Objective:

To investigate the impact of COVID-19 on ventriculoperitoneal (VP) shunt complications in patients with Normal Pressure Hydrocephalus (NPH), assessing clinical challenges, complications, and risks associated with the pandemic's neurological effects.

Background:

NPH is a neurological condition marked by the accumulation of cerebrospinal fluid (CSF) in the brain's ventricles, leading to cognitive deficits, gait ataxia, and urinary incontinence. Standard treatment involves VP shunt surgery to drain excess CSF. The COVID-19 pandemic has introduced concerns regarding its impact on intracranial pressure and possible complications in patients with VP shunts. This study reviews the relationship between COVID-19 and increased shunt revisions, mortality, and hospitalization in NPH patients.

Design/Methods:

A systematic literature review was conducted using NIH databases to analyze studies on NPH, VP shunts, and COVID-19-related neurological complications. Peer-reviewed articles, clinical trial data, and patient outcomes were evaluated to assess the influence of the pandemic on NPH treatment and VP shunt complications.

Results:

COVID-19 was linked to a nearly five-fold increase in shunt revisions in NPH patients. Out of 10,599 COVID-19-positive NPH patients with VP shunts, 834 required shunt revisions post-infection (7.87%). These patients had significantly higher mortality (4.62% vs 2.11%, p<0.0001) and hospitalization rates (27.72% vs 10.30%, p<0.0001) compared to non-COVID-19-infected shunt patients.

Conclusions:

This review highlights the increased risks for NPH patients with VP shunts during the COVID-19 pandemic, with higher revision rates, mortality, and hospitalization. The findings suggest an urgent need for further research on the long-term neurological impacts of COVID-19 on NPH patients and development of specific management protocols for shunt complications in the context of viral infections.