ABSTRACT
In overcoming the COVID-19 crisis, contribution from social science is indispensable as well as medical research. With this consideration, we have initiated a socio-life scientific survey on COVID-19, which is associated with the antibody test for the virus, targeting 3000 participants of the Nagahama Survey and 1000 medical workers at the Kyoto University Hospital. The survey is designed to highlight respondents’ changes in behavior, the effect of the COVID-19 outbreak on respondents’ values, and the actual spread of COVID-19 among the respondents. © 2022, RIETI.
ABSTRACT
Patients with Coronavirus disease 2019 (COVID-19) who receive extracorporeal membrane oxygenation (ECMO) tend to show extreme hypercoagulability and require intensive anticoagulant therapy. The prognosis is extremely poor in patients with intracranial hemorrhage. We report a case of COVID-19 complicated by acute subdural hematoma, which necessitated craniotomy for hematoma evacuation to improve the patient's prognosis. A 60-year-old man diagnosed with COVID-19 presented with severe respiratory failure and hypercoagulability and underwent ECMO along with intensive anticoagulant therapy with a large dose of heparin. Physical examination revealed anisocoria secondary to acute subdural hematoma. He denied a history of head injury, and computed tomography angiography revealed no vascular lesions. We diagnosed the patient with a non-traumatic, simple type hematoma. We discussed this case with the attending physician and reviewed the surgical indications and procedures. The attending physician recommended postoperative heparin withdrawal with ECMO. The hematoma was evacuated using a small crani-otomy. Considering the risk of COVID-19, we cautiously performed all intraoperative procedures, especially those associated with aerosol generation, such as irrigation and the use of the craniotome. Heparin was discontinued postoperatively. The modified Rankin scale (mRS) score on postoperative day 90 was mRS 3. Optimal infection control measures prevented nosocomial infections in this patient despite the emergency surgical intervention.