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Br J Ophthalmol ; 2020.
Article | WHO COVID | ID: covidwho-947816


OBJECTIVES: To assess to which extent the COVID-19 pandemic affected corneal transplantation by virtue of donor selection algorithms in different European countries DESIGN: Survey SETTING: 110 eye banks in 26 European countries PARTICIPANTS: 64 eye banks covering 95% of European corneal transplantation activity INTERVENTIONS: A questionnaire listing the number of corneas procured and distributed from February to May 2018-2020 was circulated to eye banks MAIN OUTCOME MEASURES: The primary outcome was the number of corneal procurements Additional outcomes were national algorithms for donor selection, classified according to their stringency (donors with COVID-19 history, suspected for COVID-19, asymptomatic, PCR testing) and the pandemic severity in each country We calculated Spearman's correlation coefficient to determine, two by two, the relationship between the 3-month decline in eye banking activity (procurement), the stringency of donor selection algorithm and the grading of pandemic severity (cases and deaths) A partial correlation was run to determine the relationship between decline and stringency while controlling for pandemic severity RESULTS: Procurements decreased by 38%, 68% and 41%, respectively, in March, April and May 2020 compared with the mean of the previous 2 years, while grafts decreased, respectively, by 28%, 68% and 56% corresponding to 3866 untreated patients in 3 months Significant disparities between countries and the decrease in activity correlated with stringency in donor selection independent of pandemic severity CONCLUSIONS: Our data demonstrate significant differences between countries regarding donor screening algorithms based on precautionary principles and, consequently, a decrease in the donor pool, already constrained by a long list of contraindications Fundamental studies are needed to determine the risk of SARS-CoV-2 transmission by corneal transplantation and guide evidence-based recommendations for donor selection to justify their substantial medical and economic impact

J Neurol Neurosurg Psychiatry ; 2020.
Article | WHO COVID | ID: covidwho-913803


OBJECTIVE: Single cases and small series of Guillain-Barré syndrome (GBS) have been reported during the SARS-CoV-2 outbreak worldwide We evaluated incidence and clinical features of GBS in a cohort of patients from two regions of northern Italy with the highest number of patients with COVID-19 METHODS: GBS cases diagnosed in 12 referral hospitals from Lombardy and Veneto in March and April 2020 were retrospectively collected As a control population, GBS diagnosed in March and April 2019 in the same hospitals were considered RESULTS: Incidence of GBS in March and April 2020 was 0 202/100 000/month (estimated rate 2 43/100 000/year) vs 0 077/100 000/month (estimated rate 0 93/100 000/year) in the same months of 2019 with a 2 6-fold increase Estimated incidence of GBS in COVID-19-positive patients was 47 9/100 000 and in the COVID-19-positive hospitalised patients was 236/100 000 COVID-19-positive patients with GBS, when compared with COVID-19-negative subjects, showed lower MRC sum score (26 3±18 3 vs 41 4±14 8, p=0 006), higher frequency of demyelinating subtype (76 6% vs 35 3%, p=0 011), more frequent low blood pressure (50% vs 11 8%, p=0 017) and higher rate of admission to intensive care unit (66 6% vs 17 6%, p=0 002) CONCLUSIONS: This study shows an increased incidence of GBS during the COVID-19 outbreak in northern Italy, supporting a pathogenic link COVID-19-associated GBS is predominantly demyelinating and seems to be more severe than non-COVID-19 GBS, although it is likely that in some patients the systemic impairment due to COVID-19 might have contributed to the severity of the whole clinical picture