neurosciences Department, Grand Hopital de Charleroi, Charleroi, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Neurosciences Department, Grand Hopital de Charleroi, Charleroi</wicri:regionArea><wicri:noRegion>Charleroi</wicri:noRegion></affiliation></author><author><name sortKey="Tisell, M" sort="Tisell, M" uniqKey="Tisell M" first="M" last="Tisell">M. Tisell</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurosurgery, Institute of Neuroscience and Physiology, Sahlgrenska University Hospital, Göteborg, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Neurosurgery, Institute of Neuroscience and Physiology, Sahlgrenska University Hospital, Göteborg</wicri:regionArea><wicri:noRegion>Göteborg</wicri:noRegion></affiliation></author><author><name sortKey="Vajkoczy, P" sort="Vajkoczy, P" uniqKey="Vajkoczy P" first="P" last="Vajkoczy">P. Vajkoczy</name><affiliation wicri:level="3"><nlm:affiliation>Department of Neurosurgery, Charite Universitätsmedizin Berlin, Berlin, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurosurgery, Charite Universitätsmedizin Berlin, Berlin</wicri:regionArea><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author><author><name sortKey="Visocchi, M" sort="Visocchi, M" uniqKey="Visocchi M" first="M" last="Visocchi">M. Visocchi</name><affiliation wicri:level="3"><nlm:affiliation>Department of Neurosurgery, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Neurosurgery, Fondazione Policlinico Universitario Agostino Gemelli, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32642834</idno><idno type="pmid">32642834</idno><idno type="doi">10.1007/s00701-020-04482-8</idno><idno type="pmc">PMC7343382</idno><idno type="wicri:Area/Main/Corpus">000A53</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000A53</idno><idno type="wicri:Area/Main/Curation">000A53</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000A53</idno><idno type="wicri:Area/Main/Exploration">000A53</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">A snapshot of European neurosurgery December 2019 vs. March 2020: just before and during the Covid-19 pandemic.</title><author><name sortKey="Mathiesen, T" sort="Mathiesen, T" uniqKey="Mathiesen T" first="T" last="Mathiesen">T. Mathiesen</name><affiliation wicri:level="3"><nlm:affiliation>Department of Neurosurgery, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark. Tiit.illimar.mathiesen@regionh.dk.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Neurosurgery, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen</wicri:regionArea><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation><affiliation wicri:level="3"><nlm:affiliation>Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. Tiit.illimar.mathiesen@regionh.dk.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Clinical Medicine, University of Copenhagen, Copenhagen</wicri:regionArea><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation><affiliation wicri:level="3"><nlm:affiliation>Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. Tiit.illimar.mathiesen@regionh.dk.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Clinical Neuroscience, Karolinska Institutet, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Arraez, M" sort="Arraez, M" uniqKey="Arraez M" first="M" last="Arraez">M. Arraez</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurosurgery, Carlos Haya University Hospital,, University of Malaga, Malaga, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Neurosurgery, Carlos Haya University Hospital,, University of Malaga, Malaga</wicri:regionArea><wicri:noRegion>Malaga</wicri:noRegion></affiliation></author><author><name sortKey="Asser, T" sort="Asser, T" uniqKey="Asser T" first="T" last="Asser">T. Asser</name><affiliation wicri:level="1"><nlm:affiliation>University of Tartu, Tartu, Estonia.</nlm:affiliation><country xml:lang="fr">Estonie</country><wicri:regionArea>University of Tartu, Tartu</wicri:regionArea><wicri:noRegion>Tartu</wicri:noRegion></affiliation></author><author><name sortKey="Balak, N" sort="Balak, N" uniqKey="Balak N" first="N" last="Balak">N. Balak</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurosurgery, Istanbul Medeniyet University, Göztepe Education and Research Hospital, Istanbul, Turkey.</nlm:affiliation><country xml:lang="fr">Turquie</country><wicri:regionArea>Department of Neurosurgery, Istanbul Medeniyet University, Göztepe Education and Research Hospital, Istanbul</wicri:regionArea><wicri:noRegion>Istanbul</wicri:noRegion></affiliation></author><author><name sortKey="Barazi, S" sort="Barazi, S" uniqKey="Barazi S" first="S" last="Barazi">S. Barazi</name><affiliation wicri:level="3"><nlm:affiliation>King's College Hospital, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>King's College Hospital, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Bernucci, C" sort="Bernucci, C" uniqKey="Bernucci C" first="C" last="Bernucci">C. Bernucci</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neuroscience and Surgery of the Nervous System, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Neuroscience and Surgery of the Nervous System, ASST Papa Giovanni XXIII Hospital, Bergamo</wicri:regionArea><wicri:noRegion>Bergamo</wicri:noRegion></affiliation></author><author><name sortKey="Bolger, C" sort="Bolger, C" uniqKey="Bolger C" first="C" last="Bolger">C. Bolger</name><affiliation wicri:level="1"><nlm:affiliation>National Centre for Neurosurgery, Beaumont Hospital, Dublin, Ireland.</nlm:affiliation><country xml:lang="fr">Irlande (pays)</country><wicri:regionArea>National Centre for Neurosurgery, Beaumont Hospital, Dublin</wicri:regionArea><wicri:noRegion>Dublin</wicri:noRegion></affiliation></author><author><name sortKey="Broekman, M L D" sort="Broekman, M L D" uniqKey="Broekman M" first="M L D" last="Broekman">M L D. Broekman</name><affiliation wicri:level="1"><nlm:affiliation>Departments of Neurosurgery, Haaglanden Medical Center and Leiden University Medical Center, Leiden University, Leiden, Zuid-Holland, the Netherlands.</nlm:affiliation><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Departments of Neurosurgery, Haaglanden Medical Center and Leiden University Medical Center, Leiden University, Leiden, Zuid-Holland</wicri:regionArea><wicri:noRegion>Zuid-Holland</wicri:noRegion></affiliation><affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Neurology, Massachusetts General Hospital, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Demetriades, A K" sort="Demetriades, A K" uniqKey="Demetriades A" first="A K" last="Demetriades">A K Demetriades</name><affiliation wicri:level="3"><nlm:affiliation>Department of Neurosurgery, Western General Hospital, Edinburgh, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Neurosurgery, Western General Hospital, Edinburgh</wicri:regionArea><placeName><settlement type="city">Édimbourg</settlement><region type="country">Écosse</region></placeName></affiliation></author><author><name sortKey="Feldman, Z" sort="Feldman, Z" uniqKey="Feldman Z" first="Z" last="Feldman">Z. Feldman</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel.</nlm:affiliation><country xml:lang="fr">Israël</country><wicri:regionArea>Department of Neurosurgery, Sheba Medical Center, Ramat Gan</wicri:regionArea><wicri:noRegion>Ramat Gan</wicri:noRegion></affiliation></author><author><name sortKey="Fontanella, M M" sort="Fontanella, M M" uniqKey="Fontanella M" first="M M" last="Fontanella">M M Fontanella</name><affiliation wicri:level="1"><nlm:affiliation>Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Spedali Civili di Brescia, Brescia, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Spedali Civili di Brescia, Brescia</wicri:regionArea><wicri:noRegion>Brescia</wicri:noRegion></affiliation></author><author><name sortKey="Foroglou, N" sort="Foroglou, N" uniqKey="Foroglou N" first="N" last="Foroglou">N. Foroglou</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurosurgery, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece.</nlm:affiliation><country xml:lang="fr">Grèce</country><wicri:regionArea>Department of Neurosurgery, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki</wicri:regionArea><wicri:noRegion>Thessaloniki</wicri:noRegion></affiliation></author><author><name sortKey="Lafuente, J" sort="Lafuente, J" uniqKey="Lafuente J" first="J" last="Lafuente">J. Lafuente</name><affiliation wicri:level="3"><nlm:affiliation>Neurosurgery, Hospital Del Mar, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Neurosurgery, Hospital Del Mar, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Maier, A D" sort="Maier, A D" uniqKey="Maier A" first="A D" last="Maier">A D Maier</name><affiliation wicri:level="3"><nlm:affiliation>Department of Neurosurgery, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Neurosurgery, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen</wicri:regionArea><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation><affiliation wicri:level="3"><nlm:affiliation>Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Clinical Medicine, University of Copenhagen, Copenhagen</wicri:regionArea><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author><author><name sortKey="Meyer, B" sort="Meyer, B" uniqKey="Meyer B" first="B" last="Meyer">B. Meyer</name><affiliation wicri:level="4"><nlm:affiliation>Department of Neurosurgery, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurosurgery, Technical University of Munich, Klinikum rechts der Isar, Munich</wicri:regionArea><placeName><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Haute-Bavière</region><settlement type="city">Munich</settlement></placeName><orgName type="university">Université Louis-et-Maximilien de Munich</orgName></affiliation></author><author><name sortKey="Niemel, M" sort="Niemel, M" uniqKey="Niemel M" first="M" last="Niemel">M. Niemel</name><affiliation wicri:level="1"><nlm:affiliation>Helsinki University and Helsinki University Hospital, Helsinki, Finland.</nlm:affiliation><country xml:lang="fr">Finlande</country><wicri:regionArea>Helsinki University and Helsinki University Hospital, Helsinki</wicri:regionArea><wicri:noRegion>Helsinki</wicri:noRegion></affiliation></author><author><name sortKey="Roche, P H" sort="Roche, P H" uniqKey="Roche P" first="P H" last="Roche">P H Roche</name><affiliation wicri:level="4"><nlm:affiliation>Department of Neurosurgery, Hôpital Nord, Assistance Publique - Hôpitaux de Marseille, Aix Marseille Université, Marseille, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Neurosurgery, Hôpital Nord, Assistance Publique - Hôpitaux de Marseille, Aix Marseille Université, Marseille</wicri:regionArea><placeName><region type="region">Provence-Alpes-Côte d'Azur</region><region type="old region">Provence-Alpes-Côte d'Azur</region><settlement type="city">Marseille</settlement></placeName><orgName type="university">Université d'Aix-Marseille</orgName></affiliation></author><author><name sortKey="Sala, F" sort="Sala, F" uniqKey="Sala F" first="F" last="Sala">F. Sala</name><affiliation wicri:level="1"><nlm:affiliation>Section of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University Hospital, Verona, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Section of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University Hospital, Verona</wicri:regionArea><wicri:noRegion>Verona</wicri:noRegion></affiliation></author><author><name sortKey="Sampr N, N" sort="Sampr N, N" uniqKey="Sampr N N" first="N" last="Sampr N">N. Sampr N</name><affiliation wicri:level="1"><nlm:affiliation>Servicio de Neurocirugía, Hospital Universitario Donostia, San Sebastián, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Servicio de Neurocirugía, Hospital Universitario Donostia, San Sebastián</wicri:regionArea><wicri:noRegion>San Sebastián</wicri:noRegion></affiliation></author><author><name sortKey="Sandvik, U" sort="Sandvik, U" uniqKey="Sandvik U" first="U" last="Sandvik">U. Sandvik</name><affiliation wicri:level="3"><nlm:affiliation>Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Clinical Neuroscience, Karolinska Institutet, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation><affiliation wicri:level="1"><nlm:affiliation>Department of Neurosurgery, Karolinska University Hospital, Solna, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Neurosurgery, Karolinska University Hospital, Solna</wicri:regionArea><wicri:noRegion>Solna</wicri:noRegion></affiliation></author><author><name sortKey="Schaller, K" sort="Schaller, K" uniqKey="Schaller K" first="K" last="Schaller">K. Schaller</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurosurgery, Geneva University Medical Center & Faculty of Medicine, Geneva, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Neurosurgery, Geneva University Medical Center & Faculty of Medicine, Geneva</wicri:regionArea><wicri:noRegion>Geneva</wicri:noRegion></affiliation></author><author><name sortKey="Thome, C" sort="Thome, C" uniqKey="Thome C" first="C" last="Thome">C. Thome</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurosurgery, Medical University Innsbruck, Innsbruck, Austria.</nlm:affiliation><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Neurosurgery, Medical University Innsbruck, Innsbruck</wicri:regionArea><wicri:noRegion>Innsbruck</wicri:noRegion></affiliation></author><author><name sortKey="Thys, M" sort="Thys, M" uniqKey="Thys M" first="M" last="Thys">M. Thys</name><affiliation wicri:level="1"><nlm:affiliation>Neurosciences Department, Grand Hopital de Charleroi, Charleroi, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Neurosciences Department, Grand Hopital de Charleroi, Charleroi</wicri:regionArea><wicri:noRegion>Charleroi</wicri:noRegion></affiliation></author><author><name sortKey="Tisell, M" sort="Tisell, M" uniqKey="Tisell M" first="M" last="Tisell">M. Tisell</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurosurgery, Institute of Neuroscience and Physiology, Sahlgrenska University Hospital, Göteborg, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Neurosurgery, Institute of Neuroscience and Physiology, Sahlgrenska University Hospital, Göteborg</wicri:regionArea><wicri:noRegion>Göteborg</wicri:noRegion></affiliation></author><author><name sortKey="Vajkoczy, P" sort="Vajkoczy, P" uniqKey="Vajkoczy P" first="P" last="Vajkoczy">P. Vajkoczy</name><affiliation wicri:level="3"><nlm:affiliation>Department of Neurosurgery, Charite Universitätsmedizin Berlin, Berlin, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurosurgery, Charite Universitätsmedizin Berlin, Berlin</wicri:regionArea><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author><author><name sortKey="Visocchi, M" sort="Visocchi, M" uniqKey="Visocchi M" first="M" last="Visocchi">M. Visocchi</name><affiliation wicri:level="3"><nlm:affiliation>Department of Neurosurgery, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Neurosurgery, Fondazione Policlinico Universitario Agostino Gemelli, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author></analytic><series><title level="j">Acta neurochirurgica</title><idno type="eISSN">0942-0940</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Coronavirus Infections (epidemiology)</term><term>Europe (MeSH)</term><term>Health Resources (supply & distribution)</term><term>Health Services Needs and Demand (statistics & numerical data)</term><term>Humans (MeSH)</term><term>Intensive Care Units (supply & distribution)</term><term>Neurosurgical Procedures (statistics & numerical data)</term><term>Pandemics (MeSH)</term><term>Pneumonia, Viral (epidemiology)</term><term>Surgery Department, Hospital (supply & distribution)</term><term>Surveys and Questionnaires (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Besoins et demandes de services de santé (statistiques et données numériques)</term><term>Département hospitalier de chirurgie (ressources et distribution)</term><term>Enquêtes et questionnaires (MeSH)</term><term>Europe (MeSH)</term><term>Humains (MeSH)</term><term>Infections à coronavirus (épidémiologie)</term><term>Pandémies (MeSH)</term><term>Pneumopathie virale (épidémiologie)</term><term>Procédures de neurochirurgie (statistiques et données numériques)</term><term>Ressources en santé (ressources et distribution)</term><term>Unités de soins intensifs (ressources et distribution)</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Europe</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="ressources et distribution" xml:lang="fr"><term>Département hospitalier de chirurgie</term><term>Ressources en santé</term><term>Unités de soins intensifs</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Health Services Needs and Demand</term><term>Neurosurgical Procedures</term></keywords><keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr"><term>Besoins et demandes de services de santé</term><term>Procédures de neurochirurgie</term></keywords><keywords scheme="MESH" qualifier="supply & distribution" xml:lang="en"><term>Health Resources</term><term>Intensive Care Units</term><term>Surgery Department, Hospital</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Humans</term><term>Pandemics</term><term>Surveys and Questionnaires</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Enquêtes et questionnaires</term><term>Europe</term><term>Humains</term><term>Pandémies</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or Covid-19), which began as an epidemic in China and spread globally as a pandemic, has necessitated resource management to meet emergency needs of Covid-19 patients and other emergent cases. We have conducted a survey to analyze caseload and measures to adapt indications for a perception of crisis.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>We constructed a questionnaire to survey a snapshot of neurosurgical activity, resources, and indications during 1 week with usual activity in December 2019 and 1 week during SARS-CoV-2 pandemic in March 2020. The questionnaire was sent to 34 neurosurgical departments in Europe; 25 departments returned responses within 5 days.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>We found unexpectedly large differences in resources and indications already before the pandemic. Differences were also large in how much practice and resources changed during the pandemic. Neurosurgical beds and neuro-intensive care beds were significantly decreased from December 2019 to March 2020. The utilization of resources decreased via less demand for care of brain injuries and subarachnoid hemorrhage, postponing surgery and changed surgical indications as a method of rationing resources. Twenty departments (80%) reduced activity extensively, and the same proportion stated that they were no longer able to provide care according to legitimate medical needs.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>Neurosurgical centers responded swiftly and effectively to a sudden decrease of neurosurgical capacity due to relocation of resources to pandemic care. The pandemic led to rationing of neurosurgical care in 80% of responding centers. We saw a relation between resources before the pandemic and ability to uphold neurosurgical services. The observation of extensive differences of available beds provided an opportunity to show how resources that had been restricted already under normal conditions translated to rationing of care that may not be acceptable to the public of seemingly affluent European countries.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM"><PMID Version="1">32642834</PMID><DateCompleted><Year>2020</Year><Month>08</Month><Day>28</Day></DateCompleted><DateRevised><Year>2020</Year><Month>09</Month><Day>09</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">0942-0940</ISSN><JournalIssue CitedMedium="Internet"><Volume>162</Volume><Issue>9</Issue><PubDate><Year>2020</Year><Month>09</Month></PubDate></JournalIssue><Title>Acta neurochirurgica</Title><ISOAbbreviation>Acta Neurochir (Wien)</ISOAbbreviation></Journal><ArticleTitle>A snapshot of European neurosurgery December 2019 vs. March 2020: just before and during the Covid-19 pandemic.</ArticleTitle><Pagination><MedlinePgn>2221-2233</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1007/s00701-020-04482-8</ELocationID><Abstract><AbstractText Label="BACKGROUND">Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or Covid-19), which began as an epidemic in China and spread globally as a pandemic, has necessitated resource management to meet emergency needs of Covid-19 patients and other emergent cases. We have conducted a survey to analyze caseload and measures to adapt indications for a perception of crisis.</AbstractText><AbstractText Label="METHODS">We constructed a questionnaire to survey a snapshot of neurosurgical activity, resources, and indications during 1 week with usual activity in December 2019 and 1 week during SARS-CoV-2 pandemic in March 2020. The questionnaire was sent to 34 neurosurgical departments in Europe; 25 departments returned responses within 5 days.</AbstractText><AbstractText Label="RESULTS">We found unexpectedly large differences in resources and indications already before the pandemic. Differences were also large in how much practice and resources changed during the pandemic. Neurosurgical beds and neuro-intensive care beds were significantly decreased from December 2019 to March 2020. The utilization of resources decreased via less demand for care of brain injuries and subarachnoid hemorrhage, postponing surgery and changed surgical indications as a method of rationing resources. Twenty departments (80%) reduced activity extensively, and the same proportion stated that they were no longer able to provide care according to legitimate medical needs.</AbstractText><AbstractText Label="CONCLUSION">Neurosurgical centers responded swiftly and effectively to a sudden decrease of neurosurgical capacity due to relocation of resources to pandemic care. The pandemic led to rationing of neurosurgical care in 80% of responding centers. We saw a relation between resources before the pandemic and ability to uphold neurosurgical services. The observation of extensive differences of available beds provided an opportunity to show how resources that had been restricted already under normal conditions translated to rationing of care that may not be acceptable to the public of seemingly affluent European countries.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Mathiesen</LastName><ForeName>T</ForeName><Initials>T</Initials><Identifier Source="ORCID">0000-0001-9463-1919</Identifier><AffiliationInfo><Affiliation>Department of Neurosurgery, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark. Tiit.illimar.mathiesen@regionh.dk.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. Tiit.illimar.mathiesen@regionh.dk.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. Tiit.illimar.mathiesen@regionh.dk.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Arraez</LastName><ForeName>M</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Neurosurgery, Carlos Haya University Hospital,, University of Malaga, Malaga, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Asser</LastName><ForeName>T</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>University of Tartu, Tartu, Estonia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Balak</LastName><ForeName>N</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Department of Neurosurgery, Istanbul Medeniyet University, Göztepe Education and Research Hospital, Istanbul, Turkey.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Barazi</LastName><ForeName>S</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>King's College Hospital, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bernucci</LastName><ForeName>C</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Neuroscience and Surgery of the Nervous System, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bolger</LastName><ForeName>C</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>National Centre for Neurosurgery, Beaumont Hospital, Dublin, Ireland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Broekman</LastName><ForeName>M L D</ForeName><Initials>MLD</Initials><AffiliationInfo><Affiliation>Departments of Neurosurgery, Haaglanden Medical Center and Leiden University Medical Center, Leiden University, Leiden, Zuid-Holland, the Netherlands.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Demetriades</LastName><ForeName>A K</ForeName><Initials>AK</Initials><AffiliationInfo><Affiliation>Department of Neurosurgery, Western General Hospital, Edinburgh, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Feldman</LastName><ForeName>Z</ForeName><Initials>Z</Initials><AffiliationInfo><Affiliation>Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fontanella</LastName><ForeName>M M</ForeName><Initials>MM</Initials><AffiliationInfo><Affiliation>Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Spedali Civili di Brescia, Brescia, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Foroglou</LastName><ForeName>N</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Department of Neurosurgery, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lafuente</LastName><ForeName>J</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Neurosurgery, Hospital Del Mar, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Maier</LastName><ForeName>A D</ForeName><Initials>AD</Initials><AffiliationInfo><Affiliation>Department of Neurosurgery, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Meyer</LastName><ForeName>B</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Department of Neurosurgery, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Niemelä</LastName><ForeName>M</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Helsinki University and Helsinki University Hospital, Helsinki, Finland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Roche</LastName><ForeName>P H</ForeName><Initials>PH</Initials><AffiliationInfo><Affiliation>Department of Neurosurgery, Hôpital Nord, Assistance Publique - Hôpitaux de Marseille, Aix Marseille Université, Marseille, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sala</LastName><ForeName>F</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Section of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University Hospital, Verona, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Samprón</LastName><ForeName>N</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Servicio de Neurocirugía, Hospital Universitario Donostia, San Sebastián, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sandvik</LastName><ForeName>U</ForeName><Initials>U</Initials><AffiliationInfo><Affiliation>Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Neurosurgery, Karolinska University Hospital, Solna, Sweden.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schaller</LastName><ForeName>K</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Department of Neurosurgery, Geneva University Medical Center & Faculty of Medicine, Geneva, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Thome</LastName><ForeName>C</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Neurosurgery, Medical University Innsbruck, Innsbruck, Austria.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Thys</LastName><ForeName>M</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Neurosciences Department, Grand Hopital de Charleroi, Charleroi, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tisell</LastName><ForeName>M</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Neurosurgery, Institute of Neuroscience and Physiology, Sahlgrenska University Hospital, Göteborg, Sweden.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vajkoczy</LastName><ForeName>P</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Department of Neurosurgery, Charite Universitätsmedizin Berlin, Berlin, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Visocchi</LastName><ForeName>M</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Neurosurgery, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><CollectiveName>EANS Ethico-legal committee</CollectiveName></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>07</Month><Day>08</Day></ArticleDate></Article><MedlineJournalInfo><Country>Austria</Country><MedlineTA>Acta Neurochir (Wien)</MedlineTA><NlmUniqueID>0151000</NlmUniqueID><ISSNLinking>0001-6268</ISSNLinking></MedlineJournalInfo><SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005060" MajorTopicYN="N" 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