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

Identifieur interne : 000055 ( PubMed/Checkpoint ); précédent : 000054; suivant : 000056

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

Auteurs : David García-Azorín [Espagne] ; Katrin M. Seeher [Suisse] ; Charles R. Newton [Royaume-Uni] ; Njideka U. Okubadejo [Nigeria] ; Andrea Pilotto [Italie] ; Deanna Saylor [États-Unis] ; Andrea Sylvia Winkler [Allemagne, Norvège] ; Chahnez Charfi Triki [Tunisie] ; Matilde Leonardi [Italie]

Source :

RBID : pubmed:34021772

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.


DOI: 10.1007/s00415-021-10588-5
PubMed: 34021772
PubMed Central: PMC8140556


Affiliations:


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Le document en format XML

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<b>BACKGROUND</b>
</p>
<p>The COVID-19 pandemic leads to disruptions of health services worldwide. To evaluate the particular impact on neurological services a rapid review was conducted.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>METHODS</b>
</p>
<p>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.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>FINDINGS</b>
</p>
<p>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.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>INTERPRETATION</b>
</p>
<p>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.</p>
</div>
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<Affiliation>Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway.</Affiliation>
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<Affiliation>Child neurology department-Hedi Chaker Hospital, LR19ES 15-Sfax University, Sfax, Tunisia.</Affiliation>
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<AffiliationInfo>
<Affiliation>Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.</Affiliation>
</AffiliationInfo>
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<Keyword MajorTopicYN="N">Health services administration</Keyword>
<Keyword MajorTopicYN="N">Nervous system diseases</Keyword>
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