ORIGINAL
Introdução: Além da morbimortalidade perioperatória, o COVID-19 afetou as rotinas de cuidado e a saúde mental de pacientes e cuidadores. No entanto, as principais diretrizes desaconselham o adiamento de neurocirurgias oncológicas. O objetivo deste estudo foi avaliar a morbimortalidade neurocirúrgica durante a pandemia em um hospital oncológico. Secundariamente, avaliamos as taxas de infecção, COVID-19 e saúde mental na equipe médica. Métodos: Todos os 266 pacientes testados para o vírus SARS-CoV-2, submetidos à neurocirurgia entre março/2020 e abril/2021, foram considerados e incluídos no estudo. O grupo que testou positivo (Grupo-A) foi comparado aos pacientes que testaram negativo (Grupo-B) em relação ao tempo de internação, taxa de complicações e probabilidade de sobrevivência. Os neurocirurgiões envolvidos foram avaliados quanto à taxa de infecção e humor pelo teste RT-PCR, autodeclaração e escala HADS, respectivamente. Resultados: A taxa de infecção entre pacientes e médicos foi de 6,01% e 47,36%, respectivamente. Todos os médicos infectados adoeceram. No Grupo-A, as complicações foram mais frequentes, mas não houve diferença estatisticamente significativa. O grupo B apresentou melhor curva de sobrevida e menor chance de óbito por até 180 dias (p=0,02). Todos os médicos declararam transtornos de humor e a escala HADS identificou 21,01% e 10,52% casos prováveis de depressão e ansiedade, respectivamente. Conclusão: Entre os pacientes, as taxas de infecção e morbidade e mortalidade foram baixas, no entanto, a detecção do vírus piorou a curva de sobrevivência. As taxas de infecção, COVID-19 e alterações de humor foram altas entre os cirurgiões, mas não houve casos graves. Esses resultados refletem ajustes nas rotinas de cuidados e incentivo à vacinação em massa.
Background: In addition to perioperative morbidity and mortality, COVID-19 affected care routines and the mental health of patients and caregivers. However, the main guidelines advise against postponing oncological neurosurgeries. The aim of this study was to evaluate neurosurgical morbidity and mortality during the pandemic in an oncology hospital. Secondarily, we assessed rates of infection, COVID-19, and mental health in medical staff. Methods: All 266 patients tested for the SARS-CoV-2 virus, that underwent neurosurgery between March/2020 and April/2021, were considered and included in the study. The group that tested positive (Group-A) was compared to the patients that tested negative (Group-B) regarding length of stay, complication rate, and probability of survival. The neurosurgeons involved were evaluated for infection rate and mood by RT-PCR test, self-declaration and the HADS scale. Results: The infection rate among patients and physicians was 6.01% and 47.36%, respectively. All infected doctors fell ill. In Group-A, complications were more frequent, but there was no statistically significant difference. Group-B had a better survival curve and a lower chance of dying for up to 180 days (p=0.02). All doctors declared mood disorders and the HADS scale identified 21.01% and 10.52% probable cases of depression and anxiety, respectively. Conclusion: Among the patients, infection and morbidity and mortality rates were low; however, virus detection worsened the survival curve. Infection rates, COVID-19, and mood swings were high among surgeons, but there were no severe cases. These results reflect adjustments in care routines and encouragement for extensive vaccination.
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1MD, PhD, Department of Neurology, Faculty of Medicine, Sao Paulo University - USP, São Paulo, SP, Brasil.
2MS, Department of Neurology, Faculty of Medicine, Sao Paulo University - USP, São Paulo, SP, Brasil.
3MD, Department of Neurology, Faculty of Medicine, Sao Paulo University - USP, São Paulo, SP, Brasil.
4MD, PhD, Associate Professor, Department of Neurology, Faculty of Medicine, Sao Paulo University - USP, São Paulo, SP, Brasil.
5MD, PhD, Professor, Department of Neurology, Faculty of Medicine, Sao Paulo University - USP, São Paulo, SP, Brasil.
Received Jul 7, 2023
Accepted Jul 21, 2023
