ABSTRACT
This paper explores the effects of mourning in isolation. The authors posit that the pandemic-induced quarantine has impacted mourning processes in a negative manner, particularly insofar as the relational aspects of mourning are concerned. Through a phenomenological study based on a survey of 56 mental health care professionals, the authors examine individual experiences of living through the pandemic while enduring loss and subsequent bereavement in socially isolative conditions. The data, accompanied by several case examples, suggests that during the pandemic loss and mourning were complicated by isolation, the lack of communal grieving rituals and the presence of an increase in mental health disorders. Furthermore, the authors hypothesize that during the Covid-19 pandemic, the absence of positive relational support will result in a greater number of cases of delayed, stalled, and prolonged mourning, as well as Persistent Complex Bereavement.
ABSTRACT
INTRODUCTION AND OBJECTIVE: Continued vigilance of operative outcomes of COVID-19 patients is important given the relative novelty of the SARS-CoV-2 infection. We here sought to evaluate the 30-day mortality and cardiopulmonary adverse event rates in patients undergoing emergency surgery with perioperative COVID-19 infection, in comparison to a control group of medically managed COVID-19 patients that did not require surgical intervention. METHODS: A retrospective review of electronic medical data from a single tertiary-care center in Michigan was undertaken. Patients who had tested positive for SARS-CoV-2 infection either 7 days before or within 30 days after surgery during March-May 2020 were included in the study (n=52). Propensity score matched (1:6) patients who had been positive for SARS-CoV-2 infection during this time-period but did not undergo surgery were used as controls (n=314, Figure 1). The primary endpoint was 30-day mortality. Secondary endpoints included cardiac and pulmonary complications. Multivariable logistic regression analyses were utilized to account for baseline differences. A pvalue <0.05 was considered significant. RESULTS: The 30-day mortality (17.3% vs 13.1%, p=0.408) and cardiac (28.9% vs 19.1%, p=0.107) and pulmonary complication (55.8% vs 49.4%, p=0.392) rates were similar in patients in the surgical versus non-surgical group, respectively. Multivariable analyses confirmed that an emergency surgical intervention was not associated with increased odds for any of the studied adverse events (p >0.10 for all 3 endpoints). CONCLUSIONS: Patients undergoing emergency surgery with a co-diagnosis of SARS-CoV-2 infection in the perioperative period do not have an increased risk for short-term mortality or cardiopulmonary complications compared to the medically treated COVID-19 patients.