Optimizing Peripandemic Care for Veteran Major Non-Traumatic Lower Extremity Amputees: A Proposal Informed by a National Retrospective Descriptive Analysis of COVID-19 Risk Factor Prevalence

In response to the Coronavirus 2019 (COVID-19) pandemic, vascular surgeons in the Veteran Affairs Health Care System have been undertaking only essential cases, such as advanced critical limb ischemia. Surgical risk assessment in these patients is often complex, considers all factors known to impact short- and long-term outcomes, and the additional risk thatCOVID-19 infection could convey in this patient population is unknown. The European Centre for Disease Prevention and Control (ECDC) published risk factors (ECDC-RF) implicated in increased COVID-19 hospitalization and case-fatality which have been further evidenced by initial reports from the United States Centers for Disease Control and Prevention. CDC reports additionally indicate that African American (AA) patients have incurred disparate infection outcomes in the United States. We set forth to survey the Veterans Affairs Surgical Quality Improvement Program (VASQIP) database over a nearly 20 year span to inform ongoing risk assessment with an estimation of the prevalence of ECDC-RF in our veteran critical limb ischemia population and investigate whether an increased COVID-19 comorbidity burden exists for AA veterans presenting for major non-traumatic amputation.

Joint position statement on biontech vaccination in adolescents with allergic diseases

This Statement was prepared to encourage Hong Kong adolescents aged 12-17 years old to receive BioNTech vaccine and recommend when to refer them for vaccine allergy evaluation. Importantly, the personal and societal benefits of BioNTech vaccination outweigh the risk of non-severe adverse vaccine reactions. BioNTech is currently contraindicated only in individuals with history of anaphylaxis to this vaccine or its components (e.g., polyethylene glycol [PEG]) by appropriate allergy testing. Subjects with history of immediate and severe allergic reactions to PEG-containing drugs or vaccines or immediate allergic reaction to the first dose of BioNTech warrant paediatric allergy referral to evaluate their fitness to receive this vaccine. Allergy to unrelated drugs, food, insect venoms as well as asthma, allergic rhinitis and eczema are not contraindications for BioNTech. Patients with a history of severe allergic reactions after foods, unrelated drugs or vaccines can receive BioNTech with a longer observation of 30 minutes post-vaccination.