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Won M, Ahn C. Epidemiology and Outcome of Acute Appendicitis during and before the COVID-19 Pandemic: A Retrospective Single-Center Analysis. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050902. [PMID: 37241134 DOI: 10.3390/medicina59050902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 05/28/2023]
Abstract
Background and Objectives: We investigated epidemiological factors and outcomes, including the development of complications, for patients with appendicitis according to three sequential coronavirus disease 2019 (COVID-19) pandemic periods, divided by specific time points. Materials and Methods: This observational study included patients with acute appendicitis who arrived at a single-center between March 2019 and April 2022. The study divided the pandemic into three periods: period A as the first phase of the pandemic (from 1 March 2020 to 22 August 2021), period B as the time period the medical system stabilized (from 23 August 2021 to 31 December 2021), and period C as the time period of the exploration of patients with COVID-19 in South Korea (from 1 January 2022 to 30 April 2022). Data collection was based on medical records. The primary outcome was presence or absence of complications and the secondary outcomes were the time taken from ED visit to surgical intervention, the presence and time of the first administration of antibiotics, and the hospital stay time. Results: Of 1,101 patients, 1,039 were included, with 326 and 711 patients before and during the pandemic, respectively. Incidence of complications was not affected during the pandemic (before the pandemic 58.0%; period A 62.7%; period B,55.4%; and period C 58.1%; p = 0.358). Time from symptom onset to emergency department (ED) arrival significantly decreased during the pandemic (before the pandemic 47.8 ± 84.3 h; pandemic 35.0 ± 54 h; p = 0.003). Time from ED visit to the operating room was statistically significantly increased during the pandemic (before the pandemic 14.3 ± 21.67 h; period A 18.8 ± 14.02 h; period B 18.8 ± 8.57 h; period C 18.3 ± 12.95 h; p = 0.001). Age and time from symptom onset to ED arrival were variables affecting the incidence of complications; however, they were not affected during the pandemic (age, OR 2.382; 95% CI 1.545-3.670; time from symptom onset to ED arrival, OR 1.010, 95% CI 1.006-1.010; p < 0.001). Conclusions: This study found no differences in postoperative complications or treatment durations between pandemic periods. The incidence of appendicitis complications was significantly influenced by age and the duration between the onset of symptoms and arrival at the emergency department, but not by the pandemic period itself.
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Affiliation(s)
- Moonho Won
- Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul 06974, Republic of Korea
| | - Chiwon Ahn
- Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul 06974, Republic of Korea
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Boike S, Mir M, Olson H, Cole D, Rauf I, Surani S, Khan SA. Perioperative management of emergency and elective surgeries during the pandemic. Hosp Pract (1995) 2023; 51:12-17. [PMID: 36629125 DOI: 10.1080/21548331.2023.2166746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The effects of the 2019 novel coronavirus, SARS-CoV-2, and its associated pandemic are complex and widespread. It has permeated all aspects of daily life around the world. Unsurprisingly, it also had significant impacts on proceedings within hospitals around the world as well. Most notably, the multiple waves of the pandemic have each had untoward effects on surgical productivity within hospital systems. More specifically, the disruption of surgical procedures has impacted both emergent and elective cases. In the context of emergent procedures, hospital systems have had to reevaluate how they define 'emergent,' forcing them to determine which cases could not be rescheduled versus those that could. Elective procedures, on the other hand, were nearly halted altogether in the initial pandemic waves. If these were not completely stopped in some places, then they were greatly reduced. This paper will serve to describe the effect the pandemic has had on the proceedings of both elective and emergent surgeries. It will also describe how we have reevaluated and changed the way we define 'emergent' surgeries and describe the potential implications of this. We will also describe literature that speaks to the implications of the delay of elective procedures. Additionally, the cost implications of fewer surgical procedures performed will be discussed. Finally, we will describe literature that has established protocols for scheduling surgeries in waves of the pandemic, how these have evolved over time, and how they have created confusion for hospital systems navigating the pandemic.
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Affiliation(s)
- Sydney Boike
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Mikael Mir
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Holly Olson
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Delaney Cole
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Ibtisam Rauf
- St. George's School of Medicine, University Centre Grenada, West Indies, Grenada
| | - Salim Surani
- College Station, Texas A&M University, TX, USA.,Research Collaborator, Mayo Clinic, Rochester, MN, USA
| | - Syed Anjum Khan
- Critical Care Medicine, Mayo Clinic Health System, Mankato, MN, USA
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Rocco M, Oliveira BLDE, Rizzardi DAA, Rodrigues G, Oliveira GDE, Guerreiro MG, Cruz VS, Naufel-Junior CR. Impact of the COVID-19 Pandemic on Elective and Emergency Surgical Procedures in a University Hospital. Rev Col Bras Cir 2022; 49:e20223324. [PMID: 36000684 PMCID: PMC10578855 DOI: 10.1590/0100-6991e-20223324-en] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 06/15/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE to assess the impact of the COVID-19 pandemic on abdominal wall hernia repair surgeries and cholecystectomy in a referral center hospital. METHODS a retrospective, observational, cross-sectional study carried out at Hospital Universitário Evangélico Mackenzie (HUEM), in Curitiba, Paraná, Brazil. Data obtained through electronic medical records of patients who underwent cholecystectomy and abdominal wall hernia repair from March to December 2019 and 2020 at HUEM were included. Data were analyzed using Pearsons Chi-Square test and analysis of variance (ANOVA). RESULTS a total of 743 medical records were analyzed, with a 63.16% drop in the total number of surgeries in 2020. There was a 91.67% increase in the number of ICU admissions in 2020, as well as a 70% increase in average length of stay. A greater number of complications was observed (in 2020, 27% had complications, while in 2019 this figure was 18.8%) and an increase in mortality (in 2019, this rate was 1.3% and in 2020, 6.5%). There were 6 cases of COVID-19 in 2020, so that of these, 5 patients died. CONCLUSION during the COVID-19 pandemic, an important reduction in the number of abdominal wall hernia repair surgeries and cholecystectomy was observed. In addition, there was a statistically significant increase in postoperative complications, mortality rate and length of stay in 2020.
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Affiliation(s)
- Mateus Rocco
- - Faculdade Evangélica Mackenzie do Paraná - Curitiba - PR - Brasil
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de Bock E, Filipe MD, Simmermacher RKJ, Kroese AC, Vriens MR, Richir MC. Meta-analysis of COVID-19 prevalence during preoperative COVID-19 screening in asymptomatic patients. BMJ Open 2022; 12:e058389. [PMID: 35798523 PMCID: PMC9263349 DOI: 10.1136/bmjopen-2021-058389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 06/13/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Patients with COVID-19 may be asymptomatic and are able to transmit COVID-19 during a surgical procedure, resulting in increased pressure on healthcare and reduced control of COVID-19 spread. There remains uncertainty about the implementation of preoperative screening for COVID-19 in asymptomatic surgical patients. Therefore, this study aims to determine the prevalence of preoperative COVID-19, confirmed by reverse transcriptase PCR (RT-PCR), in asymptomatic patients. DESIGN Systematic review and meta-analysis. DATA SOURCES Pubmed and Embase databases were searched through 20 February 2022. ELIGIBILITY CRITERIA All COVID-19 articles including preoperative asymptomatic patients were included. DATA EXTRACTION AND SYNTHESIS Two independent reviewers extracted data and assessed risk of bias. Meta-analysis was performed to determine the prevalence of COVID-19 with 95% CI. Moreover, estimated positive predictive value (PPV), negative predictive value, false-positives (FP) and false-negatives were calculated for preoperative asymptomatic patients. RESULTS Twenty-seven studies containing 27 256 asymptomatic preoperative screened patients were included, of which 431 were positive for COVID-19 by RT-PCR test. In addition, the meta-analysis revealed a pooled COVID-19 prevalence of 0.76% (95% CI 0.36% to 1.59%). The calculated PPV for this prevalence is 40.8%. CONCLUSIONS The pooled COVID-19 prevalence in asymptomatic patients tested preoperatively was 0.76%, with low corresponding PPV. Consequently, nearly three-quarters of postponed surgical procedures in asymptomatic preoperative patients may be FP. In the event of similar pandemics, modification of preoperative mandatory RT-PCR COVID-19 testing in asymptomatic patients may be considered.
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Affiliation(s)
- Ellen de Bock
- Department of Surgery, Cancer Centre, University Medical Centre, Utrecht, The Netherlands
| | - Mando D Filipe
- Department of Surgery, Cancer Centre, University Medical Centre, Utrecht, The Netherlands
| | | | - A Christiaan Kroese
- Department of Anaesthesiology, University Medical Centre, Utrecht, The Netherlands
| | - Menno R Vriens
- Department of Surgery, Cancer Centre, University Medical Centre, Utrecht, The Netherlands
| | - Milan C Richir
- Department of Surgery, Cancer Centre, University Medical Centre, Utrecht, The Netherlands
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Grosser R, Romero-Velez G, Pereira X, Moran-Atkin E, Choi J, Camacho DR. Postoperative pneumonia after bariatric surgery during the COVID-19 pandemic: A NSQIP study. Surg Obes Relat Dis 2022; 18:1239-1245. [PMID: 35843783 PMCID: PMC9212841 DOI: 10.1016/j.soard.2022.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 06/07/2022] [Accepted: 06/11/2022] [Indexed: 11/13/2022]
Abstract
Background During the COVID-19 pandemic, surgical centers had to weigh the benefits and risks of conducting bariatric surgery. Obesity increases the risk of developing severe COVID-19 infections, and therefore, bariatric surgery is beneficial. In contrast, surgical patients who test positive for COVID-19 have higher mortality rates. Objective This study investigates the national prevalence of postoperative pneumonia during the COVID-19 pandemic in the bariatric surgery population. Setting The American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) database. Methods This is a cross-sectional study using the ACS-NSQIP database. The population of concern included patients who underwent sleeve gastrectomy and Roux-en-Y gastric bypass procedures. Information was extracted on rate of postoperative pneumonia and other 30-day complications between 2018 and 2020. Results All baseline characteristics were similar among patients who underwent bariatric surgery between 2018 and 2020. However, there was a 156% increase in postoperative pneumonia in 2020 compared with the previous year. Furthermore, despite the similar postoperative complication rates across the years, there was a statistically significant increase in all-cause mortality in 2020. The multivariate analysis showed that having surgery in 2020 was a statistically significant risk factor for pneumonia development postoperatively. Conclusions This study showed a statistically significant increase in the prevalence of postoperative pneumonia during the COVID-19 pandemic among bariatric surgery patients. Surgical centers must continuously evaluate the risks associated with healthcare-associated exposure to COVID-19 and weigh the benefits of bariatric surgery.
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ROCCO MATEUS, OLIVEIRA BRUNALARISSADE, RIZZARDI DARINAANDRADEADDARIO, RODRIGUES GABRIEL, OLIVEIRA GABRIELYDE, GUERREIRO MILENAGONÇALVES, CRUZ VINÍCIUSSIPPEL, NAUFEL-JUNIOR CARLOSROBERTO. Impacto da Pandemia por COVID-19 nos Procedimentos Cirúrgicos Eletivos e Emergenciais em Hospital Universitário. Rev Col Bras Cir 2022. [DOI: 10.1590/0100-6991e-20223324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
RESUMO Objetivo: avaliar o impacto da pandemia da COVID-19 em cirurgias de reparo de hérnias de parede abdominal e colecistectomia em hospital centro de referência. Métodos: estudo transversal retrospectivo observacional realizado no Hospital Universitário Evangélico Mackenzie (HUEM), em Curitiba, Paraná, Brasil. Foram incluídos os dados obtidos através de prontuários eletrônicos de pacientes que realizaram colecistectomia e reparo de hérnias de parede abdominal no período de março a dezembro de 2019 e 2020 no HUEM. Os dados foram analisados por meio do teste Qui-Quadrado de Pearson e aplicação da Análise de Variância (ANOVA). Resultados: Foram analisados 743 prontuários ao todo, sendo constatada uma queda de 63,16% no número total de cirurgias no ano de 2020. Verificou-se um aumento de 91,67% no número de internações em UTI em 2020, bem como um aumento de 70% no tempo médio de internação. Foi observado um maior número de complicações (em 2020, 27% apresentaram complicações, enquanto em 2019 este valor foi de 18,8%) e um aumento em relação à mortalidade (em 2019, esta taxa foi de 1,3% e em 2020, 6,5%). Observaram-se 6 casos de COVID-19 em 2020, de modo que destes, 5 pacientes vieram a óbito. Conclusão: durante a pandemia da COVID-19, observou-se uma importante redução na quantidade de cirurgias de reparo de hérnia de parede abdominal e colecistectomia. Além disso, houve aumento estatisticamente relevante quanto às complicações pós-operatórias, taxa de mortalidade e tempo de internamento em 2020.
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Affiliation(s)
- MATEUS ROCCO
- Faculdade Evangélica Mackenzie do Paraná, Brasil
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Mercier MR, Galivanche AR, Brand JP, Pathak N, Medvecky MJ, Varthi AG, Rubin LE, Grauer JN. COVID-positive ankle fracture patients are at increased odds of perioperative surgical complications following open reduction internal fixation surgery. PLoS One 2021; 16:e0262115. [PMID: 34972190 PMCID: PMC8719674 DOI: 10.1371/journal.pone.0262115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/17/2021] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Ankle fractures have continued to occur through the COVID pandemic and, regardless of patient COVID status, often need operative intervention for optimizing long-term outcomes. For healthcare optimization, patient counseling, and care planning, understanding if COVID-positive patients undergoing ankle fracture surgery are at increased risk for perioperative adverse outcomes is of interest. METHODS The COVID-19 Research Database contains recent United States aggregated insurance claims. Patients who underwent ankle fracture surgery from April 1st, 2020 to June 15th, 2020 were identified. COVID status was identified by ICD coding. Demographics, comorbidities, and postoperative complications were extracted based on administrative data. COVID-positive versus negative patients were compared with univariate analyses. Propensity-score matching was done on the basis of age, sex, and comorbidities. Multivariate regression was then performed to identify risk factors independently associated with the occurrence of 30-day postoperative adverse events. RESULTS In total, 9,835 patients undergoing ankle fracture surgery were identified, of which 57 (0.58%) were COVID-positive. COVID-positive ankle fracture patients demonstrated a higher prevalence of comorbidities, including: chronic kidney disease, diabetes, hypertension, and obesity (p<0.05 for each). After propensity matching and controlling for all preoperative variables, multivariate analysis found that COVID-positive patients were at increased risk of any adverse event (odds ratio [OR] = 3.89, p = 0.002), a serious adverse event (OR = 5.48, p = 0.002), and a minor adverse event (OR = 3.10, p = 0.021). DISCUSSION COVID-positive patients will continue to present with ankle fractures requiring operative intervention. Even after propensity matching and controlling for patient factors, COVID-positive patients were found to be at increased risk of 30-day perioperative adverse events. Not only do treatment teams need to be protected from the transmission of COVID in such situations, but the increased incidence of perioperative adverse events needs to be considered.
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Affiliation(s)
- Michael R. Mercier
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, United States of America
| | - Anoop R. Galivanche
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, United States of America
| | - Jordan P. Brand
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, United States of America
| | - Neil Pathak
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, United States of America
| | - Michael J. Medvecky
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, United States of America
| | - Arya G. Varthi
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, United States of America
| | - Lee E. Rubin
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, United States of America
| | - Jonathan N. Grauer
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, United States of America
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Clinical Characteristics and Perioperative Complication Profiles of COVID-19-Positive Patients Undergoing Hip Fracture Surgery. JOURNAL OF THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS GLOBAL RESEARCH AND REVIEWS 2021; 5:01979360-202110000-00012. [PMID: 34653097 PMCID: PMC8522872 DOI: 10.5435/jaaosglobal-d-21-00104] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 08/31/2021] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The coronavirus 2019 (COVID-19) pandemic disease has imposed an unprecedented degree of stress on healthcare systems. This study aimed to understand whether COVID-19 positivity is associated with an increased risk of adverse outcomes after geriatric hip fracture surgery. METHODS From a national administrative claims data set, patients who underwent hip fracture surgery from April 1, 2020, to December 1, 2020 were selected for analysis. COVID-19-positive status was assessed by the emergency International Classification of Diagnoses, 10th Revision, COVID-19 code within 2 weeks before the surgery. Demographic, comorbidity, and 30-day postoperative adverse event information were extracted. Logistic regression before and after 10:1 propensity matching was performed to identify patient risk factors associated with the occurrence of postoperative adverse events. RESULTS Of 42,002 patients who underwent hip fracture surgery, 678 (1.61%) were identified to be positive for COVID-19 infection. No significant differences in age, sex, and procedure type were found between COVID-19-positive and COVID-19-negative groups, but the COVID-19-positive patients demonstrated a higher incidence of several comorbidities. These differences were no longer significant after matching. After matching, the COVID-19-positive group had a higher incidence of any, serious, and minor adverse events (P < 0.001 for all). Controlling for preoperative variables, COVID-19 positivity was associated with an increased risk of experiencing any adverse events (odds ratio [OR] = 1.62, 95% confidence interval [95% CI] = [1.37 to 1.92], P < 0.001), serious adverse events (OR = 1.66, 95% CI = [1.31 to 2.07], P < 0.001), and minor adverse events (OR = 1.59, 95% CI = [1.34 to 1.89], P < 0.001). DISCUSSION After matching and controlling for confounding variables, COVID-19-positive hip fracture patients had increased odds of multiple postoperative events. Clinicians caring for this vulnerable geriatric population should be mindful of this risk to improve the care for these patients during the ongoing global pandemic.
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Nizam A, Nimaroff ML, Menzin AW, Goldberg GL, Miyara SJ, Molmenti E. Nosocomial COVID-19 infection in women undergoing elective cesarean delivery: a prospective cohort study. Am J Obstet Gynecol MFM 2021; 4:100490. [PMID: 34543753 PMCID: PMC8447544 DOI: 10.1016/j.ajogmf.2021.100490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 09/10/2021] [Accepted: 09/13/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The COVID-19 pandemic placed obstetricians in a difficult position of continuing to perform elective cesarean delivery without the knowledge of the risk of the spread of nosocomial infection of the COVID-19 virus. OBJECTIVE This study aimed to determine the nosocomial infection rate in women undergoing elective cesarean delivery at 2 academic institutions. STUDY DESIGN This nonrandomized prospective cohort trial evaluated patients undergoing elective cesarean delivery during the reopening phase of the COVID-19 pandemic in the state of New York at 2 large volume labor and delivery units. Eligible patients with a negative preoperative reverse transcriptase-polymerase chain reaction test and immunoglobulin G antibody test for COVID-19 were retested 6 to 9 days after discharge. The primary objective was the COVID-19 test conversion rate defined as a positive polymerase chain reaction test for SARS-CoV-2 after discharge with a negative preoperative test. This was used as a proxy for the nosocomial infection rate. RESULTS A total of 136 patients were screened for participation. Of these patients, 2 tested positive for COVID-19 on preoperative testing, and 25 declined to participate. Overall, 111 patients consented to participate, and 96 patients underwent both preoperative and postoperative testing. No patient with a negative polymerase chain reaction test preoperatively, had a positive polymerase chain reaction test for the COVID-19 virus postoperatively. CONCLUSION With strict and methodical perioperative and postpartum protocols, we can limit nosocomial COVID-19 infection in women undergoing elective cesarean delivery.
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Affiliation(s)
- Aaron Nizam
- Department of Obstetrics and Gynecology, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY (Drs Nizam, Nimaroff, Menzin, and Goldberg); Division of Gynecology Oncology, Department of Obstetrics and Gynecology, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY (Drs Nizam, Menzin, and Goldberg); Department of Surgery, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY (Dr Molmenti); Feinstein Institute for Medical Research at Northwell Health, Manhasset, NY (Drs Menzin, Goldberg, Miyara, and Molmenti).
| | - Michael L Nimaroff
- Department of Obstetrics and Gynecology, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY (Drs Nizam, Nimaroff, Menzin, and Goldberg); Division of Gynecology Oncology, Department of Obstetrics and Gynecology, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY (Drs Nizam, Menzin, and Goldberg); Department of Surgery, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY (Dr Molmenti); Feinstein Institute for Medical Research at Northwell Health, Manhasset, NY (Drs Menzin, Goldberg, Miyara, and Molmenti)
| | - Andrew W Menzin
- Department of Obstetrics and Gynecology, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY (Drs Nizam, Nimaroff, Menzin, and Goldberg); Division of Gynecology Oncology, Department of Obstetrics and Gynecology, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY (Drs Nizam, Menzin, and Goldberg); Department of Surgery, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY (Dr Molmenti); Feinstein Institute for Medical Research at Northwell Health, Manhasset, NY (Drs Menzin, Goldberg, Miyara, and Molmenti)
| | - Gary L Goldberg
- Department of Obstetrics and Gynecology, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY (Drs Nizam, Nimaroff, Menzin, and Goldberg); Division of Gynecology Oncology, Department of Obstetrics and Gynecology, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY (Drs Nizam, Menzin, and Goldberg); Department of Surgery, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY (Dr Molmenti); Feinstein Institute for Medical Research at Northwell Health, Manhasset, NY (Drs Menzin, Goldberg, Miyara, and Molmenti)
| | - Santiago J Miyara
- Department of Obstetrics and Gynecology, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY (Drs Nizam, Nimaroff, Menzin, and Goldberg); Division of Gynecology Oncology, Department of Obstetrics and Gynecology, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY (Drs Nizam, Menzin, and Goldberg); Department of Surgery, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY (Dr Molmenti); Feinstein Institute for Medical Research at Northwell Health, Manhasset, NY (Drs Menzin, Goldberg, Miyara, and Molmenti)
| | - Ernesto Molmenti
- Department of Obstetrics and Gynecology, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY (Drs Nizam, Nimaroff, Menzin, and Goldberg); Division of Gynecology Oncology, Department of Obstetrics and Gynecology, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY (Drs Nizam, Menzin, and Goldberg); Department of Surgery, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY (Dr Molmenti); Feinstein Institute for Medical Research at Northwell Health, Manhasset, NY (Drs Menzin, Goldberg, Miyara, and Molmenti)
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Reconstructive Microsurgery in the COVID-19 Environment. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3691. [PMID: 34235041 PMCID: PMC8245111 DOI: 10.1097/gox.0000000000003691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 05/20/2021] [Indexed: 11/26/2022]
Abstract
The COVID-19 pandemic has presented unique challenges to the plastic surgery field. Substantial changes have been incorporated in hospital and practice protocols in all branches of medicine. Organic medical teams were placed on scheduled shifts to prevent cross-infection, and some working teams were discontinued. Remote technology consultations and deliberations were instituted in hospitals and community medical services to maintain the flow of information on patient status. Several mitigation strategies were implemented during these times throughout medical facilities. We present those implemented in our facility to ensure adequate labor, resources, and facilities along with proper protocols for patient selection and management according to predetermined risk assessment criteria with the hope to assist the healthcare staff to minimize mortality risks.
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AlAradi J, AlHarmi RAR, AlKooheji M, Almahari SA, Isa MA, AlMarzooq R. SARS-CoV-2 in peritoneal swabs from asymptomatic patients undergoing emergency abdominal surgery. J Surg Case Rep 2021; 2021:rjab116. [PMID: 33859814 PMCID: PMC8034985 DOI: 10.1093/jscr/rjab116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 03/08/2021] [Indexed: 12/15/2022] Open
Abstract
This is a case series of five patients with acute abdomen requiring surgery who tested positive for coronavirus disease 2019 (COVID-19) and were asymptomatic, with the purpose of detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in peritoneal fluid. Nasopharyngeal swab was done as a prerequisite for admission or prior to admission as part of random testing. Two methods of viral testing were employed: Xpert® Xpress SARS-CoV-2 (rapid test) and real-time reverse transcription polymerase chain reaction (RT-PCR). Either or both tests were done, with the former performed for patients requiring surgery immediately. Surgery was performed within 24–36 h from admission. Peritoneal fluid swabs were obtained for the detection of SARS-CoV-2 using RT-PCR test. Swabs were immediately placed in viral transfer media and delivered to the public health laboratory in an ice bag. SARS-CoV-2 was not detected in peritoneal swabs. Due to the limited number of patients, further studies are required; yet, protective measures should still be taken by surgeons when dealing with COVID-19 cases.
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Affiliation(s)
- Jasim AlAradi
- Department of Surgery, Salmaniya Medical Complex, Manama, Bahrain
| | | | - Mariam AlKooheji
- Department of Surgery, Salmaniya Medical Complex, Manama, Bahrain
| | | | | | - Raed AlMarzooq
- Department of Surgery, Salmaniya Medical Complex, Manama, Bahrain
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Lim MA, Pranata R. Coronavirus disease 2019 (COVID-19) markedly increased mortality in patients with hip fracture - A systematic review and meta-analysis. J Clin Orthop Trauma 2021; 12:187-193. [PMID: 32958988 PMCID: PMC7495188 DOI: 10.1016/j.jcot.2020.09.015] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/21/2020] [Accepted: 09/14/2020] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION This systematic review and meta-analysis aimed to evaluate the prevalence of coronavirus disease 2019 (COVID-19) and its impact on mortality in patients with hip fracture. METHODS We performed a systematic literature search in PubMed, Cochrane Central Database, and medRvix from inception up to July 13, 2020 on research articles that enrolled hip fracture patients who had information on COVID-19 and clinically validated definition of death. RESULTS A total of 984 participants from 6 studies were included in our study. The pooled prevalence of COVID-19 was 9% [95% CI: 7-11%]. The mortality rate in patients with concomitant hip fracture and COVID-19 was found to be 36% (95% CI: 26-47%), whereas the mortality rate in hip fracture without COVID-19 is 2% (95% CI: 1-3%). Meta-analysis showed that COVID-19 was associated with a seven-fold increase in risk (RR 7.45 [95% CI: 2.72, 20.43], p < 0.001; I2: 68.6%) of mortality in patients with hip fracture. Regression-based Harbord's test showed no indication of small-study effects (p = 0.06). CONCLUSION The present meta-analysis showed that COVID-19 increased the risk of mortality in patients with hip fracture. TRIAL REGISTRATION This study is registered with PROSPERO, July 21, 2020, number CRD42020199618. Available from https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020199618.
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Affiliation(s)
| | - Raymond Pranata
- Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia
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Lim MA, Pranata R. Teleorthopedic: A Promising Option During and After the Coronavirus Disease 2019 (COVID-19) Pandemic. Front Surg 2020; 7:62. [PMID: 33005624 PMCID: PMC7485288 DOI: 10.3389/fsurg.2020.00062] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 07/23/2020] [Indexed: 01/08/2023] Open
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Köckerling F, Köckerling D, Schug-Pass C. Elective hernia surgery cancellation due to the COVID-19 pandemic. Hernia 2020; 24:1143-1145. [PMID: 32728968 PMCID: PMC7387883 DOI: 10.1007/s10029-020-02278-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 07/23/2020] [Indexed: 11/28/2022]
Affiliation(s)
- F Köckerling
- Department of Surgery and Centre for Minimally Invasive Surgery, Academic Teaching Hospital of Charité Medical School, Vivantes Hospital, Neue Bergstrasse 6, 13585, Berlin, Germany.
| | - D Köckerling
- Medical Sciences Division, University of Oxford, Oxford, UK
| | - Ch Schug-Pass
- Department of Surgery and Centre for Minimally Invasive Surgery, Academic Teaching Hospital of Charité Medical School, Vivantes Hospital, Neue Bergstrasse 6, 13585, Berlin, Germany
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