Letter: Safety Considerations for Neurosurgical Procedures During the COVID-19 Pandemic

UMMS Affiliation

Department of Neurological Surgery

Publication Date


Document Type

Letter to the Editor


Health Services Administration | Infectious Disease | Nervous System Diseases | Neurology | Surgery | Surgical Procedures, Operative | Virus Diseases


The highest viral load for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is found in the lungs, nasopharynx, and oropharynx. Thus, working in close proximity to the face likely represents the greatest risk of SARS-CoV-2 exposure for neurosurgeons, many of whom have contracted and/or died from COVID-19. However, sources of exposure other than the respiratory tract should also be considered. SARS-CoV-2 viremia has been reported. SARS-CoV (which is closely related to SARS-CoV-2) can invade the brain. SARS-CoV-2 ribonucleic acid has been detected in the cerebrospinal fluid (CSF) of COVID-19 patients with altered mental status, intracranial hypertension, and/or brain imaging abnormalities, raising the possibility of SARS-CoV-2 meningitis or encephalitis. Thus, blood, brain, and CSF should be treated as potentially infectious until proven otherwise.


COVID-19, Coronavirus, neurosurgery, infection, safety

DOI of Published Version



Daci R, Natarajan SK, Johnson MD. Letter: Safety Considerations for Neurosurgical Procedures During the COVID-19 Pandemic. Neurosurgery. 2020 May 7:nyaa196. doi: 10.1093/neuros/nyaa196. Epub ahead of print. PMID: 32379310. Link to article on publisher's site

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