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2.
J Glob Health ; 10(2): 020507, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: covidwho-1154782

RESUMEN

Background: In a surgical setting, COVID-19 patients may trigger in-hospital outbreaks and have worse postoperative outcomes. Despite these risks, there have been no consistent statements on surgical guidelines regarding the perioperative screening or management of COVID-19 patients, and we do not have objective global data that describe the current conditions surrounding this issue. This study aimed to clarify the current global surgical practice including COVID-19 screening, preventive measures and in-hospital infection under the COVID-19 pandemic, and to clarify the international gaps on infection control policies among countries worldwide. Methods: During April 2-8, 2020, a cross-sectional online survey on surgical practice was distributed to surgeons worldwide through international surgical societies, social media and personal contacts. Main outcome and measures included preventive measures and screening policies of COVID-19 in surgical practice and centers' experiences of in-hospital COVID-19 infection. Data were analyzed by country's cumulative deaths number by April 8, 2020 (high risk, >5000; intermediate risk, 100-5000; low risk, <100). Results: A total of 936 centers in 71 countries responded to the survey (high risk, 330 centers; intermediate risk, 242 centers; low risk, 364 centers). In the majority (71.9%) of the centers, local guidelines recommended preoperative testing based on symptoms or suspicious radiologic findings. Universal testing for every surgical patient was recommended in only 18.4% of the centers. In-hospital COVID-19 infection was reported from 31.5% of the centers, with higher rates in higher risk countries (high risk, 53.6%; intermediate risk, 26.4%; low risk, 14.8%; P < 0.001). Of the 295 centers that experienced in-hospital COVID-19 infection, 122 (41.4%) failed to trace it and 58 (19.7%) reported the infection originating from asymptomatic patients/staff members. Higher risk countries adopted more preventive measures including universal testing, routine testing of hospital staff and use of dedicated personal protective equipment in operation theatres, but there were remarkable discrepancies across the countries. Conclusions: This large international survey captured the global surgical practice under the COVID-19 pandemic and highlighted the insufficient preoperative screening of COVID-19 in the current surgical practice. More intensive screening programs will be necessary particularly in severely affected countries/institutions. Study registration: Registered in ClinicalTrials.gov: NCT04344197.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Infección Hospitalaria/prevención & control , Control de Infecciones/estadística & datos numéricos , Tamizaje Masivo/estadística & datos numéricos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Pautas de la Práctica en Medicina/estadística & datos numéricos , Procedimientos Quirúrgicos Operativos/normas , Betacoronavirus , Infecciones por Coronavirus/transmisión , Infección Hospitalaria/virología , Estudios Transversales , Hospitales/normas , Hospitales/estadística & datos numéricos , Humanos , Control de Infecciones/normas , Tamizaje Masivo/normas , Neumonía Viral/transmisión , Políticas , Pautas de la Práctica en Medicina/normas , Procedimientos Quirúrgicos Operativos/efectos adversos , Encuestas y Cuestionarios
4.
Am J Infect Control ; 49(4): 484-488, 2021 04.
Artículo en Inglés | MEDLINE | ID: covidwho-1149015

RESUMEN

In China, the COVID-19 epidemic has had a definite turning point under the nationwide efforts to combat it. The battle against the epidemic has lasted for more than one and a half months and will continue in the short term. Severe infectious risks, massive consumption of medical personnel and materials bring unprecedented challenges to the treatment of non-COVID-19 with emergency and severe cases. To improve the management of emergency and severe cases of non-COVID-19 during the epidemic period, attention should be paid not only to "cure" but also to "prevent." Through the prehospital triage and in-hospital buffer, this paper provides the admission and treatment experience for emergency and severe cases of non-COVID-19, expecting to provide a valuable reference for saving more patients during the outbreak of COVID-19.


Asunto(s)
/terapia , Infección Hospitalaria/prevención & control , Servicios Médicos de Urgencia/métodos , Servicios Médicos de Urgencia/normas , Servicio de Urgencia en Hospital/organización & administración , Humanos , Triaje/métodos
5.
BMC Pregnancy Childbirth ; 21(1): 212, 2021 Mar 17.
Artículo en Inglés | MEDLINE | ID: covidwho-1140481

RESUMEN

BACKGROUND: Asymptomatic carriage of COVID-19 in pregnant women has been reported and could lead to outbreaks in maternity units. We sought to ascertain the impact of rapid isothernal nucleic acid based testing for COVID-19 in an unselected cohort of pregnant women attending our maternity unit. We also assessed the correlation between community prevalence and asymptomatic carriage. METHODS: Data for the retrospective cohort study were collected from a large UK tertiary maternity unit over a 4-week period using computerised hospital records. Literature searches were performed across multiple repositories. COVID-19 prevalence was extracted from online repositories. RESULTS: Nasopharyngeal and oropharyngeal swabs were obtained from 457/465 (98%) women during the study period. The median turnaround time for results was 5.3 h (interquartile range (IQR) 2.6-8.9 h), with 92% of the results returned within 24 h. In our cohort, only one woman tested positive, giving a screen positive rate of 0.22% (1/457; 95% CI: 0.04-1.23%). One woman who tested negative developed a fever postnatally following discharge but was lost to follow-up. From our literature review, we did not find any correlation between asymptomatic carriage in pregnant women and the reported regional prevalence of COVID-19. CONCLUSIONS: Testing using the SAMBA-II machine was acceptable to the vast majority of pregnant women requiring admission and had a low turnaround time. Asymptomatic carriage is low, but not correlated to community prevalence rates. Screening pregnant women on admission will remain an important component in order to minimise nosocomial infection.


Asunto(s)
/métodos , Portador Sano/diagnóstico , Infección Hospitalaria/prevención & control , Complicaciones Infecciosas del Embarazo/diagnóstico , /epidemiología , Portador Sano/epidemiología , Estudios de Cohortes , Femenino , Maternidades , Humanos , Tamizaje Masivo , Pruebas en el Punto de Atención , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Estudios Retrospectivos , Factores de Tiempo , Reino Unido/epidemiología
6.
Int J Qual Health Care ; 33(Supplement_1): 51-55, 2021 Jan 12.
Artículo en Inglés | MEDLINE | ID: covidwho-1139994

RESUMEN

BACKGROUND: In response to the coronavirus disease of 2019 (COVID-19) pandemic, healthcare systems worldwide have stepped up their infection prevention and control efforts in order to reduce the spread of the infection. Behaviours, such as hand hygiene, screening and cohorting of patients, and the appropriate use of antibiotics have long been recommended in surgery, but their implementation has often been patchy. METHODS: The current crisis presents an opportunity to learn about how to improve infection prevention and control and surveillance (IPCS) behaviours. The improvements made were mainly informal, quick and stemming from the frontline rather than originating from formal organizational structures. The adaptations made and the expertise acquired have the potential for triggering deeper learning and to create enduring improvements in the routine identification and management of infections relating to surgery. RESULTS: This paper aims to illustrate how adopting a human factors and ergonomics perspective can provide insights into how clinical work systems have been adapted and reconfigured in order to keep patients and staff safe. CONCLUSION: For achieving sustainable change in IPCS practices in surgery during COVID-19 and beyond we need to enhance organizational learning potentials.


Asunto(s)
Control de Infecciones/métodos , Procedimientos Quirúrgicos Operativos/normas , Antibacterianos/uso terapéutico , Infección Hospitalaria/prevención & control , Monitoreo Epidemiológico , Ergonomía/métodos , Higiene de las Manos , Humanos , Control de Infecciones/normas
8.
Medicine (Baltimore) ; 100(5): e24503, 2021 Feb 05.
Artículo en Inglés | MEDLINE | ID: covidwho-1125447

RESUMEN

ABSTRACT: Recently, the coronavirus disease 2019 (COVID-19) epidemic has greatly threatened global public health. The responsibility of healthcare-associated infection control professionals (ICPs) is to prevent and control the nosocomial infections. The mental health status of ICPs deserves more attention, however, the correlational research is still lacking. This study aims to investigate the incidence and risk factors of mental health status among ICPs in China during the outbreak of COVID-19.A national cross-sectional survey was performed. The online questionnaire was completed by 9228 ICPs from 3776 hospitals throughout China. Data collection tools were used, including demographics data questionnaire, the Chinese version of the 12-item general health questionnaire (GHQ-12) and the Chinese version of the psychological capital questionnaire (PCQ) for medical staff. Univariate and multivariable analyses were conducted.The total score of mental health of Chinese ICPs was 3.45 ±â€Š2.57. 5608 (60.77%) ICPs might have mental health problems. The psychological capital was in the upper-middle level with an average score of 3.72 ±â€Š0.38. An increased mental health problem risk was associated with the greater self-efficacy and working in the public hospital; a significantly lower risk was obtained by working in the second-class hospital rather than in the third-class hospitals. Besides, mental health problem risk of ICPs working in hospitals of the western economic region or northeast economic region was more significant than that in hospitals of the central economic region. However, a lower risk was caused by the unmarried than married, and working years in department ≤1 year contributed to the lower risk than that >20 years. Moreover, fewer working hours per week, higher values of hope, and optimism each were contributed to a lower risk.Chinese healthcare-associated ICPs were under different levels of mental health problems in fighting against COVID-19. More importantly, we should actively deal with the mental health problem of ICPs and help them get rid of psychological disorders.


Asunto(s)
Infección Hospitalaria , Profesionales para Control de Infecciones , Control de Infecciones , Exposición Profesional , Estrés Laboral , Adulto , /prevención & control , China/epidemiología , Infección Hospitalaria/epidemiología , Infección Hospitalaria/prevención & control , Estudios Transversales , Femenino , Humanos , Control de Infecciones/métodos , Control de Infecciones/organización & administración , Profesionales para Control de Infecciones/psicología , Profesionales para Control de Infecciones/estadística & datos numéricos , Masculino , Salud Mental/estadística & datos numéricos , Exposición Profesional/prevención & control , Exposición Profesional/estadística & datos numéricos , Estrés Laboral/epidemiología , Estrés Laboral/etiología , Estrés Laboral/prevención & control , Medición de Riesgo , Encuestas y Cuestionarios
9.
PLoS One ; 16(3): e0248282, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-1124945

RESUMEN

Compliance with infection prevention and control (IPC) protocols is critical in minimizing the risk of coronavirus disease (COVID-19) infection among healthcare workers. However, data on IPC compliance among healthcare workers in COVID-19 treatment centers are unknown in Ghana. This study aims to assess IPC compliance among healthcare workers in Ghana's COVID-19 treatment centers. The study was a secondary analysis of data, which was initially collected to determine the level of risk of COVID-19 virus infection among healthcare workers in Ghana. Quantitative data were conveniently collected using the WHO COVID-19 risk assessment tool. We analyzed the data using descriptive statistics and logistic regression analyses. We observed that IPC compliance during healthcare interactions was 88.4% for hand hygiene and 90.6% for Personal Protective Equipment (PPE) usage; IPC compliance while performing aerosol-generating procedures (AGPs), was 97.5% for hand hygiene and 97.5% for PPE usage. For hand hygiene during healthcare interactions, lower compliance was seen among nonclinical staff [OR (odds ratio): 0.43; 95% CI (Confidence interval): 0.21-0.89], and healthcare workers with secondary level qualification (OR: 0.24; 95% CI: 0.08-0.71). Midwives (OR: 0.29; 95% CI: 0.09-0.93) and Pharmacists (OR: 0.15; 95% CI: 0.02-0.92) compliance with hand hygiene was significantly lower than registered nurses. For PPE usage during healthcare interactions, lower compliance was seen among healthcare workers who were separated/divorced/widowed (OR: 0.08; 95% CI: 0.01-0.43), those with secondary level qualifications (OR 0.08; 95% CI 0.01-0.43), non-clinical staff (OR 0.16 95% CI 0.07-0.35), cleaners (OR: 0.16; 95% CI: 0.05-0.52), pharmacists (OR: 0.07; 95% CI: 0.01-0.49) and among healthcare workers who reported of insufficiency of PPEs (OR: 0.33; 95% CI: 0.14-0.77). Generally, healthcare workers' infection prevention and control compliance were high, but this compliance differs across the different groups of health professionals in the treatment centers. Ensuring an adequate supply of IPC logistics coupled with behavior change interventions and paying particular attention to nonclinical staff is critical in minimizing the risk of COVID-19 transmission in the treatment centers.


Asunto(s)
/psicología , Adhesión a Directriz/tendencias , Personal de Salud/psicología , Adulto , Infecciones por Coronavirus/prevención & control , Infección Hospitalaria/prevención & control , Estudios Transversales , Femenino , Ghana/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Humanos , Control de Infecciones/métodos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Conocimiento , Masculino , Pandemias/prevención & control , Equipo de Protección Personal/tendencias , Encuestas y Cuestionarios , Virosis/transmisión
12.
CMAJ Open ; 9(1): E149-E156, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-1115549

RESUMEN

BACKGROUND: Information on the epidemiology of patients in hospital with laboratory-confirmed coronavirus disease 2019 (COVID-19) in Canadian acute care hospitals is needed to inform infection prevention and control strategies and public health measures. The aim of this surveillance was to describe the epidemiology of patients in hospital with laboratory-confirmed COVID-19 in a network of Canadian acute care hospitals between Mar. 1 and Aug. 31, 2020. METHODS: Through prospective surveillance, we identified adult and pediatric patients in hospital with laboratory-confirmed COVID-19 using a standard definition between Mar. 1 and Aug. 31, 2020, through the Canadian Nosocomial Infection Surveillance Program (CNISP), a network of 78 hospitals. Patient demographic and clinical characteristics and data on treatment, interventions and outcomes were reviewed and described. RESULTS: As of Aug. 31, 2020, the CNISP had received data for 1906 patients in hospital with COVID-19 in 49 sentinel hospitals in 9 provinces. The majority of patients in hospital with COVID-19 were older (median age 71 yr) and had underlying medical conditions (85.8%). Few children with COVID-19 were admitted to a participating hospital (n = 37, 1.9%). Acquisition of COVID-19 in hospitals was infrequent (6.4% of all cases). A total of 32.8% of patients were admitted from a long-term care facility or retirement home. Health care workers constituted 10.6% of adult patients aged 18-65 years in hospital with COVID-19. Thirty-day attributable mortality was 16.2%. Hospital admission rates peaked in mid-April and were highest in Ontario and Quebec. INTERPRETATION: Surveillance findings indicate that a high proportion of Canadian patients in hospital with COVID-19 during the first 6 months of the pandemic were older adults with underlying medical conditions. Active surveillance of patients in hospital with COVID-19 is critical to enhancing our knowledge of the epidemiology of COVID-19 and to identifying populations at risk for severe outcomes, which will help guide Canada's response in the coming months.


Asunto(s)
/diagnóstico , Servicio Ambulatorio en Hospital/estadística & datos numéricos , /genética , Adulto , Anciano , Anciano de 80 o más Años , /mortalidad , Niño , Preescolar , Infección Hospitalaria/epidemiología , Infección Hospitalaria/prevención & control , Monitoreo Epidemiológico , Femenino , Personal de Salud/estadística & datos numéricos , Hospitalización/estadística & datos numéricos , Humanos , Lactante , Masculino , Persona de Mediana Edad , Mortalidad/tendencias , Ontario/epidemiología , Estudios Prospectivos , Quebec/epidemiología
14.
Indian J Ophthalmol ; 69(3): 510-516, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: covidwho-1089029

RESUMEN

The instrumentation used in ophthalmic clinics can be a source of epidemics in health care set up. Contact tonometry with Schiotz or Applanation tonometer is associated with nosocomial epidemic keratoconjunctivitis outbreaks. Recently identified SARS-CoV-2 (COVID -19) spreads mainly via the respiratory route and fomites and can transmit through other body fluids, including tear film. Various ophthalmic instruments can become a common source of spreading cross infections. Chemical disinfection is one of the most common methods employed to decontaminate instruments and environmental surfaces and prevent transmission of infectious pathogens to patients through medical and surgical instruments. Various chemical disinfectants are available with a varied spectrum to work on a different group of organisms. In this article, we briefly cover commonly used chemical disinfectants in ophthalmic practice like Alcohol (Ethyl Alcohol, Isopropyl Alcohol), Chlorine-based solution (mainly Sodium Hypochlorite), Glutaraldehyde, Hydrogen Peroxide, Formaldehyde, Iodophors, and Quaternary Ammonium Compounds.


Asunto(s)
/epidemiología , Infección Hospitalaria/prevención & control , Transmisión de Enfermedad Infecciosa/prevención & control , Desinfectantes/farmacología , Desinfección/métodos , Oftalmología , Pandemias , Humanos
15.
Afr J Paediatr Surg ; 18(1): 24-27, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-1089021

RESUMEN

Background: The novel coronavirus and the disease it causes COVID-19, like other viral outbreaks, have an unpredictable timeline. Therefore, a triumph in the battle against COVID-19 could only be achieved if a health care system's capacity to support a potentially overwhelming increase in critical patient care needs is maintained, and the viral curve is flattened. Accordingly, health care bodies around the globe called upon prioritising appropriate resource allocation as it relates to elective invasive procedures and minimising the use of essential items required to care for patients. The unpredictability COVID-19 timeline in the absence of effective drug treatments and vaccination along with the restrictive health care policies implemented suggest that patients may be deprived of access to needed surgical care, likely for many months. However, the potential undue delay in delivering essential elective surgical care may have a more detrimental impact on patients' health compared to that of COVID-19 itself. This particularly applies to the paediatric population in which infection rates have been demonstrated to be considerably lower and mortalities have not been reported yet. Therefore, the need emerges for actions to be taken that allow for the resumption of essential elective surgical procedures in this population of patients. Materials and Methods: A comprehensive search through surgical guidance and recommendations to develop a set of evidence based recommendations that allow for the safe and timely delivery of essential paediatric surgical care during the time of COVID-19. Conclusion: No compelling evidence that the paediatric population is at an increased risk of morbidity or mortality exists. Therefore, delaying essential paediatric surgical care cannot be justified as it may have a potentially negative health impact, and continuous refinements of surgical recommendations are encouraged in view of evolving circumstances.


Asunto(s)
/prevención & control , Procedimientos Quirúrgicos Electivos , /epidemiología , Niño , Infección Hospitalaria/prevención & control , Humanos , Control de Infecciones , Tamizaje Masivo , Pandemias , Equipo de Protección Personal , Asignación de Recursos , Triaje
16.
J Wound Care ; 30(Sup2): S12-S17, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: covidwho-1083226

RESUMEN

COVID-19 is highly contagious and its rapid spread burdens the healthcare system. As the number of confirmed cases goes up, the shortage of medical resources has become a challenge. To avoid the collapse of the healthcare system during the fight with COVID-19, all healthcare workers, including wound care practitioners, should adapt to new roles and use any appropriate methods available to slow the spread of the virus. Integrating telemedicine into wound care during the outbreak helps maintain social distancing, preserve personal protective equipment and medical resources, and eliminate unnecessary exposure for both vulnerable patients and high-risk healthcare workers.


Asunto(s)
Atención Ambulatoria , Pie Diabético/terapia , Telemedicina , Triaje , Heridas y Traumatismos/terapia , Infección Hospitalaria/prevención & control , Procedimientos Quirúrgicos Electivos , Hospitalización , Humanos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control
18.
J Infect Dev Ctries ; 15(1): 58-68, 2021 Jan 31.
Artículo en Inglés | MEDLINE | ID: covidwho-1079734

RESUMEN

INTRODUCTION: SARS-CoV2 pandemic marks the need to pay attention to bacterial pathogens that can complicate the hospital stay of patients in the intensive care unit (ICU). ESKAPE bacteria which includes Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter cloacae are considered the most important, because of their close relationship with the development of ventilator-associated pneumonia (VAP). The aim of this work was to identify and characterize ESKAPE bacteria and to detect their possible clonal spread in medical devices, patients, and medical personnel of the ICU for COVID-19 patients of the Hospital Juarez de Mexico. METHODOLOGY: Genetic identification of ESKAPE bacteria was performed by analyzing the 16S rRNA gene. Resistance assays were performed according to the CLSI guidelines. Assembly of AdeABCRS operon and inhibition assays of pumps efflux in Acinetobacter baumannii isolates were performed. Associated gene involved in biofilm formation (icaA) was performed in isolates belonging to the Staphylococcus genus. Finally, typing by ERIC-PCR and characterization of mobile genetic element SCCmec were done. RESULTS: Heterogeneous distribution of ESKAPE and non-ESKAPE bacteria was detected in various medical devices, patients, and medical personnel. Acinetobacter baumannii and Staphylococcus aureus were the predominant ESKAPE members. The analysis of intergenic regions revealed an important clonal distribution of A. baumannii (AdeABCRS+). Genotyping of SCCmec mobile genetic elements and the icaA gene showed that there is no clonal distribution of S. aureus. CONCLUSIONS: Clonal spread of A. baumannii (AdeABCRS+) highlights the importance of adopting good practices for equipment disinfection, surfaces and management of COVID-19 patients.


Asunto(s)
Infecciones por Acinetobacter/transmisión , Acinetobacter baumannii/aislamiento & purificación , Infección Hospitalaria/prevención & control , Unidades de Cuidados Intensivos , Acinetobacter baumannii/patogenicidad , Antibacterianos/farmacología , Biopelículas/crecimiento & desarrollo , Infección Hospitalaria/microbiología , Farmacorresistencia Bacteriana/genética , Equipos y Suministros/microbiología , Genotipo , Humanos , Secuencias Repetitivas Esparcidas , México , Neumonía Asociada al Ventilador/microbiología
19.
Heart Surg Forum ; 24(1): E022-E030, 2021 01 15.
Artículo en Inglés | MEDLINE | ID: covidwho-1079392

RESUMEN

BACKGROUND: Prioritization among patients with coronary artery disease represents a difficult issue during the SARS-CoV-2 pandemic. We present our clinical practices and patients' outcomes after elective, emergent, and urgent cardiovascular surgery and percutaneous coronary interventions (PCI). We also investigated the rate of nosocomial infection of SARS-CoV-2 in health workers (HWs), including surgeons after cardiovascular procedures and percutaneous interventions (PCI). MATERIAL AND METHODS: We performed 186 cardiovascular operations and PCI between March 15 and October 15. According to the level of priority (LoP), we performed urgent and emergent coronary artery bypass grafting (CABG) and cardiac valve repair or replacement surgery in 44 patients. In one patient with acute chordae rupture with pulmonary edema, we performed mitral valve replacement. We performed the aortic arch repair in two patients with type-I aortic dissection in urgent situations. Therefore, in 47 patients we performed cardiac operations in urgent or emergent situations. Elective CABG (N = 28) and elective cardiac valve (N = 10) surgeries were performed (total: 38). While rescue PCI was urgently performed in 47 patients with ST-segment elevation myocardial infarction (STEMI), it was performed in elective or emergent situations in 40 patients with myocardial ischemia. Endovascular treatment was performed in four patients with deep venous thrombosis (DVT) and in four patients with chronic arterial occlusion, respectively. Surgical vascular repair and embolectomy were performed in patients with peripheral artery injury (N = 6) and acute arterial embolic events (N = 4), respectively. We performed thoracic computed tomography followed by reverse transcriptase-polymerase chain reaction (RT-PCR) test in patients with irregular diffuse reticular opacities with or without consolidation on chest X-ray. Blood coagulation disorders including d-dimer, thromboplastin time (TT), and partial thromboplastin time (aPTT) were measured prior to procedures. RESULTS: No mortality and morbidity was seen after percutaneous and surgical arterial or venous procedures. The total mortality rate was 4.1% (8 of 186 CAD patients or valve surgery) after urgent and emergent CABG (N = 4), an urgent valve replacement (N = 1), and PCI (N = 3). Low cardiac output syndrome (LOS) and major adverse cardiac cerebrovascular event (MACCE) were the mortality factors after cardiac surgery. The reasons for death after PCI were sudden cardiac arrest related to the dissection of the left main coronary artery during procedure and pneumonia due to COVID-19 (N = 2). Ground-glass opacities in combination with pulmonary consolidations were detected in seven patients. Interlobular septal and pleural thickening with patchy bronchiectasis in the bilateral lower lobe involvement was found after thoracic computed tomography in these patients. We confirmed in-hospital COVID-19 using a PCR test in two patients with STEMI prior to PCI. PT and aPTT increased, but fibrin degradation products did not in those two patients. We confirmed COVID-19 via phone call in six CABG patients and one PCI patient after discharge from the hospital. None of the patients diagnosed with COVID-19 died after being discharged from the hospital. CONCLUSION: Cardiovascular surgery and PCI can safely be performed with acceptable complications and mortality rates in elective situations, during the COVID-19 pandemic. Preoperative control of OR traffic, careful evaluation of the patient's history, consultation, and precautions taken by healthcare professionals are important, during and after procedures. Also important is wearing a mask and face shield and careful disinfection of equipment and space.


Asunto(s)
/transmisión , Procedimientos Quirúrgicos Cardiovasculares , Infección Hospitalaria/transmisión , Procedimientos Quirúrgicos Electivos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/estadística & datos numéricos , Pandemias , Intervención Coronaria Percutánea , Adulto , Anciano , Anciano de 80 o más Años , /prevención & control , Procedimientos Quirúrgicos Cardiovasculares/efectos adversos , Infección Hospitalaria/prevención & control , Humanos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Masculino , Persona de Mediana Edad , Intervención Coronaria Percutánea/efectos adversos , Complicaciones Posoperatorias , Medición de Riesgo
20.
Cir Cir ; 89(1): 4-11, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-1077009

RESUMEN

Background: The coronavirus disease 2019 (COVID-19) outbreak have major implications in conventional surgical practice. As the number of patients with this diagnosis is rising, the infection risk for the surgical staff will be higher. Few publications have addressed the surgical management of patients diagnosed with COVID-19. Objective: To assess recommendations for care of patients and surgical team during the COVID-19 pandemic. Method: MEDLINE, Embase and the Cochrane Database of Systematic Reviews (April 2020) were searched the key words "COVID-19", "PROTOCOL" and "SURGERY". Relevant recommendations, guidelines and cases series were checked for the most accurate information for apply to our center. Results: We found 379 papers that included the key words. A total of 25 papers were included in the manuscript based in the pertinence of the recommendations. Three major topics were selected: perioperative, intraoperative and postoperative. Conclusion: As an attempt to regulate the surgical team approach, we present recommendations to preserve patients and surgical staff safety with high quality standards of care through reproducible strategies applicable in most hospital centers.


Asunto(s)
/prevención & control , Infección Hospitalaria/prevención & control , Control de Infecciones/métodos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Transmisión de Enfermedad Infecciosa de Profesional a Paciente/prevención & control , Pandemias , Aerosoles , Contaminación del Aire Interior , Citas y Horarios , Desinfección/métodos , Contaminación de Equipos/prevención & control , Humanos , México , Exposición Profesional , Quirófanos , Aislamiento de Pacientes , Atención Perioperativa , Equipo de Protección Personal , Personal de Hospital , Sala de Recuperación , Esterilización/métodos , Equipo Quirúrgico
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