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Article ; Online: Gun violence in United States during the second year of the COVID-19 pandemic.

Ssentongo, Paddy / Ssentongo, Anna / Heilbrunn, Emily S / Chinchilli, Vernon M

2023 Volume 11, Page(s) 950475

Abstract: Objective: In the first year of the COVID-19 pandemic, gun violence (GV) rates in the United States (US) rose by 30%. We estimate the relative risk of GV in the US in the second year compared to the first year of the pandemic, in time and space.: ... ...

Abstract	Objective: In the first year of the COVID-19 pandemic, gun violence (GV) rates in the United States (US) rose by 30%. We estimate the relative risk of GV in the US in the second year compared to the first year of the pandemic, in time and space. Methods: Daily police reports of gun-related injuries and deaths in the 50 states and the District of Columbia from March 1, 2020, to February 28, 2022, were obtained from the GV Archive. Generalized linear mixed-effects models in the form of Poisson regression analyses were utilized to estimate state-specific rates of GV. Results: Nationally, GV rates during the second year of the pandemic (March 1, 2021, through February 28, 2022) remained the same as that of the first year (March 1, 2020, through February 28, 2021) (Intensity Ratio = 0.996; 95% CI 0.98, 1.01; Conclusion: GV risk in the US is heterogeneous. It continues to be a public health crisis, with 18% of the states demonstrating significantly higher GV rates during the second year of the COVID-19 pandemic compared to the same timeframe 1 year prior.
MeSH term(s)	United States/epidemiology ; Humans ; Gun Violence ; COVID-19/epidemiology ; Pandemics ; Public Health ; District of Columbia
Language	English
Publishing date	2023-03-06
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2023.950475
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Medical Student Attitudes Toward Blood Donation in Times of Increased Need.

Khatun, Rahima / Otaibi, Banan W / Ssentongo, Anna / Hazelton, Joshua P / Cooper, AmandaB

The American surgeon

2021 Volume 88, Issue 9, Page(s) 2338–2344

Abstract: Background: In situations of increased need, such as mass casualty incidents (MCIs) and COVID-19, donated blood products are in shortage across the United States. Medical students are a potential pool for blood donors. The aim of this study was to ... ...

Abstract	Background: In situations of increased need, such as mass casualty incidents (MCIs) and COVID-19, donated blood products are in shortage across the United States. Medical students are a potential pool for blood donors. The aim of this study was to determine overall attitudes of medical students at a single academic institution toward blood donation during times of increased need. Methods: Three anonymous REDCap surveys were administered to all medical students at a rural academic institution. Surveys 1 and 2 were administered preceding and after an institution-wide MCI drill, in September and November 2019, respectively. Survey 3 was administered following a student-organized COVID-19 blood drive in June 2020. Multivariable analysis was performed to determine if factors, ie, experience with MCI drills and emergency medical services (EMS) training, were associated with willingness to donate blood. Furthermore, barriers to donation among those not willing to donate were assessed. Results: Overall response rate for MCI surveys (surveys 1 and 2) was 38% (mean age 25.2 years and 50% women). 91% (n = 210) of respondents were willing to donate blood. Previous participation in MCI drills and EMS training was not associated with higher willingness to donate blood. Response rate for survey 3 was 15.6% (59.4% women), and 30 (31.3%) respondents indicated they did not volunteer to donate blood during the COVID-19 drive. Most common reasons for not donating were "other," medical concerns, and being out-of-town. Conclusions: Majority of medical students are willing to donate blood during times of increased need and offer a possible solution to increase blood donor pool.
MeSH term(s)	Adult ; Blood Donors ; COVID-19/epidemiology ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Mass Casualty Incidents ; Students, Medical ; Surveys and Questionnaires ; Tissue and Organ Procurement
Language	English
Publishing date	2021-04-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	202465-2
ISSN	1555-9823 ; 0003-1348
ISSN (online)	1555-9823
ISSN	0003-1348
DOI	10.1177/00031348211011083
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Article: Central Obesity Is a Predictor of Stress Hyperglycemia in Critically Ill Geriatric Trauma Patients (P21-051-19)

Ssentongo, Anna / Armen, Scott / Oh, John / Soybel, David / Ssentongo, Paddy

Current developments in nutrition. 2019 June 13, v. 3, no. Supplement_1

2019

Abstract: In the elderly population, hyperglycemia is associated with increased rates of infections, length of hospital stay (LOS) and mortality. However, there is a lack of informative studies addressing the drivers of hyperglycemia. We hypothesized that central ... ...

Abstract	In the elderly population, hyperglycemia is associated with increased rates of infections, length of hospital stay (LOS) and mortality. However, there is a lack of informative studies addressing the drivers of hyperglycemia. We hypothesized that central obesity has an effect on hyperglycemia. Therefore, our objective is to investigate whether central obesity predicts hyperglycemia within the first 48 hours of admission in elderly trauma patients admitted to the ICU. Our trauma registry was queried for all trauma patients aged 65 and older from 2012 to 2018 with an intensive care unit (ICU) LOS of at least 3 days. CT scan images were reviewed for visceral fat area, waist circumference to height ratio (WCHR), waist circumference to hip ratio (WHR) and the presence of sarcopenia, which has been implicated in adverse outcomes of trauma, in the presence or absence of obesity. Of 320 elderly patients, 7% developed infections, 3% developed stroke, 52% had an increased ICU LOS >6 days, and 48% had an increased total hospital LOS >14 d. The prevalence of sarcopenia was 26%, increased visceral fat area >200 cm2 was 87%, WCHR >0.65 was 25%, and WHR >1 was 54% All of these factors except sarcopenia were significant predictors of hyperglycemia >140 mg/dL (OR: 4.0, 95% CI: 2.53–6.46), (OR: 2.45, 95% CI: 1.47–4.16) and (OR: 3.1, 95% CI: 1.93–4.9) respectively. A total of 143 patients (45%) had an average glucose >140 mg/dL within the first 48 hours after admission and this was independently associated with infections (OR: 2.64, 95% CI: 1.06–7.13), stroke (OR: 5.88, 95% CI: 1.48–38.96), increased ICU LOS (OR: 1.87, 95% CI: 1.20–2.94) and increased hospital LOS (OR: 1.59, 95% CI: 1.02–2.48). Central obesity independently predicts hyperglycemia in geriatric trauma patients. The influence of metabolic stressors related to adiposity may drive elevated glucose levels and could represent a novel target for future outcomes studies in geriatric critical illness None.
Keywords	adiposity ; computed tomography ; elderly ; glucose ; hips ; hospitals ; hyperglycemia ; mortality ; obesity ; patients ; sarcopenia ; stroke ; visceral fat ; waist circumference
Language	English
Dates of publication	2019-0613
Publishing place	Oxford University Press
Document type	Article
ISSN	2475-2991
DOI	10.1093/cdn/nzz041.P21-051-19
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Renin-angiotensin-aldosterone system inhibitors and mortality in patients with hypertension hospitalized for COVID-19: a systematic review and meta-analysis

Ssentongo, A. / Ssentongo, P. / Heilbrunn, E. S. / Lekoubou, A. / Du, P. / Liao, D. / Oh, J. S. / Chinchilli, V. M.

Abstract: Objective: The association between renin-angiotensin-aldosterone (RAAS) inhibitors and Coronavirus diseases 2019 (COVID-19) mortality is unclear. We aimed to explore the association of RAAS inhibitors, including angiotensin-converting inhibitors (ACEi) ... ...

Abstract	Objective: The association between renin-angiotensin-aldosterone (RAAS) inhibitors and Coronavirus diseases 2019 (COVID-19) mortality is unclear. We aimed to explore the association of RAAS inhibitors, including angiotensin-converting inhibitors (ACEi) and angiotensin II receptor blockers (ARBs) with COVID-19 mortality in patients with hypertension. Methods: MEDLINE, SCOPUS, OVID, and Cochrane Library were searched for the period of January 1, 2020 to May 20, 2020. Studies reporting the association of RAAS inhibitors (ACEi and ARBs) and mortality in patients with hypertension, hospitalized for COVID-19 were extracted. Two reviewers independently extracted appropriate data of interest and assessed the risk of bias. All analyses were performed using random-effects models on log-transformed risk ratio estimates, and heterogeneity was quantified. Results: Data were collected on 2,065,805 individuals (mean age, 58.73 years; 53.4% male). Patients with hypertension taking RAAS inhibitors were 35% less likely to die from COVID-19 compared to patients with hypertension not taking RAAS inhibitors (pooled RR= 0.65, 95% Confidence Intervals (CI): 0.45-0.94). To explore the association of COVID-19 and specific classes of RAAS inhibitors, we conducted a subgroup analysis of ARBs and ACEi separately from studies that provided them. Pooled risk ratio estimates from ARBs and ACEi showed a lower but not significant risk of death from COVID-19 (RR=0.93, 95% CI: 0.70-1.22) and ACEi (RR=0.65, 95% CI: 0.32-1.30). Conclusions: In this meta-analysis, it was discovered that taking RAAS inhibitors, significantly decreased the risk of COVID-19 mortality in patients with hypertension. This indicates a potential protective role that RAAS-inhibitors may have in COVID-19 patients with hypertension.
Keywords	covid19
Publisher	MedRxiv; WHO
Document type	Article ; Online
DOI	10.1101/2020.05.21.20107003
Database	COVID19

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Article ; Online: The association of cardiovascular disease and other pre-existing comorbidities with COVID-19 mortality: A systematic review and meta-analysis

Ssentongo, P. / Ssentongo, A. E. / Heilbrunn, E. S. / Chinchilli, V. M.

Abstract: Importance. Exploring the association of coronavirus-2019 disease (COVID-19) mortality with chronic pre-existing conditions may promote the importance of targeting these populations during this pandemic in order to optimize survival. Objective. To ... ...

Abstract	Importance. Exploring the association of coronavirus-2019 disease (COVID-19) mortality with chronic pre-existing conditions may promote the importance of targeting these populations during this pandemic in order to optimize survival. Objective. To explore the association of pre-existing conditions with COVID-19 mortality. Data Sources. MEDLINE, the OVID databases, SCOPUS, and Cochrane Register of Controlled Trials were searched for the period October 1, 2019 to May 1, 2020. Snowballing was used to identify additional studies. Study Selection. Observational studies (n=19) reporting on 61,455 patients with relative risks (RR) or hazard ratios or odds ratios that reported the risk of mortality in patients with COVID-19 and comorbid conditions were included for the current study. Data Extraction and Synthesis. Two independent reviewers extracted data and assessed the risk of bias. All analyses were performed using random-effects models and heterogeneity was quantified. Main Outcomes and Measures The outcome of interest was the risk of COVID-19 mortality in patients with and without pre-existing conditions, reported as RR. Comorbidities explored were cardiovascular diseases (coronary artery disease, hypertension, cardiac arrhythmias, and congestive heart failure), chronic obstructive pulmonary disease, type 2 diabetes, cancer, chronic kidney disease, chronic liver disease, and stroke. Results. Ten chronic conditions from 19 studies were included in the meta-analysis (n=61,455 patients with COVID-19; mean age, 61 years; 57% male). Any cardiovascular disease, coronary heart disease, hypertension, congestive heart failure, and cancer significantly increased the risk of mortality from COVID-19. Cardiovascular disease was associated with a 135% higher risk of COVID-19 mortality (RR=2.35, 95%CI 1.44-3.84 n=9). The risk of mortality from COVID-19 in patients with coronary heart disease was 2.4 times as high as those without coronary heart disease (RR= 2.40, 95%CI=1.71-3.37, n=5) and twice as high in patients with hypertension as high as that compared to those without hypertension (RR=1.89, 95%CI= 1.58-2.27, n=9). Patients with cancer also were at twice the risk of mortality from COVID-19 compared to those without cancer (RR=1.93 95%CI 1.15-3.24, n=4), and those with congestive heart failure were at 2.5 times the risk of mortality compared to those without congestive heart failure (RR=2.66, 95%CI 1.58-4.48, n=3). Conclusions and Relevance COVID-19 patients with all any cardiovascular disease, coronary heart disease, hypertension, congestive heart failure, and cancer have an increased risk of mortality. Tailored infection prevention and treatment strategies targeting this high-risk population are warranted to optimize survival.
Keywords	covid19
Publisher	MedRxiv; WHO
Document type	Article ; Online
DOI	10.1101/2020.05.10.20097253
Database	COVID19

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Article ; Online: COVID-19 Contact Tracing Highlights Disparities: Household Size and Low-English Proficiency.

Giglio, Marisa E / Pelton, Matthew / Yang, Ae Lim / Patel, Akshilkumar / Buzzelli, Lindsay K / Schick, Jacob / Ssentongo, Anna / Tian, Zizhong / Ryan, Casey A / Razavi, Nina / Fredrick, Benjamin

Health equity

2022 Volume 6, Issue 1, Page(s) 330–333

Abstract: Although it is known that coronavirus disease 2019 (COVID-19) disproportionately affects racial and ethnic minorities, our study characterizes the connection between COVID-19 susceptibility and both limited English proficiency (LEP) and large household ... ...

Abstract	Although it is known that coronavirus disease 2019 (COVID-19) disproportionately affects racial and ethnic minorities, our study characterizes the connection between COVID-19 susceptibility and both limited English proficiency (LEP) and large household size. We examined demographic and social data for 1130 individuals who tested positive for or were exposed to COVID-19. Analysis revealed that LEP persons were 3.2 times as likely to report difficulty obtaining supplies for quarantine. Individuals in large households were 1.9 times as likely to report difficulty obtaining supplies for quarantine and 2.0 times as likely to report inability to quarantine. This study, therefore, informs interventions targeted to these populations.
Language	English
Publishing date	2022-04-27
Publishing country	United States
Document type	Journal Article
ISSN	2473-1242
ISSN (online)	2473-1242
DOI	10.1089/heq.2021.0148
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Renin-angiotensin-aldosterone system inhibitors and the risk of mortality in patients with hypertension hospitalised for COVID-19: systematic review and meta-analysis

Ssentongo, A. E. / Ssentongo, P. / Heilbrunn, E. S. / Lekoubou, A. / Du, P. / Liao, D. / Oh, J. S. / Chinchilli, V. M.

Open Heart

Abstract: OBJECTIVE: The association between the use of renin-angiotensin-aldosterone (RAAS) inhibitors and the risk of mortality from COVID-19 is unclear We aimed to estimate the association of RAAS inhibitors, including ACE inhibitors (ACEi) and angiotensin II ... ...

Abstract	OBJECTIVE: The association between the use of renin-angiotensin-aldosterone (RAAS) inhibitors and the risk of mortality from COVID-19 is unclear We aimed to estimate the association of RAAS inhibitors, including ACE inhibitors (ACEi) and angiotensin II receptor blockers (ARBs) with COVID-19 mortality risk in patients with hypertension METHODS: PubMed (MEDLINE) SCOPUS, OVID, Cochrane Library databases and medrxiv org were searched from 1 January 2020 to 1 September 2020 Studies reporting the association of RAAS inhibitors (ACEi or ARBs) and mortality in patients with hypertension, hospitalised for COVID-19 were extracted Two reviewers independently extracted appropriate data of interest and assessed the risk of bias All analyses were performed using random-effects models on log-transformed risk ratio (RR) estimates, and heterogeneity was quantified RESULTS: Fourteen studies were included in the systematic review (n=73,073 patients with COVID-19;mean age 61 years;53% male) Overall, the between-study heterogeneity was high (I(2)=80%, p<0 01) Patients with hypertension with prior use of RAAS inhibitors were 35% less likely to die from COVID-19 compared with patients with hypertension not taking RAAS inhibitors (pooled RR 0 65, 95% CI 0 45 to 0 94) The quality of evidence by Grading of Recommendations, Assessment, Development and Evaluations was graded as 'moderate' quality CONCLUSIONS: In this meta-analysis, with prior use of RAAS inhibitors was associated with lower risk mortality from COVID-19 in patients with hypertension Our findings suggest a potential protective effect of RAAS-inhibitors in COVID-19 patients with hypertension PROSPERO REGISTRATION NUMBER: The present study has been registered with PROSPERO (registration ID: CRD 42020187963)
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #913813
Database	COVID19

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Article ; Online: Renin-angiotensin-aldosterone system inhibitors and mortality in patients with hypertension hospitalized for COVID-19: a systematic review and meta-analysis

Ssentongo, Anna / Ssentongo, Paddy / Heilbrunn, Emily S. / Lekoubou, Alain / Du, Ping / Liao, Duanping / Oh, John S / Chinchilli, Vernon M.

medRxiv

Abstract	Objective: The association between renin-angiotensin-aldosterone (RAAS) inhibitors and Coronavirus diseases 2019 (COVID-19) mortality is unclear. We aimed to explore the association of RAAS inhibitors, including angiotensin-converting inhibitors (ACEi) and angiotensin II receptor blockers (ARBs) with COVID-19 mortality in patients with hypertension. Methods: MEDLINE, SCOPUS, OVID, and Cochrane Library were searched for the period of January 1, 2020 to May 20, 2020. Studies reporting the association of RAAS inhibitors (ACEi and ARBs) and mortality in patients with hypertension, hospitalized for COVID-19 were extracted. Two reviewers independently extracted appropriate data of interest and assessed the risk of bias. All analyses were performed using random-effects models on log-transformed risk ratio estimates, and heterogeneity was quantified. Results: Data were collected on 2,065,805 individuals (mean age, 58.73 years; 53.4% male). Patients with hypertension taking RAAS inhibitors were 35% less likely to die from COVID-19 compared to patients with hypertension not taking RAAS inhibitors (pooled RR= 0.65, 95% Confidence Intervals (CI): 0.45-0.94). To explore the association of COVID-19 and specific classes of RAAS inhibitors, we conducted a subgroup analysis of ARBs and ACEi separately from studies that provided them. Pooled risk ratio estimates from ARBs and ACEi showed a lower but not significant risk of death from COVID-19 (RR=0.93, 95% CI: 0.70-1.22) and ACEi (RR=0.65, 95% CI: 0.32-1.30). Conclusions: In this meta-analysis, it was discovered that taking RAAS inhibitors, significantly decreased the risk of COVID-19 mortality in patients with hypertension. This indicates a potential protective role that RAAS-inhibitors may have in COVID-19 patients with hypertension.
Keywords	covid19
Language	English
Publishing date	2020-05-26
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2020.05.21.20107003
Database	COVID19

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Article ; Online: Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection

Nepogodiev D. / Bhangu A. / Glasbey J.C. / Li E. / Omar O.M. / Simoes J.F. / Abbott T.E. / Alser O. / Arnaud A.P. / Bankhead-Kendall B.K. / Breen K.A. / Cunha M.F. / Davidson G.H. / Di Saverio S. / Gallo G. / Griffiths E.A. / Gujjuri R.R. / Hutchinson P.J. / Kaafarani H.M. /

Lederhuber H. / Loffler M.W. / Mashbari H.N. / Minaya-Bravo A. / Morton D.G. / Moszkowicz D. / Pata F. / Tsoulfas G. / Venn M.L. / Cox D. / Roslani A.C. / Alakaloko F. / de Vries J.-P.P. / Aaraj M.A. / Abbott S.J. / Abdalla M.O. / Abdelaal A.S. / Ademuyiwa A.O. / Aherne T.M. / Ali O.M. / Alkadeeki G.Z. / Almeida A.C. / Alrahawy M.M. / Ambler G.K. / Alameer E. / Andreani S.M. / De Andres-Asenjo B. / Antonanzas L.L. / Aoun S.G. / Ashoush F.M. / Augestad K.M. / Avellana R.B. / Ayeni F.A. / Ayorinde J.O. / Babu B.H. / Baig M.M. / Bajomo O.M. / Baker O.J. / Baker M.P. / Baldwin A.J. / Ban V.S. / Baron R.D. / Barranquero A.G. / Barry C.P. / DI Bartolomeo A. / Bass G.A. / Bath M.F. / Batjer H.H. / Beamish A.J. / Belgaumkar A.P. / Bence M.N. / Benson R.A. / Bernal-Sprekelsen J.C. / Bhama A.R. / Bhavaraju A.V. / Biffl W.L. / Blundell C.M. / Boddy A.P. / Borgstein A.B. / Bosanquet D.C. / Bosch K.D. / Bouhuwaish A.E. / Bozkurt M.A. / Brathwaite C.E. / Brown B.C. / Brown O.D. / Brown A.K. / Buarque I.L. / Bueno-Canones A.D. / Bulugma M.R. / Burke J.R. / Byrne M.H. / Cagigal-Ortega E.P. / Callcut R.A. / DI Candido F. / Canova M.E. / Carlos W.J. / Caruana E.J. / Cato L.D. / Catton A.B. / Ceretti A.P. / Chase T.J. / Chiara F.D. / Chowdhury A.H. / Chung E.A. / Cicerchia P.M. / Clough E.C. / Coleman N.L. / Collins C.G. / Collins M.L. / Colonna E.T. / Comini L.V. / Coughlin P.A. / Cruzado L.F.-G. / Davidson B.R. / Davies R.J. / Davies E.J. / Davis N.F. / Dawson B.E. / Dean B.J. / Delgado M.G.-C. / Diaz J.J. / Dickson K.E. / Diez-Alonso M.M. / Dixon J.R. / Doe M.J. / Drake T.D. / Drake F.T. / Duffy J.P. / Dunne D.F. / Dunne N.J. / Duran-Munoz-Cruzado V.M. / Durst A.Z. / Eardley N.J. / Edwards J.G. / Elfallal A.H. / Elfiky M.M. / Elliott J.A. / Emile S.H. / Emslie K.M. / Endorf F.W. / Engel J.L. / Enjuto D.T. / Etchill E.W. / Evans J.P. / Fahey B.A. / Faria C.S. / Feo C.V. / Ferguson H.J. / Fernandez B.D. / Fernandez A.G. / Fernandez A.J. / Fernandez-Pacheco B.C. / Fitzgerald J.E. / Fonsi G.B. / Font R.F. / Fowler A.L. / Fretwell K.R. / Fructuoso L.S. / Fusai G.K. / Garcia M.H. / Garcia-Urena M.A. / Gill C.K. / Gisbertz S.S. / Del Giudice R. / Giuffrida M.C. / Di Giuseppe M. / Gomez M.F. / Guariglia C.A. / Hainsworth A.J. / Hall B.J. / Hall J.R. / Hammond J.S. / Haqqani M.H. / Harrison E.M. / Hazelton J.P. / van Heinsbergen M. / Hill A.D. / Hing C.B. / Hirji S.A. / Ho M.W. / Holbrook C.M. / Holme T.J. / Hopkins J.C. / Hopkinson D.N. / Hossain F.S. / Hudson V.E. / Hughes J.L. / Hwang E.S. / Ibrahim M.A. / Isolani S.M. / Jenkinson M.D. / Jenny H.E. / Jeyaretna D.S. / Jones R.P. / Jones A.P. / Jonker P.K. / Jonsson M.L. / Joyce D.P. / Kalkwarf K.J. / Kamarajah S.K. / El Kassas M. / Kavanagh D.O. / Keatley J.M. / Khalefa M.A. / Khan J.S. / Kirmani B.H. / Kisiel A.P. / Kouris S.M. / Kowal M.R. / Labib P.L. / Larkin J.O. / Lauscher J.C. / Leclercq W.K. / Ledesma F.S. / Leite-Moreira A.M. / Leung E.Y. / Lewis S.E. / Lima M.J. / Lin D.J. / Liu H.H. / Lowery A.J. / 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G.S. / Mateo-Sierra O. / Martinez-Perez C. / Serrano Gonzalez J. / Hernandez Bartolome M.A. / Diaz Perez D. / Gutierrez Samaniego M. / Galindo Jara P. / Sharma N. / Smart N.J. / Keller D.S.

an international cohort study

2020

Abstract: Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and ... ...

Abstract	Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p<0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p<0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p<0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research.
Keywords	Adult ; Aged ; Betacoronavirus ; Coronavirus Infections ; Elective Surgical Procedures ; Emergency Medical Services ; Female ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Pandemics ; Pneumonia ; Viral ; Postoperative Complications ; Respiratory Tract Diseases ; Retrospective Studies ; Surgical Procedures ; Operative ; Young Adult ; covid19
Subject code	610 ; 616
Language	English
Publishing country	it
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection

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an international cohort study

2020

Abstract	Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research.
Keywords	covid19
Language	English
Publisher	Elsevier
Publishing country	uk
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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