Pandemic Impacted Concussion Treatment, Timing and Methods

PITTSBURGH – The COVID-19 pandemic and associated “lockdowns” dramatically decreased the incidence of sport-related concussions, and patients with concussion were more hesitant to seek in-person care, prompting some to utilize available telehealth services, according to new research led by the University of Pittsburgh and UPMC Sports Medicine Concussion Program.

The results, published online in Journal of Neurotrauma, found a significant decline in sport-related concussions during the pandemic with proportional increases in non-sport concussions from recreational injuries, auto accidents and falls. Patients also waited to seek care for their concussions during the pandemic, a reflection of apprehensions due to COVID-19. Prior to the pandemic, patients were 1.4 times more likely to get treated within seven days of the injury.  

“Patients waited nearly a month, an average of 26 days, longer to seek care for their injuries during the COVID-19 pandemic than before, and our previous research indicates that waiting to seek care following a concussion results in longer recovery times resulting from delayed treatment,” said lead author Anthony Kontos, Ph.D., research director at Pitt’s Sports Medicine Concussion Program.  

Kontos and his team analyzed medical records for 3,021 concussion patients who presented to a primary clinical concussion program serving the Pittsburgh region from March 15, 2019 to March 16, 2021. The design separated visits into pre-pandemic (March 2019 to February 2020) and pandemic (March 2020 to February 2021) time periods for comparison. Findings indicated that there were 743 fewer overall concussions during the pandemic period, a decrease of approximately 40% from the pre-pandemic period.  

A total of 9.4 percent of all concussion initial clinic visits were conducted via telehealth during the pandemic period, as opposed to zero percent during the pre-pandemic period. 

“Early clinical evaluation and treatment from a qualified specialist is extremely helpful to effectively manage this injury, senior author Michael “Micky” Collins, Ph.D., executive and clinical director of UPMC’s Sports Medicine Concussion Program. “Telehealth options can help fill gaps in the availability of in-person care during COVID-19, and for patients in rural or underserved areas. These findings highlight the potential for telehealth to reach patients who are unable or unwilling to come to the clinic.”

Kontos, Collins and colleagues say future research should examine the reliability of concussion assessments and quality of care between virtual and in-person visits. 

Co-authors include Michael Collins, Ph.D., Shawn R. Eagle, Ph.D., Cyndi Holland, M.P.H., Robert Hickey, M.D., and Christopher Santucci, all of the University of Pittsburgh; and Danny Thomas, M.D., M.P.H., of the Medical College of Wisconsin. 

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