Introduction

The Coronavirus disease 2019 (COVID-19) pandemic has uprooted healthcare systems worldwide, disrupting care and increasing dependence on alternative forms of health care delivery. It is yet to be determined how the pandemic affected neuro-oncology patient outcomes, given that the majority of even “elective” neurosurgical oncology procedures are time-sensitive. This study quantifies changes in neuro-oncological care during the height of the pandemic and investigates patient outcomes in 2020 compared to a historical control.

Methods

We performed a retrospective review of patients with malignant brain tumor diagnoses who were seen at our institution between March 13 and May 1 of 2020 and 2019. Alterations in care, including shift from in-person to telehealth, delays in evaluation and intervention, and treatment modifications were evaluated. These variables were analyzed with respect to brain tumor control and mortality.

Results

112 patients from 2020 to 166 patients from 2019 were included. There was no significant difference in outcomes between the cohorts, despite significantly more treatment delays (p = 0.0160) and use of telehealth (p < 0.0001) in 2020. Patients in 2020 who utilized telehealth visits had significantly more stable tumor control than those who had office visits (p = 0.0124), consistent with appropriate use of in-person visits for patients with progression.

Conclusions

Our study showed that use of telehealth and selective alterations in neuro-oncological care during the COVID-19 pandemic did not lead to adverse patient outcomes. This suggests that adaptive physician-led changes were successful and may inform management during the ongoing pandemic, especially with the emergence of the Delta variant.

中文翻译：

---

COVID-19 大流行对神经肿瘤学结果的影响

介绍

2019 年冠状病毒病 (COVID-19) 大流行已将全球医疗保健系统连根拔起，扰乱了医疗保健服务，并增加了对替代医疗保健服务形式的依赖。鉴于大多数甚至“选择性”的神经外科肿瘤手术都是时间敏感的，因此大流行如何影响神经肿瘤患者的预后尚待确定。这项研究量化了大流行高峰期间神经肿瘤护理的变化，并与历史对照相比，调查了 2020 年的患者结果。

方法

我们对 2020 年 3 月 13 日至 5 月 1 日和 2019 年在我们机构就诊的恶性脑瘤患者进行了回顾性审查。护理的变化，包括从面对面医疗到远程医疗的转变、评估和干预的延迟以及治疗对修改进行了评估。就脑肿瘤控制和死亡率分析了这些变量。

结果

纳入了 2020 年的 112 名患者至 2019 年的 166 名患者。尽管 2020 年治疗延误 (p = 0.0160) 和远程医疗的使用 (p < 0.0001) 显着增加，但队列之间的结果没有显着差异。2020 年，使用远程医疗就诊的患者的肿瘤控制明显比那些使用远程医疗的患者更稳定。办公室就诊（p = 0.0124），与对进展患者适当使用面对面就诊一致。

结论

我们的研究表明，在 COVID-19 大流行期间使用远程医疗和选择性改变神经肿瘤护理并不会导致不良的患者预后。这表明由医生主导的适应性变革是成功的，并且可能会在持续的大流行期间为管理层提供信息，尤其是随着 Delta 变体的出现。