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Background: Studies have suggested that myocardial damage due to severe acute respiratory syndrome-2 (SARS-CoV-2), commonly referred to as COVID-19, may increase the risk of arrhythmias. Objective(s): To compare the one-year incidence of atrial fibrillation (AF) among patients with COVID-19 as compared to patients with non-COVID-19 acute upper respiratory infection (AURI). Method(s): The Optum Clinformatics database, an administrative claims databaseof commercially insured beneficiaries in the United States (US), was used for study purposes. Three cohorts of patients were identified: patients with COVID-19 diagnosis in any setting (April 2020-June 2021);patients with AURI in the pandemic period (April 2020-June 2021);and patients with AURI in the pre-pandemic period (January 2018-December 2018). Patients with prior AF diagnosis were excluded from each cohort. Three sets of analysis comparing AF incidence were performed: COVID-19 cohort vs AURI pandemic cohort;COVID-19 cohort vs AURI pre-pandemic cohort;and AURI pandemic cohort vs AURI pre-pandemic cohort. For each of the three comparisons, a matching weight method was used to help ensure balance among groups on baseline socio-demographic and clinical comorbidities. Logistic regression was used to assess the odds of 1-year incident AF among matched patients. Result(s): When comparing the matched COVID-19 (n=102,227) and AURI pandemic (n=102,101) cohorts, one-year incidence of AF was significantly higher in the COVID-19 cohort (2.2% vs 1.2%;p<0.001), who were 83% more likely to develop AF (odds ratio [OR] 1.83;95% confidence interval [CI] 1.72-1.95) as compared to the AURI group. COVID-19 patients were also observed to have significantly higher risk of incident AF as compared to AURI pre-pandemic cohort (2.7% vs 1.6%;p<0.001;OR 1.70, 95% CI 1.63-1.78). No significant difference was observed in AF incidence among the AURI pandemic versus AURI pre-pandemic cohort (1.1% vs 1.2%;p=0.133;OR 0.95, 95% CI 0.90-1.01). Figure 1 depicts differences in AF incidence across the comparator cohorts. Conclusion(s): Patients with COVID-19 were observed to have a higher incidence of AF as compared to those with upper respiratory infections. Awareness amongst clinicians of an increased AF incidence in COVID-19 affected patients appears warranted. [Formula presented] French language not detected for EMBFRA articles source xmlCopyright © 2023
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Background: The unprecedented prevalence of olfactory disfunction (OD) by SARS-CoV- 2 has revealed the lack of specialized units dealing with sense of smell. The main objective of the study is to know the number of newly created olfactory units (OU) since the COVID-19 pandemic, as well as to evaluate the diagnosis, management and treatment of patients with OD. Method(s): Prospective cross-sectional study. Carried out by means of a survey with 20 items: having or not having an OU, demographic data, smell test, evolution and management of OD, data on treatments. The variables of the survey were approved by the rhinology commission of the Spanish society of ENT. The digital survey was distributed to all members of Spanish ENT and Allergy Societies. Result(s): A total of 16 responses were missing data, and further 12 responses were duplicated. Finally, 136 surveys were included. From them 82.4% answers were from otolaryngologists and 17.7% from allergists. The cohort of allergists and otolaryngologists was compared to ensure comparability of both samples. There were significant differences in the instrumental assessment of the olfaction, VAS and smell test (p = 0.016) was more common in otolaryngologists. Also, the prescription of olfactory rehabilitation (OR) (p < 0.001) was more common in otolaryngologists. The 40.5% (+/- 7.6) of all the existent OU were created after COVID-19 pandemics. The 33.9% (+/- 4.5) of the respondent have an OU now, while 22.3% (+/- 3.9) already had it before COVID-19 pandemics. It means that 17% of hospitals who did not have an OU before COVID-19, now they have it, while 82.8% are still lacking it. OR was prescribed for 1-3 months by 38%;3-6 months by 48.1% and > 6 months by 13.9%. Those with an OU prescribe OR during more time (p = 0.002) being the most frequent answer 3-6 months (69.4%) when they have OU while 1-3 months (52.4%) for those who do not have it. Conclusion(s): This study revealed that COVID-19 pandemic has stimulated the creation of OU and has demonstrated the utility of OU to deal with patients with OD, as their daily practice is more adapted to up-to- date clinical evidence between allergist and otolaryngologists.
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Introduction: Due to restrictions caused by the COVID-19 pandemic, elective procedures were canceled or postponed. This study aims to compare the epidemiological profile of cases from Brazilian’s Public Healthcare System (SUS) and Private Healthcare (PH) in a teaching single-center facility between 2019 and 2021. Methods: Data were gathered from patients who underwent lung resection (LR) by PUCRS’s Sao Lucas Hospital Thoracic Surgery team between 2019 and 2021. Data were obtained by retrospective review of electronic charts in March 2022. A retrospective analysis was made. Results: There were 212 procedures performed, being 80 in 2019, 66 in 2020 and 66 in 2021. In 2019, there were 45 (56.2%), in 2020, 43 (65.1%), and in 2021, 34 (51,5%) LR on SUS. Lobectomies on SUS in 2019 were 19 (42.2%), in 2020, 13 (30.2%), and in 2021, 17;on PH were 19 (54.2%) in 2019, 12 (52.1%) in 2020, and 18 in 2021. On SUS, in 2019 were performed 41 (91%) open thoracic surgeries and in 2020, there were 33 (76%);on PH, in 2019 video-assisted thoracic surgery (VATS) was done in 24 (68.5%) patients, 17 (73.9%) in 2020 and 29 (75%) in 2021. Procedures for oncological disease (primary or metastatic) on SUS in 2019 were performed in 27 (60%) patients, 23 (53.4%) in 2020, and 13 (44,8%) in 2021;on PH, in 2019, there were 23 (65.5%) patients, in 2020 were 15 (65.2%), and 16 (55,2%) in 2021. On SUS there were 24 women in 2019 (53%) and in 2020 (55%);on PH, there were 23 (65%) men in 2019 and 13 (56%) in 2020. The mean age of patients on SUS was 59, and 66 on PH. Clinical staging (CS) for primary lung cancer on SUS in 2019 was 12 (50%) CS I, 8 CS II, 3 CS III, and 1 CS IV;in 2020 was 8 (47%) CS I, 6 CS II, and 3 CS III. On PH, in 2019, there were 12 (66.6%) CS I, 4 CSII, and 2 CS IV;in 2020, 11 (84.6%) CS I and 2 CS II. Conclusions: We found maintenance in the numbers of procedures in 2020 and 2021, but a global reduction in the number of LR on SUS, mainly because the pandemic became worst in its second year, leading to the closure of surgery centers. And a reduction of 17.5% in the number of LR in 2020, compared with 2019. Lobectomies lowered 36.8% on PH and 31.5% on SUS between 2019 and 2020. Albeit there was a reduction in general incidence, LR for oncological reasons predominated. In 2021 it represented 82,8%, with 44,8% on SUS, and 52,2% on PH. There was a higher average age on PH. Open thoracic surgery was most frequent on SUS due to limitations on offered equipment, while VATS predominated on PH (difference: 44.5%). The predominant CS remained equal on both healthcare systems, CS I, which indicates maintenance of early-stage diagnoses. Nevertheless, the overall incidence has diminished (33.33% [SUS] and 8.3% [PH]), a probable reflection of the pandemic. Keywords: COVID-19, Thoracic Surgery, Lung Cancer
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With the appearance of the COVID 19 pandemic, a suspension of face-to-face activities in the university educational field was established in Argentina in March 2020. The teaching-learning process (EA) in the basic area of dental careers became virtual. In this context of adaptation to the virtual EA process, a diversity of problems arose that conditioned its normal development. In addition to these difficulties for the students, there is scarce academic training for the new entrants of this year who have completed their secondary-level studies in 2020. The objective of this work was to identify, interpret, analyze and diagnose the integral situation of the student population in the context of a pandemic, to know the socio-demographic characteristics, academic backgrounds, different technological applications that they use, computer, technological and socio-affective problems;willingness to maintain virtuality;teacher performance. A descriptive, cross-sectional, observational, retrospective, and qualitative-quantitative study was developed. A mixed semi-structured survey using a Google form, 245 students studying Histology and Embryology, the first year of the Dentistry career of the UNR years 2020 and 2021, voluntary and anonymous, with multiple single answer options, with an expected non-response rate of less than 25%. It was available for 10 calendar days. The modality adopted was multiple choice of a single answer. An analytical comparison was made with a study carried out with similar characteristics for students in the 2020 cycle. The most obvious difficulties manifested in this analytical study are based on socio-demographic problems, with the majority of the students residing outside the city of Rosario. Socio-economically, their academic performance has seriously worsened, because in many situations they are family support. In the previous training of the middle school, it was evidenced that the virtuality of the closing of the cycle was deficient in the pre-university preparation. In relation to the socio-affective, a feeling of dissatisfaction and anguish prevails. Furthermore, technological inaccessibility in many situations acted unfavorably. In comparison, the problems maintain a similarity, but in 2021 there is a marked increase in the academic dropout rate, as well as a decrease in academic performance.
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Background: The world and Cuba in the last two years have been affected by Covid-19. It is of vital importance for Public Health to have statistical studies of infected cases, prognostic equations of the same and possible peaks of the disease, with a view to applying the appropriate measures to combat the pandemic. Objective: The objective of the work is to carry out statistical studies on the data of confirmed cases in the province of Cienfuegos, in the period from March 2020 to August 2021. Methods: The Applied Mathematics Research Group of the University of Cienfuegos carried out a statistical study of the databases of patients confirmed with Covid-19, in the 8 municipalities of the province of Cienfuegos, from March 2020 to August 2021. applied descriptive statistics on the accumulated confirmed cases, age, sex, doses of vaccines received and the probable dates of the highest pandemic peak. The Gompertz, Weibull and Loglogistic logistic population growth models were used to obtain forecast equations for confirmed cases. The basic reproduction numbers Ro and effective Rt were calculated. Results: Knowledge of the adjustment equations in the municipalities of the province of Cienfuegos allows health and government authorities to design strategies to reduce effective reproduction and their monitoring increases the effectiveness of the measures taken. There is an adequacy of the models presented with respect to the predicted and real values, which allows their reliability for the forecasts made. Conclusions:The logistic, Weibull and Gompertz population growth models used to obtain forecast equations in the province of Cienfuegos of confirmed cases of COVID-19, allow future monitoring, control and projection of the behavior of the pandemic according to significant indicators in Cienfuegos.
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Academic stays at higher education institutions located outside students’ usual environment for less than a year have become increasingly popular. The research reported in this article aimed to examine the current situation of international academic tourism in the region of Barcelona (Spain). The main objectives were to profile academic tourists, to analyse the impact of the COVID-19 pandemic on inbound academic tourism flows, and to explore the outcomes of academic travel experiences. Following a mixed-methods approach, two focus groups and three in-depth interviews were conducted to collect data from both a supply and demand perspective, in addition to a survey designed for international students. A total of 132 questionnaires were analysed by means of descriptive statistics and through chi-square and ANOVA tests. Qualitative data was processed by means of categorisation and content analysis using QDA Miner. The main results indicate that academic tourism has positive sustainable impacts and is conducive to transformational experiences. Tourists’ profile has been identified and the effects of the pandemic have been pinpointed. Due to COVID-19, academic tourism flows experienced a serious decline and the satisfaction degree with the academic travel experience was lower. Nonetheless, most of the respondents would recommend Barcelona as an academic destination. © 2022 by the authors.
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BACKGROUND AND AIMS: The poor humoral response after vaccination against SARS-CoV-2 in kidney transplant (KT) patients led to the approval of a third dose. Recent data show an increase in the antibody titer, although lower than in the general population. Our aim is to analyze the humoral immune response after the third dose a mRNA vaccine against SARS-CoV-2 and the evolution of the antispike antibody (antiS) titers in KT recipients. METHOD: We performed a prospective cohort study of stable KT patients from our center who received three doses of a mRNA vaccine from March to November 2021. KT recipients with less than 6 months after transplantation and with active oncological or hematologic disease were excluded. We determined antiS titers (Abbott SARS-CoV- 2 IgG chemiluminescent microparticle immunoassay) at baseline, one month after the second dose and one month after the third one. We compared those KT patients who seroconverted with 2 and with 3 doses of vaccine and those who did not seroconvert. To identify risk factors for no seroconversion, a logistic regression analysis was carried out. RESULTS: We included 83 KT. Mean age was 59.3 years and 62.7% were male. The median time from KT to the first vaccine dose was 94 months and between the second and third dose median time was 4 months. Seroconversion rate was 63.8% after 2 doses and 85.5% after the third one (P < 0.001). Twelve KT did not develop antibodies (Table 1). Patients who did not seroconvert were older (P = 0.047), had a worse renal function (P = 0.009) and had fewer lymphocytes than those that developed antibodies (0.013). Besides, they almost half of them received a KT from a non-heart-beating donor (P = 0.026) and were treated with thymoglobulin in the 2 years prior to the vaccine more frequently (P = 0.007). In patients who seroconverted after 2 doses, we observed a 10-fold increase in the antiS titer after the third vaccine (82 [34-350] UI/mL versus 814 [205-2415] UI/mL;P < 0.001). No patients had neither acute rejection nor serious adverse effects. In the multivariable analysis advanced age, a worse kidney function and recent treatment with thymoglobulin were risk factors for no seroconversion (Table 1). CONCLUSION: The third dose of a mRNA vaccine against SARS-CoV-2 significantly increased the seroconversion rate and the antiS titers in stable KT patients. Advanced age, poorer kidney function and immunosuppressive treatment are risk factors for no seroconversion. (Table Presented).
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This paper focuses on describing the impact of the application of public policies on student access to the tele-training platform of the University of Cienfuegos and the level of student satisfaction with tele-training services from UCF. Two instruments were applied in the study, the review of documents based on the possibilities offered by the Moodle Reports to analyze the behavior in the access to tele-training resources before and after the measures were applied by ETECSA. An online questionnaire allowed obtaining information about how students access the different services and the level of satisfaction. The main results are that the measure to free up access costs has managed to exponentially increase access to available platforms and resources. The survey allowed to know the tools and main contents that the students use for the development of the activities and to determine the main deficiencies on which to project improvement actions. Finally, the level of satisfaction that students have with the process is recognized as adequate. © 2022, University of Cienfuegos, Carlos Rafael Rodriguez. All rights reserved.
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Introduction: Cancer patients have been considered a high-risk population in the COVID-19 pandemic. We previously investigated risk of COVID-19 death in COVID-19 positive cancer patients during a median follow-up of 134 days, and identified the following risk factors: male sex, age >60 years, Asian ethnicity, hematological cancer type, cancer diagnosis for >2.5 years, patients presenting with fever or dyspnea, and high levels of ferritin and C-reactive protein (CRP). Here, we further investigate which factors are associated with a COVID-19 related death within 7 days of diagnosis. Methods: Using data from Guy's Cancer Centre and one of its partner trusts (King's College Hospital), we included 306 cancer patients with a confirmed COVID-19 diagnosis (February 29th-July 31st 2020). 72 patients had a COVID-19 related death (24%) of whom 35 died within 7 days (50%). Cox proportional hazards regression was used to identify which factors were associated with a COVID-19 related death <7 days of diagnosis. Results: Of the 72 cancer patients who had a COVID-19 related death, the mean age was 72 years (Standard Deviation (SD) 14). A total of 53 (74%) patients were men. 37 (52%) had a hematological cancer type, 47 (65%) had stage IV cancer, and 42 (58%) had been diagnosed with cancer more than 24 months before COVID-19 related death. In the group of patients who died within 7 days of diagnosis (n= 35), mean age was 73 years (SD 13.96), 24 (68%) were men, 20 (57%) had a hematological cancer type, 26 (74%) had stage IV cancer, and 24 (68%) had been diagnosed with cancer >24 months before COVID-19 diagnosis. Factors associated with COVID-19 related death <7 days of diagnosis were: hematological cancer (Hazard Ratio (HR): 2.74 (95% Confidence Interval (CI): 1.21-6.22)), 2-5 yrs since cancer diagnosis (HR: 4.81 (95%CI: 1.47-15.69)), and >5 yrs since cancer diagnosis (HR: 4.41 (95%CI: 1.38-14.06)). Additionally, patients who presented with dyspnea had increased risk of COVID-19 related death <7 days compared to asymptomatic patients (HR: 5.25 (95%CI 2.14-12.89)). CRP levels in the third tercile (146-528 mg/L) as compared to the first were also associated with increased risk of an early death due to COVID-19. Conclusion: From all the factors identified in our previous COVID-19 related death analysis, only hematological cancer type, a longer-established cancer diagnosis (2-5 years and more than 5 years), dyspnea at time of diagnosis and high levels of CRP were indicative of an early COVID-19 related death (within 7 days of diagnosis) in cancer patients.
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Purpose: This study intends to map the supply chain and characterize the business processes of a cultural center in an aggregated and coordinated operation to serve families in need during the Covid-19 pandemic. This case study analyzes distinct aspects of humanitarian management capable of contributing to the management of commercial supply chains. Design/methodology/approach: Adopting a case study approach, this research contextualizes the view on humanitarian supply chains related to the importance of participating organizations' engagement and the relationship and similarity with business organizations. Findings: The study presents the model adopted to undertake the aid operations, maps the cultural center's humanitarian supply chain, clarifies the relationships and operations developed and compares the business processes with those of commercial chains. Possibilities and initiatives are discussed that can contribute to business organizations' greater engagement in humanitarian actions. Research limitations/implications: Restricted to one case involving the cultural center and the other agents researched, the information and considerations are limited, and any generalization should be treated with caution. Practical implications: The study is a practical example that clarifies how business organizations can engage in the supply chain of humanitarian institutions. It also illustrates ways to help these institutions improve their fund-raising initiatives. Social implications: This study is justified by the representativeness of humanitarian actions in critical periods such as the Covid-19 pandemic. The study also presents potential ways to contribute to operations of this nature and to encourage business organizations to improve participation in humanitarian movements. Originality/value: Many studies on the subject have highlighted the importance of comparing humanitarian and business supply chains through real case research. © 2021, Emerald Publishing Limited.
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Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pathogen responsible for the coronavirus disease 2019 (COVID-19) pandemic. Aside from the pulmonary manifestations, COVID-19 is associated with increased risk of venous and arterial thrombotic complications. The actual impact of SARS-CoV-2 infection on platelet reactivity and whether this is mediated by a hyperinflammatory status has not been fully elucidated to date. Objective: To evaluate platelet reactivity in COVID-19 patients compared to healthy subjects and to assess the association between platelet reactivity and levels of inflammatory biomarkers among COVID-19 patients. Methods: This prospective observational investigation included COVID-19 patients admitted into a tertiary care hospital and adult healthy volunteers, all of them not receiving any antiplatelet therapy. Subjects were classified in three groups: 1) Healthy subjects (HS group);2) COVID-19 patients in a pulmonary phase (viral pneumonia and bilateral infiltrates) but without meeting criteria for systemic hyperinflammation (C19-Pulm group);and 3) COVID-19 patients in a hyperinflammation phase (C19-Infl group) meeting at least 2 of the following criteria: CRP>100mg/l, D-dimer >1000mcg/l, LDH>400U/l, ferritin>1000ng/ml, IL-6>70ng/l. Blood samples for platelet function testing and quantification of inflammatory parkers were collected at a single visit. Platelet function was measured with multiple electrode aggregometry using ADP (MEA-ADP, primary endpoint), arachidonic acid (AA) and thrombin receptor activating peptide (TRAP) as stimuli. Unadjusted analyses are presented. Results: A total of 60 patients were included in the present investigation (20 in each group). A significantly greater platelet reactivity, measured with MEA-ADP, was observed in both groups of COVID-patients compared to healthy subjects (HS: 634,9±53,5, C19-Pulm: 919,9±53,5 and C19-Infl: 931,6±53,5 AU∗min;p for C19-Pulm vs. HS <0,001, p for C19-Infl vs. HS <0,001, p for C19-Pulm vs. C19-Infl 0,878;Figure 1). Parallel findings were found when using AA as stimulus for platelet aggregation showing greater platelet aggregation in COVID-19 patients compared to healthy subjects, but numerical differences were not statistically significant when using TRAP. Among COVID-19 patients, when stratified by IL-6 levels splitted into tertiles, greater platelet reactivity was observed in patients with higher IL-6 concentrations (mid and upper tertile together) compared to those with values in the lower tertile, as assessed with MEA-ADP (lower tertile: 829,0±75,8, mid and upper tertile: 1028,7±56,2;p=0,043);a similar trend was observed with AA and TRAP as stimuli. Conclusion: Patients with severe COVID-19 disease have greater platelet reactivity than healthy subjects. Increased IL-6 levels might be associated with the observed heightened platelet reactivity among COVID-19 patients.
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The VIE (Virtual presence in higher education hybrid learning environments) is an Erasmus+ project which was approved in the extraordinary call during the COVID pandemic to support digital education readiness and collaborative skills. This project is aimed to design and implement a highly interactive digital collaborative learning platform. VIE envisions a digital work environment through which students will design solutions to learning challenges through brainstorming and synthesizing by building on each other's ideas. The VIE solution will simulate the way that students work together in a classroom towards design solution by taking notes on a common blackboard that all can see and update at the same time. The service functionality will include: avatar presence through which participants will be able to recognize their team members in the digital environment;sharing of ideas in the form of building blocks that all can see, review, edit, and combine simultaneously towards building a larger solution from smaller contributions;and project organization that allows the effective management and prioritization of tasks in a visual and engaging manner. Interaction will be supported through both desktop and mobile devices for maximizing access flexibility. © 2021 IEEE.
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HERA is an Erasmus+ project aimed at the development of soft skills in higher education engineering and economics students through collaborative serious games. It proposes a digital learning game platform whose goal is to expose students to complex challenges, the solution to which requires integration of knowledge from diverse fields in a manner that simulates how engineering and economics professionals work and collaborate in the real world. The platform shows the typical landscape of a virtual city game, like SimCity, where it is possible to perform different actions to develop a city in an appropriate and suitable way. Available scenarios involve problems related to sustainable mobility, smart parking solutions, circular economy related to recycling, flood management, e-commerce development, Olympic Games management and even COVID. Gamifying the problem-solving process will promote active student engagement in learning through a sense of mission, a sense of affiliation, healthy competition, rewards, and social recognition by peers among other mechanisms. © 2021 IEEE.
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Background: At the Rapid Access Diagnostic Unit at Guy's Hospital London, we review patients with vague symptoms that are concerning for malignancy. As part of our response to the COVID-19 pandemic, we developed a virtual triage pathway with the aim to reduce face-to-face appointments and prioritise resources towards patients with an underlying cancer diagnosis. Methods: Patients were triaged by clinicians based on a telephone consultation with the patient and history and blood tests provided in the referral. Those triaged as high risk were either directly booked for investigation ("straight-to-test") or booked for a face-to-face consultation for further history and examination. Low risk patients were either put on a watch-and-wait pathway with a telephone follow-up in 3-4 weeks or discharged back to the GP with a robust plan on symptom management. The patient outcomes were tracked and compared to the outcomes from the face-to-face assessment service used prior to the COVID-19 pandemic (Dec 2016-Feb 2020). Patients triaged as low risk and discharged were tracked to monitor for any subsequent cancer diagnoses. Results: There were 804 referrals triaged between March 2020-January 2021. 75% were triaged to a face-to-face assessment and 18% triaged straight-to-test. 4% were placed on the watch-and-wait pathway and 3% were returned to the GP with advice. In those triaged as high risk, 8.2% were diagnosed with cancer, 54% were diagnosed with a serious-benign condition and 38% with a non-serious or no condition. In the patients triaged as low risk and placed on the watch-and-wait pathway, 14% were brought in for a face-to-face assessment based on their follow-up telephone assessment. None of the patients on the watch-and-wait pathway were found to have a cancer diagnosis, 11% were diagnosed with a seriousbenign condition, and 89% were diagnosed with a non-serious or no condition. There was an overall cancer diagnosis rate of 7.6% compared with a pre-COVID-19 diagnosis rate of 6.6%. Conclusions: The virtual triage pathway effectively risk-assessed patients, with those triaged as high risk having an 8.2% cancer diagnosis rate compared to a 0% cancer diagnosis rate in those triaged as low risk. Furthermore, the virtual triage service had a higher cancer diagnosis rate compared to the pre-COVID-19 face-to-face assessment service. Therefore the virtual triage service provides an efficient pathway for cancer diagnosis in patients presenting with vague symptoms, reducing the number of face-to-face appointments and supporting management of low risk patients in the community.
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Introduction: All restrictions and social isolation imposed by the COVID-19 pandemic did not prevent the evolution of non-infectious diseases, interfering in the diagnosis and the beginning of the treatment for other pathologies. This study aims to measure the impact caused by the pandemic on the diagnosis and staging of lung cancer in patients who underwent lung resection (LR) in 2020 compared to 2019, as well as to describe the epidemiological profile of these patients. Methods: In this retrospective study, data from patients who underwent LR (lobectomy, segmentectomy, wedge resection, and pneumonectomy) by PUCRS’s Sao Lucas Hospital Thoracic Surgery team in Brazil within 2019 and 2020 were collected from medical records in March 2021. Only primary lung cancer patients were included. A descriptive analysis was performed. Results: There were 144 LR analyzed, 80 in 2019 and 66 (45.83%) in 2020. The number of LR due to primary lung cancer was 42 (52.5%) in 2019 and 30 (45.45%) in 2020. The comparison between years indicates a reduction of 28.57% in the number of LR. Of the 30 surgeries in 2020, 23 were lobectomies (76.66%), 3 segmentectomies (10%), 1 wedge resection, and 3 pneumonectomies. The incidence of lobectomies in men decreased 35.29% (17 in 2019;11 in 2020) and remained stable in women (13 in 2019;12 in 2020). The average age of patients who were subjected to LR was 61.57 in 2019 and 57.9 in 2020. In cancer patients, the average age was 59.9 (61.9 in 2019;57.98 in 2020). The incidence of adenocarcinoma was 29 in 2019 (69%) and 19 in 2020 (63.3%), being the most prevalent histological type. According to our review, clinic staging (CS) for lung cancer with the highest incidence in the two years analyzed was IA2, with 26.6% of cases in 2020 and 28.5% in 2019. CS IIA corresponded to 20% in 2020 and 9.5% in 2019, IIB 16.6% in 2019 and 6.6% in 2020, IA1 16.6% in 2020 and 2.38% in 2019, IA3 19% in 2019 and 13.3 % in 2020. Of the 42 patients who were performed LR for primary cancer in 2019, 17 (40.47%) underwent video-assisted thoracoscopic surgery (VATS), and from 29 (55.17) in 2020, 16 were VATS. Conclusion: In general, the pandemic and its restrictions of access to tertiary diagnostic and treatment centers decreased the number of patients. There was a reduction of 28.57% in the number of procedures performed for primary lung. Most patients continued to receive a CS IA2 diagnosis, however, the percentage of diagnosis in CS IIA had grown. This percentage is worrying, as it shows that patients took longer to receive adequate treatment or were unable to make an early diagnosis. On the other hand, the average age of diagnosis decreased in 2020, which may indicate early diagnosis perhaps related to incidental findings in COVID19 CT scans. Our lower number of VATS is related to the lack of endoscopic staples in public healthcare system. Keywords: lung cancer, public healthcare, Surgery
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OBJECTIVE: The COVID-19 pandemic caused that the Health Department of the Autonomous Region of Madrid redirected the Obstetrics, Gynecology and Neonatology emergency care. On March 24th 2020, the HULP launched a program of postpartum early discharge and home visit. The objective of this work was to detect if the care strategy "Voluntary early discharge and home visit by the midwife (2nd year EIR)" applied by the HULP during the COVID-19 pandemic had any adverse effect on the woman and/or the newborn. METHODS: Cross-sectional observational descriptive study using convenience sampling among women included in the early discharge-home visit program from March 24th to May 5th 2020. 222 medical records and telephone surveys to postpartum women who complied with the inclusion criteria were analyzed. The statistical analysis was performed using SAS 9.4. RESULTS: The average of inpatient time was 25 hours and 15 minutes. 8.6% of newborns were sent back to the HULP, and 2.2% were readmitted for hyperbilirubinemia. 2.3% of parents took their infants to the Emergency Care Unit, but only 0.46% needed readmission. 0.4% of postpartum women were readmitted. At the discharge, 84.2% of newborns exclusively breastfed. After one week of the birth, 73.4% of infants were exclusively breastfeeding, 18% were mixed breastfeeding, and 8.6% were bottle feeding. 89.6% of women believed early discharge was appropriate. Home visit was described as "very satisfactory" in 83.3% of cases, and the care provided, in 88.7% of cases. CONCLUSIONS: With the early discharge-home visit program, continuity of care is provided, health problems were detected and resolved and high maternal satisfaction levels were obtained.