The Effects of the COVID-19 Pandemic on Patients with Concussion Presenting to a Specialty Clinic.

Kontos, Anthony P; Eagle, Shawn R; Holland, Cynthia L; Thomas, Danny; Hickey, Robert; Santucci, Chris; Collins, Michael W

The purpose of this study is to examine the effects of the COVID-19 pandemic on patients presenting with concussion at a specialty clinic. This study used a retrospective cohort design to compare participants (n=3,021) with a suspected concussion, including a Pandemic cohort (n=1,139; March 2020-February 2021) and a Pre-Pandemic cohort (n=1,882; March 2019-February 2020). Concussions and patient characteristics including age, sex, days since injury, and injury mechanism were extracted from a electronic health record. There were 39.5% (n= 743) fewer concussions in Pandemic. Pandemic presented to the clinic 25.8 days later (p<0.001) and were 1.9 years older (p<0.001) than Pre-Pandemic. Sport-related concussions decreased 59.6% overall for Pandemic. Pandemic was associated with proportional increases of concussions involving recreational activities (Odds Ratio [OR]= 6.11, p<.001), motor vehicle collisions (OR= 1.39 p<.001), and falls/assaults (OR= 1.33, p<.001). A total of 9.4% (107/1,139) of all Pandemic concussion initial clinical visits were performed using telehealth (0% in Pre-Pandemic). Concussion visit volume to a sub-specialty clinic decreased by approximately 40% during the COVID-19 pandemic and patients presented to the clinic nearly one month later. The increase in telehealth highlights the potential to expand clinical care outreach during the current and future pandemics or similar restrictive time periods.