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?:abstract
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Background During the coronavirus 19 (COVID-19) pandemic, physicians have begun adapting their daily practices to prevent transmissions In this study we aimed to provide surgical neuro-oncologists with practice guidelines during the COVID-19 pandemic based on objective data from a high-volume brain tumor surgeon at the current COVID-19 epicenter Methods All outpatient visits and surgeries performed by the senior author during the COVID-19 pandemic were compared between the initial quarantine (3/23/20 – 5/4/20), the plateau period following quarantine (5/5/20-6/27/20), and the second peak (6/28/20-7/20/20) In-person and telemedicine visits were evaluated for crossovers Surgeries were subdivided based on lesion type and evaluated across the same time period Results From 3/23/20 – 7/20/20, 469 clinic visits and 196 surgeries were identified After quarantine was lifted, face-to-face visits increased (P<0 01) yet no change in telehealth visits occurred Of 327 telehealth visits, only 5 8% converted to in-person during the 4-month period with the most cited reason being patient preference (68 4%) Of the 196 surgeries performed during the pandemic, 29 1% occurred during quarantine, 49 0% during the plateau, and 21 9% occurred in the second peak No COVID negative patients developed symptoms at follow-up 55 6% were performed on malignant tumors and 31 6% were benign with no difference in case volumes throughout the pandemic Conclusions Despite exceptional challenges, we have maintained a high-volume surgical neuro-oncology practice at the epicenter of the COVID-19 pandemic We provide the protocols implemented at our institution in order to maximize neuro-oncology care while mitigating risk of COVID-19 exposure to both patients and providers
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