“Staying Home” - Early Changes in Patterns of Neurotrauma in New York City during the COVID-19 Pandemic

Lara-Reyna, Jacques; Yaeger, Kurt A.; Rossitto, Christina P.; Camara, Divaldo; Wedderburn, Raymond; Ghatan, Saadi; Bederson, Joshua B.; Margetis, Konstantinos

ABSTRACT Objective New York City is the epicenter of the novel coronavirus disease 2019 (COVID-19) pandemic in the United States. Traumatic brain injury accounts for a significant proportion of admissions to our trauma center. We sought to characterize the effect of the pandemic on neurotraumas, given the cancellation of non-essential activities during the crisis. Methods Retrospective and prospective review were performed from November 2019 to April 2020. General demographics, clinical status, mechanism of trauma, diagnosis, and treatment instituted were recorded. We dichotomized the data between pre-COVID-19 (before March 1st) and COVID-19 periods and compared the differences between the two groups. We present the timeline of events since the beginning of crisis in relation to the number of neurotraumas. Results A total of 150 patients composed our cohort with a mean age of 66.2 years (SD+/-: 18.9), and 66% male. More males sustained neurotrauma in the COVID-19 period compared with the pre-COVID-19 (60.4% vs 77.6%, p=0.03). The most common mechanism of trauma was mechanical fall, but it was observed less frequently compared to the pre-COVID-19 period (61.4% vs 40.8; p=0.03). Subdural hematoma, traumatic subarachnoid hemorrhage, and intracerebral contusion accounted for the most common pathologies in both periods. Non-operative management was selected for most patients (79.2 vs 87.8%, p= 0.201) in both periods. Conclusions A decrease in the frequency of neurotraumas was observed during the COVID-19 crisis concomitant with the increase in COVID-19 patients in the city. This trend began after the cancellation of non-essential activities and the implementation of social distancing recommendations.