ABSTRACT
Background: COVID-19 can complicate the perioperative course to increase postoperative mortality in infected patients, and also is a serious threat to medical staff. However, studies summarizing the impact of COVID-19 on the perioperative mortality of patients and on the safety of surgical team are lacking.Methods: We searched PubMed, Cochrane Library, Embase and a Chinese database with the search terms “COVID-19” or “SARS-CoV-2” and “Surgery” or “Operation” for all published articles on COVID-19 since the outbreak. The search was finalized on May 29th, 2020.Findings: A total of 255 patients from 36 studies were included in our meta-analysis. The mean age of operative patients with COVID-19 was 50.03 years, and 56% were female. A total of 27 patients were deceased, with an overall mortality of 7%. All deceased patients had postoperative complications associated with operation or COVID-19, including respiratory failure/ARDS/short of breath/dyspnea, fever/cough/fatigue or myalgia, cardiopulmonary system, shock/infection, acute kidney injury and severe lymphopenia. While only respiratory failure/ARDS/short of breath/dyspnea after operation was associated with significantly higher mortality (r=0.879, p =0.001), while fever/cough/fatigue or myalgia demonstrated marginally significant association with mortality (r=0.619, p =0.056). 13 of the 36 studies reported medical staff infection and levels of personal protection, and a total of 38 medical staff were infected. Of note, none of the staffs with PPE 3 was infected.Interpretation: COVID-19 patients, in particular whose with severe respiratory complications, may have high postoperative mortality. And, medical staff in close contact with infected patients are suggested to take high level PPE.Funding Statement: This work was supported by Heilongjiang postdoctoral scientific research developmental fund (LBH-Q17127); Youth Elite Training Foundation (JY2015-05) of Harbin Medical University Cancer Hospital, and the National Natural Science Foundation of China (NO. 81970247, and NO. 81670770).Declaration of Interests: None.
Subject(s)
Dyspnea , Lymphopenia , Fever , Acute Kidney Injury , COVID-19 , Fatigue , Respiratory InsufficiencyABSTRACT
The global pandemic of Coronavirus disease 2019 (COVID-19) is a disaster for human society. A convenient and reliable in vitro neutralization assay is very important for the development of neutralizing antibodies, vaccines and other inhibitors. In this study, G protein-deficient vesicular stomatitis virus (VSVdG) bearing full-length and truncated spike (S) protein of SARS-CoV-2 were evaluated. The virus packaging efficiency of VSV-SARS-CoV-2-Sdel18 (S with C-terminal 18 amino acid truncation) is much higher than VSV-SARS-CoV-2-S. A neutralization assay for antibody screening and serum neutralizing titer quantification was established based on VSV-SARS-CoV-2-Sdel18 pseudovirus and human angiotensin-converting enzyme 2 (ACE2) overexpressed BHK21 cell (BHK21-hACE2). The experimental results can be obtained by automatically counting EGFP positive cell number at 12 hours after infection, making the assay convenient and high-throughput. The serum neutralizing titer of COVID-19 convalescent patients measured by VSV-SARS-CoV-2-Sdel18 pseudovirus assay has a good correlation with live SARS-CoV-2 assay. Seven neutralizing monoclonal antibodies targeting receptor binding domain (RBD) of SARS-CoV-2-S were obtained. This efficient and reliable pseudovirus assay model could facilitate the development of new drugs and vaccines.