Recent updates on the safety of neurosurgery during the COVID-19 pandemic

The coronavirus 2019 (COVID-19), caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2- 2), is highly contagious and has disastrous healthcare systems worldwide. Medical personnel are at a high risk of becoming infected with viruses; therefore, knowing what personal protective equipment (PPE) to use in each situation is critical. Furthermore, elective clinics and operations have been reduced to redirect the workforce to the acute specialties battling the outbreak; proper differentiation between patients who require immediate care and those who can be seen over the phone or whose treatment can be postponed is thus critical. Because Iran was one of the first and worst-affected countries, the Iranian Ministry of Health and Education has issued particular recommendations based on consensual best practices and, where available, literature. Only emergency surgical procedures are indicated, and all patients should be examined at least twice before surgery (on days 4 and 2). Procedures for positive patients should be postponed until the nasopharyngeal swab test is negative. Filtering facepiece 3 (FFP3) and/or powered air-purifying respirator (PAPR) devices, goggles, full-face visor, double gloves, water-resistant gowns, and protective caps are all required if the procedure is critical to the patient's survival. It is advised that negative patients utilize at most minuscule an FFP2 mask. Drills should never be used because they enhance the aerosolization of potentially infectious mucous particles. The manipulation of the dura should be minimized due to the probable neurotropism of SARS-CoV-2. We will be able to deal with the evolving and intricate implications of this new pandemic only through generally agreed-upon protocols and coordination.