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Zeitschrift fur Geburtshilfe und Neonatologie ; 225(SUPPL 1):e37-e38, 2021.
Article in English | EMBASE | ID: covidwho-1735327

ABSTRACT

Background Critical illness during pregnancy puts mother and fetus at serious risks. Current literature regarding the effect of coronavirus 2 (SARS-CoV-2) describes an increased risk for maternal mortality as well as high rates of preterm delivery, however data vary and depend on the respective health care system. We aimed to describe maternal characteristics and clinical presentation of SARS-CoV-2 positive pregnant and postpartum women requiring intensive care treatment for COVID-19 in Germany, in order to explore risk factors for severe COVID-19 courses as well as to provide an overview on treatments applied. Methods COVID-19 Related Obstetric and Neonatal Outcome Study (CRONOS), an ongoing prospective multicenter registry for SARS-CoV-2 positive pregnant women from 150 centres in Germany was analyzed with respect to intensive care treatment for COVID-19. We extracted information for all women requiring intensive care treatment for COVID-19 and compared maternal characteristics, course of disease, as well as maternal and neonatal outcomes. Results Out of 2445 cases in CRONOS registry, 96 women (4%) had a documented intensive care unit (ICU) stay and were analyzed. While 75 (78%) women were pregnant when receiving ICU treatment, 21 (22%) were admitted post-delivery. Median maternal age was 33 (IQR, 30-36) years. COVID-19 was diagnosed at a median gestational age of 32 (IQR, 28-35) weeks. We observed the following interventions as highest form of treatment required for COVID-19: continuous monitoring of vital signs (n=6 (6%)), insufflation of oxygen (n=32 (33%)), non-invasive ventilation (n=17 (18%)), invasive ventilation (n=29 (30%)) and escalation to extracorporeal membrane oxygenation (ECMO, n=12 (13%)). Maternal characteristics such as maternal age, ethnicity, body mass index at admission, history of smoking, comorbidities and concomitant medication, as well as gestational age were analyzed. No significant differences between patients receiving different forms of respiratory therapy for COVID-19 could be identified. Preterm delivery was observed in 45 women (47%). Two women (2%) died of COVID-19 and four fetuses (4%) were stillborn. Conclusions Our cohort shows that progression of COVID-19 in pregnant and postpartum women requiring ICU treatment is rare. Preterm birth rate is high and COVID-19 requiring respiratory support is not necessarily related to poor maternal or neonatal outcome. But, as one in ten patients admitted to ICU might require ECMO therapy, all pregnant women suffering from COVID-19 should be closely monitored. In future studies, detail about obstetric women requiring intensive care treatment for COVID-19 should be further evaluated.

2.
Stroke ; 53(SUPPL 1), 2022.
Article in English | EMBASE | ID: covidwho-1724025

ABSTRACT

Background: Comprehensive Stroke Center nurses are required to receive 8 hours of stroke education annually;meeting this objective has been a challenge for administrators due to staffing shortages as well as the need to social distance during the COVID pandemic prompting virtual learning as a method to meet these standards. Web based courses often lack the multiplicity of diverse learning modalities needed for success. Purpose: Our objective was to provide a meaningful way to provide stroke education using the six perceptual modalities needed for adult learning which included visual, aural, printed, tactile, interactive, and kinesthetic learning. Methods: The stroke administrative team conducted a needs analysis based on nursing requests, outcome metrics, and requirements of the Joint Commission. A hybrid approach was delivered to the staff using four hours of classroom didactics, three hours of online classes, and one hour of education at hospital skills fairs, and unit meetings. Classrooms utilized social distancing, requiring multiple classes to be offered. Results: Nurses were surveyed with a 12 question Likert scale about how well they were prepared to integrate learned material into clinical practice comparing both virtual and live modalities. They were also asked about individual learning modalities. Twenty-five people responded to the survey. Only 12% of virtual learner respondents felt strongly prepared to care for stroke patients compared to 76% of classroom learners. Seventy-nine percent preferred classroom learning compared to 17% virtual, with a 4% hybrid preference. Learning preferences were multifactorial for visual, aural, printed, tactile, interactive, and kinesthetic learning being 95%, 48%, 56%, 40%, 11%, and 20% respectively. Conclusions: Virtual learning provides solutions in difficult situations, however classroom education is the preferred method of learning for healthcare professionals delivering evidenced based care for acute stroke patients. Planning committees should at least consider a hybrid approach that offer classroom time to caregivers.

3.
J Eur Acad Dermatol Venereol ; 35(5): e312-e314, 2021 May.
Article in English | MEDLINE | ID: covidwho-1494746
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