Strategies to meet blood demand for transfusions during the COVID-19 pandemic: lessons learnt from a large central hospital in Malawi

Background: The coronavirus disease-19 (COVID-19) pandemic affected blood banks globally. We sought to examine how COVID-19 affected blood supply and transfusion in our institution. Method(s): The study was conducted at the Queen Elizabeth Central Hospital (QECH) and the Malawi Blood Transfusion Service (MBTS) in Malawi. Data from April to November 2020, collected during the pandemic, were compared with data from the same time period in 2019 pre-COVID-19. Additionally, in-depth interviews with key personnel were conducted at both institutions. Statistical analysis was performed using Stata 15 and qualitative data were analyzed using Nvivo software. Result(s): There was a significant reduction in blood supplied to the QECH from 7,303 [2019] to 6,028 units [2020] (P<0.04). The highest reduction in blood supply was to the Adult Emergency & Trauma department (29%) while the lowest was in Obstetrics & Gynecology, and Pediatric departments (17% reduction each). This is despite that the transfusion services continued to conduct blood drives during the pandemic, and the hospital laboratory prioritized blood issuing for emergency indications. Conclusion(s): Blood supply has significantly reduced during COVID-19 pandemic in our centers. Developing plans for overcoming similar shortages in future pandemics is critical.Copyright © Annals of Blood. All rights reserved.

Mental status in patients with cerebral infarction in central China at the early stage of coronavirus disease-19 pandemic

Aims: The study aimed to analyze the changes in mental health and social support in patients with cerebral infarction during the recovery period at the early stage of coronavirus disease pandemic. Subjects and Methods: During January-March 2020, 98 patients with cerebral infarction during the recovery period were selected from Wuhan city. Among them, 42 patients were living alone (called the solitary group) and 56 patients lived with their spouses (called the spouse group). The Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) were used to evaluate anxiety and depression, respectively, and Multi-Dimensional Scale of Perceived Social Support (MSPSS), social support for patients. Statistical Analysis Used: The statistical calculations were carried out using GraphPad Prism 5.01 software (GraphPad, San Diego, California, USA). Results: At the early stage of the pandemic, patients with cerebral infarction in the solitary group and the spouse group experienced varying degrees of anxiety and depression. The SAS and SDS scores in the solitary group were significantly higher than those in the spouse group (P < 0.01). The subscale scores of MSPSS in the solitary group were lower than those in the spouse group (P < 0.01). Conclusions: It is necessary for medical staff to help the patients to overcome anxiety and depression and provide more social support to patients, especially for those patients living alone. © 2022 Heart and Mind ;Published by Wolters Kluwer - Medknow.

Impact of the coronavirus disease-19 pandemic on electrophysiological procedures at a national referral center.

INTRODUCTION: The coronavirus disease (COVID-19) pandemic has generated serious repercussions on the health system, reducing the number of all cardiology procedures worldwide. OBJECTIVES: Describe the impact of the COVID-19 pandemic on the procedures performed by the electrophysiology department in a national referral center. METHODS: We made a retrospective review of our data base and we compared procedures made in the past 3 years since 2017-2019 with the procedures made in the 2020. We divided the procedures into two large groups: Cardiac Implantable Electronic Devices (CIED) related procedures and electrophysiological procedures (EP) which included conventional and complex ablations. RESULTS: There was a significant reduction in all the procedures, the average of procedures performed in the last 3 previous years was 467, while in 2020, we performed only 319 (p = 0.01); this represents a reduction of 33.4% in the total number of procedures. There was no statistical difference regarding the CIED related procedures, the average of procedures in the past 3 previous years was 174, and in 2020 we performed 190 procedures (p = 0.46). Regarding the EP, the average of the past 3 previous years was 293, while in 2020, we performed only 129 procedures (p < 0.01). The reduction in the EP was 55.97%. The most affected months were April, May, and June. CONCLUSIONS: The COVID-19 pandemic considerably affected the number of the procedures in our center, reducing it by 33.4%. The reduction of procedures fundamentally affected the ablations, with a reduction of 55.97%. The number of CIED related procedures was not affected.

How correct is the postponed cholecystectomy during the coronavirus disease-19 pandemic process? Gallstone ileus is not a myth anymore.

Posponer cirugías electivas durante el proceso pandémico de Covid-19 aumentó el riesgo de complicaciones graves de enfermedades benignas. El íleo biliar es una de las raras complicaciones de la colelitiasis (0,3-0,5%). Los episodios recurrentes de colecistitis aguda están involucrados en la fisiopatología. La demostración de la tríada de Rigler en tomografía computarizada es diagnóstica. Para reducir la morbilidad se recomienda la cirugía dos etapas: extirpar el cálculo por enterotomía en la primera operación, cirugía biliar en la segunda operación. El íleo biliar debe estar en el diagnóstico diferencial de las obstrucciones intestinales mecánicas, especialmente en pacientes con antecedentes de ataques de colecistitis durante el proceso pandémico de Covid-19 porque las cirugías electivas se detuvieron.Postponing elective surgeries during the coronavirus disease-19 (COVID-19) pandemic process increased the risk of severe complications of benign diseases. Gallstone ileus is one of the rare complications of cholelithiasis (0.3-0.5%). Recurrent episodes of acute cholecystitis are involved in pathophysiology. Demonstration of Rigler's triad on computed tomography is diagnostic. To reduce morbidity stepped surgery is recommended: remove the stone by enterotomy at the first operation and biliary surgery at the second operation. Gallstone ileus should be in the differential diagnosis of mechanical intestinal obstructions, especially in patients with a history of cholecystitis attacks during the COVID-19 pandemic process because elective surgeries stopped.