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Background <p>COVID-19 pandemic has substantially affected neurosurgical care globally through service reorganizations, delayed presentation, alterations in case selection, and limited perioperative resources. However, overall impact of these changes on clinical outcomes in neurosurgical patients remains unclear. Hence, this review evaluated clinical outcomes of neurosurgical patients managed during COVID-19 era compared with pre-pandemic era.</p> Methods <p>Systematic search of PubMed, Embase, Scopus, Web of Science was conducted from inception of database till March 2026. Pooled effect estimates were calculated using random-effects meta-analysis. Odds ratios (ORs) were used for dichotomous outcomes and weighted mean differences (WMDs) for continuous outcomes. Heterogeneity was assessed using I² statistic.</p> Results <p>Twenty studies were included. In the primary pre-pandemic comparison, mortality was significantly higher during the COVID-19 era across 18 studies including 35,639 patients (OR = 1.49, 95%CI 1.20–1.85; I² = 44.7%). Postoperative complications were also increased across 13 studies including 12,174 patients (OR = 1.44, 95%CI 1.04–1.98; I² = 78.5%). No significant difference was observed for requirement of mechanical ventilation (OR = 1.20, 95%CI 0.81–1.76; I² = 0.0%), whereas length-of-stay findings were inconclusive because of high heterogeneity (WMD = -1.46 days, 95%CI -3.19 to 0.28; I² = 85.8%).</p> Conclusions <p>Neurosurgical patients managed during the COVID-19 era had higher mortality and postoperative complication rates than those treated before the pandemic. These findings highlight the vulnerability of neurosurgical care systems to large-scale health-system disruption and underscore the need for resilient strategies to ensure timely and safer neurosurgical care during future disruptions.</p> Clinical trial registration <p>Not applicable.</p>

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Clinical outcomes of neurosurgical patients during the COVID-19 pandemic: a systematic review and meta-analysis of global data

  • 期刊论文

  • 发表日期：

    2026年8月5日

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  • Xuan Bai,
  • Siyu Dong

摘要

Background

COVID-19 pandemic has substantially affected neurosurgical care globally through service reorganizations, delayed presentation, alterations in case selection, and limited perioperative resources. However, overall impact of these changes on clinical outcomes in neurosurgical patients remains unclear. Hence, this review evaluated clinical outcomes of neurosurgical patients managed during COVID-19 era compared with pre-pandemic era.

Methods

Systematic search of PubMed, Embase, Scopus, Web of Science was conducted from inception of database till March 2026. Pooled effect estimates were calculated using random-effects meta-analysis. Odds ratios (ORs) were used for dichotomous outcomes and weighted mean differences (WMDs) for continuous outcomes. Heterogeneity was assessed using I² statistic.

Results

Twenty studies were included. In the primary pre-pandemic comparison, mortality was significantly higher during the COVID-19 era across 18 studies including 35,639 patients (OR = 1.49, 95%CI 1.20–1.85; I² = 44.7%). Postoperative complications were also increased across 13 studies including 12,174 patients (OR = 1.44, 95%CI 1.04–1.98; I² = 78.5%). No significant difference was observed for requirement of mechanical ventilation (OR = 1.20, 95%CI 0.81–1.76; I² = 0.0%), whereas length-of-stay findings were inconclusive because of high heterogeneity (WMD = -1.46 days, 95%CI -3.19 to 0.28; I² = 85.8%).

Conclusions

Neurosurgical patients managed during the COVID-19 era had higher mortality and postoperative complication rates than those treated before the pandemic. These findings highlight the vulnerability of neurosurgical care systems to large-scale health-system disruption and underscore the need for resilient strategies to ensure timely and safer neurosurgical care during future disruptions.

Clinical trial registration

Not applicable.