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Objective: To analyze the epidemiological characteristics of coronavirus disease 2019 (COVID-19) cases in Jingzhou, Hubei, and provide scientific basis for the prevention and control of similar epidemic in future.
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BACKGROUND: The global pandemic of coronavirus disease 2019 pneumonia poses a particular challenge to the emergency surgical treatment of elderly patients with high-risk acute abdominal diseases. Elderly patients are a high-risk group for surgical treatment. If the incarceration of gallstones cannot be relieved, emergency surgery is unavoidable. CASE SUMMARY: We report an 89-year-old male patient with acute gangrenous cholecystitis and septic shock induced by incarcerated cholecystolithiasis. He had several coexisting, high-risk underlying diseases, had a history of radical gastrectomy for gastric cancer, and was taking aspirin before the operation. Nevertheless, he underwent emergency laparoscopic cholecystectomy, with maintenance of postoperative heart and lung function, successfully recovered, and was discharged on day 8 after the operation. CONCLUSION: Emergency surgery for elderly patients with acute abdominal disease is safe and feasible during the coronavirus disease 2019 pandemic, the key is to abide strictly by the hospital's epidemic prevention regulations, fully implement the epidemic prevention procedure for emergency surgery, fully prepare before the operation, accurately perform the operation, and carefully manage the patient postoperatively.
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Objective • To explore the spatial distribution and spatial-temporal clustering of coronavirus disease 2019(COVID-19) in Jingzhou City. Methods • Data of COVID-19 cases in Jingzhou City from January 1 to March 12, 2020 were collected. Trend surface analysis, spatial autocorrelation and spatial-temporal scanning analysis were conducted to understand the spatial-temporal distribution of COVID-19 at town (street) level in Jingzhou City, and the spatial-temporal clustering characteristics of local cases and imported cases were compared. Results • Trend surface analysis showed that the incidence rate of COVID-19 in Jingzhou City was slightly "U" from west to east, slightly higher in the east, and inverted "U" from south to north, slightly higher in the south. Global autocorrelation showed that the incidence rate of COVID-19 in Jingzhou City was positively correlated (Moran's I=0.410, P=0.000). Local spatial autocorrelation analysis showed that the highly clustered areas and hot spot areas were mainly in Shashi District, Jingzhou District and the main urban area of Honghu City (Xindi Street) (P<0.05). Five clusters were found by spatial-temporal scanning of imported cases. The cluster time of the main cluster was from January 18 to February 3, 2020, and it was centered on Lianhe Street, covering 15 towns (streets) in Shashi District and Jingzhou District (LLR=174.944, RR=7.395, P=0.000). Five clusters were found by spatial-temporal scanning of local cases. The cluster time of the main cluster was from January 20 to February 24, 2020, which was located in Xindi Street, Honghu City (LLR=224.434, RR=16.133, P=0.000). Conclusion • Obvious spatialtemporal clustering of COVID-19 was found in Jingzhou City, and Shashi District, Jingzhou District and Honghu City were the most prevalent areas.