The impact of the SARS-CoV-2 pandemic on referral characteristics to a national tertiary spinal injuries unit

Background: The SARS-CoV-2 pandemic has had profound implications on healthcare institutions The aim of this study is to assess and compare referral patterns during Covid-19 to corresponding dates for the preceding three years (2017-2019), in order to pre-emptively coordinate the logistics of the surgical unit for similar future experiences Methods: A retrospective review was carried out at our institution, a national tertiary referral centre for spine pathology Two distinct time-points were chosen to represent the varied levels of social restriction during the current pandemic;(i) Study period 1 (SP1) from 11/03/20-08/06/ 20 represents a national lockdown, and (ii) Study period 2 (SP2) from 09/06/20-09/09/20 indicates an easing of restrictions Both periods were compared to corresponding dates (CP1: 11/03-08/06 and CP2: 09/06-09/09) for the preceding three years (2017-2019) Data collected included age, gender, and mechanism of injury (MOI) for descriptive analyses MOIs were categorised into disc disease, cyclist, road-traffic-accident (RTA), falls 2m, malignancy, sporting injuries, and miscellaneous Results: All MOI categories witnessed a reduction in referral numbers during SP1;disc disease (-29%), cyclist (-5%), RTAs (-66%), Falls 2m (-17%), malignancy (-33%), sporting injuries (-100%), miscellaneous (-58%) 4/8 categories (RTAs, falls 2m) showed a further reduction (-34%, -27%) during SP2 One category (sporting injuries) portrayed a complete return to normal values during SP2 while a notable increase in cyclist related referrals were witnessed (+63%) when compared with corresponding dates of previous years Conclusion: Spinal injury continues to occur across almost all categories, albeit at considerably reduced numbers RTAs and falls remained the most common mechanism of injury Awareness needs to be drawn to the reduction of malignancy related referrals to dissuade people with such symptoms from avoiding presentation to hospital over periods of social restrictions