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COVID-19-associated gastrointestinal and liver injury: clinical features and potential mechanisms
9 Nov, 2020Abstract
Coronavirus disease-2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The infection is spreading globally and poses a huge threat to human health. Besides common respiratory symptoms, some patients with COVID-19 experience gastrointestinal symptoms, such as diarrhea, nausea, vomiting, and loss of appetite. SARS-CoV-2 might infect the gastrointestinal tract through its viral receptor angiotensin-converting enzyme 2 (ACE2) and there is increa... -
Effect of Tocilizumab vs Standard Care on Clinical Worsening in Patients Hospitalized With COVID-19 Pneumonia
27 Oct, 2020Key Points
Question Does early tocilizumab administration prevent clinical worsening in patients hospitalized with coronavirus disease 2019 (COVID-19) pneumonia?
Findings In this randomized clinical trial of 126 patients with a partial pressure of arterial oxygen to fraction of inspired oxygen (Pao2/Fio2) ratio between 200 and 300 mm Hg at enrollment, the rate of the primary clinical end point (clinical worsening) was not significantly different between the control group and the toc... -
How COVID-19 inspired surgical residents to rethink educational programs
27 Oct, 2020The coronavirus disease 2019 (COVID-19) pandemic has caused significant disruptions to education for surgical residents across the country. Residents have experienced reduced operative exposure, decreased time caring for hospitalized patients, and altered rotation schedules. A number of studies have been published since the start of the COVID-19 pandemic regarding the effect of the crisis on residents and resident education across fields including internal medicine, emergency medicine, otolar... -
Safety in endoscopy for patients and healthcare workers during the COVID-19 pandemic
20 Oct, 2020AbstractThe coronavirus disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is still wreaking havoc in many parts of the world and poses a great burden to healthcare systems worldwide. Mitigation and suppression strategies have been implemented globally but the disease has proven to be difficult to contain. Initially many elective gastrointestinal (GI) endoscopies were cancelled to reduce the risk of infection and conserve personal protective e... -
Low dispersion in the infectiousness of COVID-19 cases implies difficulty in control
20 Oct, 2020Abstract
The individual infectiousness of coronavirus disease 2019 (COVID-19), quantified by the number of secondary cases of a typical index case, is conventionally modelled by a negative-binomial (NB) distribution. Based on patient data of 9120 confirmed cases in China, we calculated the variation of the individual infectiousness, i.e., the dispersion parameter k of the NB distribution, at 0.70 (95% confidence interval: 0.59, 0.98). This suggests that the dispersion in the individual inf... -
Nosocomial SARS‐CoV‐2 transmission in postoperative infection and mortality: analysis of 14 798 procedures
10 Oct, 2020Abstract
This study used a national administrative database to estimate perioperative SARS‐CoV‐2 infection risk, and associated mortality, relative to nosocomial transmission rates. The impact of nosocomial transmission was greatest after major emergency surgery, whereas laparoscopic surgery may be protective owing to reduced duration of hospital stay. Procedure‐specific risk estimates are provided to facilitate surgical decision‐making and informed consent.
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Global impact of the first coronavirus disease 2019 (COVID‐19) pandemic wave on vascular services
5 Oct, 2020Abstract
This online structured survey has demonstrated the global impact of the COVID‐19 pandemic on vascular services. The majority of centres have documented marked reductions in operating and services provided to vascular patients. In the months during recovery from the resource restrictions imposed during the pandemic peaks, there will be a significant vascular disease burden awaiting surgeons.
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Auto-antibodies against type I IFNs in patients with life-threatening COVID-19
5 Oct, 2020Abstract
Interindividual clinical variability in the course of SARS-CoV-2 infection is immense. We report that at least 101 of 987 patients with life-threatening COVID-19 pneumonia had neutralizing IgG auto-Abs against IFN-ω (13 patients), the 13 types of IFN-α (36), or both (52), at the onset of critical disease; a few also had auto-Abs against the other three type I IFNs. The auto-Abs neutralize the ability of the corresponding type I IFNs to block SARS-CoV-2 infection in vitro. These au... -
Covid-19: Risk of death more than doubled in people who also had flu, English data show
29 Sep, 2020
People infected with both flu and SARS-CoV-2 are more than twice as likely to die as someone with the new coronavirus alone, emerging evidence from England has shown.
An analysis by Public Health England (PHE) of cases from January to April 2020 also found that people with the two viruses were more at risk of severe illness. Most cases of coinfection were in older people, and more than half of them died.
The data, published as a preprint on medRxiv,1 were released as PHE lau... -
COVID-19 can affect the heart
28 Sep, 2020COVID-19 has a spectrum of potential heart manifestations with diverse mechanisms
The family of seven known human coronaviruses are known for their impact on the respiratory tract, not the heart. However, the most recent coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has marked tropism for the heart and can lead to myocarditis (inflammation of the heart), necrosis of its cells, mimicking of a heart attack, arrhythmias, and acute or protracted heart failure (musc... -
Determinants of the outcomes of patients with cancer infected with SARS-CoV-2: results from the Gustave Roussy cohort
23 Sep, 2020Abstract
Patients with cancer are presumed to be at increased risk of severe COVID-19 outcomes due to underlying malignancy and treatment-induced immunosuppression. Of the first 178 patients managed for COVID-19 at the Gustave Roussy Cancer Centre, 125 (70.2%) were hospitalized, 47 (26.4%) developed clinical worsening and 31 (17.4%) died. An age of over 70 years, smoking status, metastatic disease, cytotoxic chemotherapy and an Eastern Cooperative Oncology Group score of ≥2 at the last vis... -
HPB surgery in the time of COVID
22 Sep, 2020
Editor
The pandemic resulting from the transmission of the SARS‐CoV‐2 to the human population has stressed every health care system in the world. The impact on the provision of surgical services has been profound and one of the first and ubiquitous responses was to cease all non‐essential surgical operating. HPB centres internationally have reported a reduction in the number of surgical resections and the adoption of non‐surgical management of pathologies that traditionally were tr...