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Journal article : Review

Disruptions of neurological services, its causes and mitigation strategies during COVID-19: a global review

Abstract:
Background The COVID-19 pandemic leads to disruptions of health services worldwide. To evaluate the particular impact on neurological services a rapid review was conducted.
Methods Studies reporting the provision of neurological services during the pandemic and/or adopted mitigation strategies were included in this review. PubMed and World Health Organization’s (WHO) COVID-19 database were searched. Data extraction followed categories used by WHO COVID-19 pulse surveys and operational guidelines on maintaining essential health services during COVID-19.
Findings The search yielded 1101 articles, of which 369 fulfilled eligibility criteria, describing data from 210,419 participants, being adults (81%), children (11.4%) or both (7.3%). Included articles reported data from 105 countries and territories covering all WHO regions and World Bank income levels (low income: 1.9%, lower middle: 24.7%, upper middle: 29.5% and high income; 44.8%). Cross-sectoral services for neurological disorders were most frequently disrupted (62.9%), followed by emergency/acute care (47.1%). The degree of disruption was at least moderate for 75% of studies. Travel restrictions due to lockdowns (81.7%) and regulatory closure of services (65.4%) were the most commonly reported causes of disruption. Authors most frequently described telemedicine (82.1%) and novel dispensing approaches for medicines (51.8%) as mitigation strategies. Evidence for the effectiveness of these measures is largely missing.
Interpretation The COVID-19 pandemic affects all aspects of neurological care. Given the worldwide prevalence of neurological disorders and the potential long-term neurological consequences of COVID-19, service disruptions are devastating. Different strategies such as telemedicine might mitigate the negative effects of the pandemic, but their efficacy and acceptability remain to be seen.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1007/s00415-021-10588-5

Authors

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Role:
Author
ORCID:
0000-0002-3132-1064
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Institution:
University of Oxford
Division:
MSD
Sub department:
Psychiatry
Oxford college:
St John's College
Role:
Author
ORCID:
0000-0002-6999-5507
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Role:
Author
ORCID:
0000-0003-2975-8803
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Role:
Author
ORCID:
0000-0003-2029-6606


Publisher:
Springer
Journal:
Journal of Neurology More from this journal
Volume:
268
Issue:
11
Pages:
3947-3960
Place of publication:
Germany
Publication date:
2021-05-22
Acceptance date:
2021-04-29
DOI:
EISSN:
1432-1459
ISSN:
0340-5354
Pmid:
34021772


Language:
English
Keywords:
Subtype:
Review
Pubs id:
1179494
Local pid:
pubs:1179494
Deposit date:
2021-10-07
ARK identifier:

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