ABSTRACT
Abstract Introduction: We investigated the clinical course and outcomes of patients submitted to cardiovascular surgery in Brazil and who had developed symptoms/signs of coronavirus disease 2019 (COVID-19) in the perioperative period. Methods: A retrospective multicenter study including 104 patients who were allocated in three groups according to time of positive real time reverse transcriptase-polymerase chain reaction (RT-PCR) for the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2): group 1, patients who underwent cardiac surgery > 10 days after positive RT-PCR; group 2, patients with a positive RT-PCR within 10 days before or after surgery; group 3, patients who presented positive RT-PCR > 10 days after surgery. The primary outcome was mortality and secondary outcomes were postoperative complications, intensive care unit (ICU) length of stay, and postoperative days of hospitalization. Results: The three groups were similar with respect to age, the European System of Cardiac Operative Risk Evaluation score, and comorbidities, except hypertension. Postoperative complications and death were significantly higher in groups 2 and 3 than in group 1, and no significant difference between groups 2 and 3 was seen. Group 2 showed a high prevalence of surgery performed as an urgent procedure. Although no significant differences were observed in ICU length of stay, total postoperative hospitalization time was significantly higher in group 3 than in groups 1 and 2. Conclusion: COVID-19 affecting the postoperative period of patients who underwent cardiovascular surgery is associated with a higher rate of morbidity and mortality. Delaying procedures in RT-PCR-positive patients may help reduce risks of perioperative complications and death.
Subject(s)
Humans , COVID-19 , Brazil , Retrospective Studies , Perioperative Period , SARS-CoV-2Subject(s)
Humans , Coronavirus Infections , Myocardial Revascularization , Treatment Outcome , PandemicsABSTRACT
The aim of the present study is to evaluate the role of the blood glucose (BG) level in emotional learning in the elevated plus maze (EPM), an animal model of anxiety. In Experiment 1, male Wistar rats were submitted to different EPM trial lengths (1- or 5-min). Blood samples were withdrawn before and after the maze exploration, through a polyethylene cannula chronically implanted into the jugular vein. In Experiment 2, the animals received either saline or 2-deoxy-D-glucose, a glucoprivic drug (2-DG, 250 or 500 mg kg(-1)) by i.p. route, 30 min before a 5-min EPM exposure and were retested in the maze (Trial1/Trial2 EPM procedure) 24 h later. In an independent group of rats, blood samples were withdrawn 0, 5, 15, and 30 min after 2-DG administration, through the jugular vein, to determine BG. In Experiment 3, the animals underwent a vagotomy and were tested in a Trial1/Trial2 EPM procedure four weeks later. The results showed that rats exploring the EPM for 5 min displayed increased fear and higher hyperglycemia than those exploring the EPM for 1 min. In addition, rats submitted to 5-min EPM Trial1 length displayed higher level of fear on Trial2, as well as higher percentage of shortening of the %Open arm entries and %Open arm time from Trial1 to Trial2, which characterizes the occurrence of emotional learning. In contrast, rats previously vagotomized or treated with 2-DG (500 mg kg(-1)) showed the same level of fear on both EPM trials and a low percentage of shortening, from Trial1 to Trial2, of the %Open arm entries and %Open arm time, indicating poor emotional learning. The data is discussed regarding the role of glycaemia in emotional learning in the EPM.
