Disruptions of neurological services, its causes and mitigation strategies during COVID-19: a global review.
Identifieur interne : 000055 ( PubMed/Checkpoint ); précédent : 000054; suivant : 000056Disruptions 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 :
- Journal of neurology [ 1432-1459 ] ; 2021.
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:
- Allemagne, Espagne, Italie, Nigeria, Norvège, Royaume-Uni, Suisse, Tunisie, États-Unis
- Angleterre, Bavière, District de Haute-Bavière, Lombardie, Maryland, Oxfordshire, Østlandet
- Milan, Munich, Oslo, Oxford
- Université Louis-et-Maximilien de Munich, Université d'Oxford
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pubmed:34021772Le document en format XML
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<front><div type="abstract" xml:lang="en"><p><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>
</front>
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<Abstract><AbstractText Label="BACKGROUND" NlmCategory="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.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="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.</AbstractText>
<AbstractText Label="FINDINGS" NlmCategory="RESULTS">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.</AbstractText>
<AbstractText Label="INTERPRETATION" NlmCategory="CONCLUSIONS">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.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>García-Azorín</LastName>
<ForeName>David</ForeName>
<Initials>D</Initials>
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</AffiliationInfo>
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<ForeName>Andrea</ForeName>
<Initials>A</Initials>
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<AffiliationInfo><Affiliation>Department of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, Brescia, Italy.</Affiliation>
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<Initials>D</Initials>
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<ForeName>Andrea Sylvia</ForeName>
<Initials>AS</Initials>
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</AffiliationInfo>
<AffiliationInfo><Affiliation>Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y" EqualContrib="Y"><LastName>Charfi Triki</LastName>
<ForeName>Chahnez</ForeName>
<Initials>C</Initials>
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<AffiliationInfo><Affiliation>Child neurology department-Hedi Chaker Hospital, LR19ES 15-Sfax University, Sfax, Tunisia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y" EqualContrib="Y"><LastName>Leonardi</LastName>
<ForeName>Matilde</ForeName>
<Initials>M</Initials>
<Identifier Source="ORCID">http://orcid.org/0000-0003-0552-8923</Identifier>
<AffiliationInfo><Affiliation>Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.</Affiliation>
</AffiliationInfo>
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<Month>05</Month>
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<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword>
<Keyword MajorTopicYN="N">Health services administration</Keyword>
<Keyword MajorTopicYN="N">Nervous system diseases</Keyword>
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