Splenic Infarction with Aortic Thrombosis in COVID-19

Coronavirus disease 2019 (COVID-19) has been associated with an increased risk of venous and arterial thrombotic disease. Although pulmonary embolism has been the most common thrombotic complication, there have been recent reports of COVID-19-associated large-vessel ischemic stroke, acute upper- and lower-limb ischemia, as well as infarctions of the abdominal viscera, including renal, splenic, and small bowel infarctions. Here, we describe a case of splenic infarction (SI) associated with aortic thrombosis, which evolved despite the prophylactic use of low-molecular-weight heparin (LMWH), in a 60-year-old female patient with COVID-19. The patient was treated clinically with a therapeutic dose of LMWH, followed by warfarin, and eventually presented a favorable outcome. We also present a review of the literature regarding SI in patients with COVID-19.

Did organizational models and designs of end-of-life care in burn intensive care units change during the COVID-19 Pandemic? Professionals' views and experiences

Background: Burns are a global public health problem, accounting for around 300,000 deaths annually. 25% of patients aged 45-65 with severe burns die. Given the changing environment of the COVID-19 pandemic, health services, including burn intensive care units (BurnICUs), were redesigned to be most effective. Aim: To explore organizational models and designs of end-of-life (EOL) care in BurnICUs during the COVID-19 pandemic. Methods: Qualitative study using in-depth interviews. All 5 BurnICUs reference centres across Portugal were invited;3 participated. 15 professionals (12 nurses;3 physicians) were interviewed after the first wave of the pandemic (July-October 2020), until reaching theoretical saturation. Analysis: inductive thematic analysis. Results: Five themes emerged and divided in sub-themes: (i) Risk of infection/sepsis and strict visiting procedures (flexibility, by-passing visiting restrictions;struggle with visiting restrictions;videoconferencing);(ii) Hampered consultation model (specialist consultation and interventions from other professionals were impeded);(iii) Difficulties in case management (physicians on call);(iv) Palliative care (PC) not included;and (v) BurnICUs were reorganized. Discussion: Organization design refers to the way in which the building blocks of organizations are (re)arranged to improve effectiveness and adaptive capacity. Findings show that decisions were made to adapt BurnICUs both to the challenges and impact of the COVID-19 pandemic and to the needs of critically burned patients. Tasks, rules, procedures and communication channels were reorganized. Conclusions: BurnICUs were redesigned as organizational needs changed during the COVID-19 pandemic. Despite strict visiting procedures, strategies were implemented to meet patients and families' needs at the EOL. As before the pandemic, palliative care was not involved in EOL care. Findings show the need to further explore PC involvement in EOL care in BurnICUs.

CHARMIE: A collaborative healthcare and home service and assistant robot for elderly care

The global population is ageing at an unprecedented rate. With changes in life expectancy across the world, three major issues arise: an increasing proportion of senior citizens;cognitive and physical problems progressively affecting the elderly;and a growing number of single-person households. The available data proves the ever-increasing necessity for efficient elderly care solutions such as healthcare service and assistive robots. Additionally, such robotic solutions provide safe healthcare assistance in public health emergencies such as the SARS-CoV-2 virus (COVID-19). CHARMIE is an anthropomorphic collaborative healthcare and domestic assistant robot capable of performing generic service tasks in non-standardised healthcare and domestic environment settings. The combination of its hardware and software solutions demonstrates map building and self-localisation, safe navigation through dynamic obstacle detection and avoidance, different human-robot interaction systems, speech and hearing, pose/gesture estimation and household object manipulation. Moreover, CHARMIE performs end-to-end chores in nursing homes, domestic houses, and healthcare facilities. Some examples of these chores are to help users transport items, fall detection, tidying up rooms, user following, and set up a table. The robot can perform a wide range of chores, either independently or collaboratively. CHARMIE provides a generic robotic solution such that older people can live longer, more independent, and healthier lives. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.