Characteristics and Effectiveness of the Coronavirus Disease 2019 (COVID-19) Prevention and Control in a Representative City in China.

BACKGROUND SARS-CoV-2 has caused a pandemic. Control measures differ among countries. It is necessary to assess the effectiveness of these control measures. MATERIAL AND METHODS We collected the data of COVID-19 patients and control measures between January 18, 2020 and September 18, 2020 from the Changshou District and analyzed the clinical characteristics, epidemiological data, and the adjustment of policies to assess the effectiveness of control measures. The control of COVID-19 was divided into 2 stages, with the lifting of lockdown in Hubei province (March 25, 2020) as a dividing line. RESULTS We identified 32 patients through different means in the first stage. All the imported patients entered this area before the lockdown. In 93.1% of patients, the last exposure occurred before the implementation of the stay-at-home order and centralized isolation. Tracing of high-risk people and RT-PCR screening identified 56.3% of cases. In the second stage, all the high-risk people were under centralized isolation. Nine asymptomatic patients were identified. City lockdown and stay-at-home orders were not issued again, and no second-generation patients were found. CONCLUSIONS We have provided a successful model to control the transmission of COVID-19 in a short period.

Early prediction of noninvasive ventilation failure in COPD patients: derivation, internal validation, and external validation of a simple risk score.

BACKGROUND: Early identification of noninvasive ventilation (NIV) failure is a promising strategy for reducing mortality in chronic obstructive pulmonary disease (COPD) patients. However, a risk-scoring system is lacking. METHODS: To develop a scale to predict NIV failure, 500 COPD patients were enrolled in a derivation cohort. Heart rate, acidosis (assessed by pH), consciousness (assessed by Glasgow coma score), oxygenation, and respiratory rate (HACOR) were entered into the scoring system. Another two groups of 323 and 395 patients were enrolled to internally and externally validate the scale, respectively. NIV failure was defined as intubation or death during NIV. RESULTS: Using HACOR score collected at 1-2 h of NIV to predict NIV failure, the area under the receiver operating characteristic curves (AUC) was 0.90, 0.89, and 0.71 for the derivation, internal-validation, and external-validation cohorts, respectively. For the prediction of early NIV failure in these three cohorts, the AUC was 0.91, 0.96, and 0.83, respectively. In all patients with HACOR score > 5, the NIV failure rate was 50.2%. In these patients, early intubation (< 48 h) was associated with decreased hospital mortality (unadjusted odds ratio = 0.15, 95% confidence interval 0.05-0.39, p < 0.01). CONCLUSIONS: HACOR scores exhibited good predictive power for NIV failure in COPD patients, particularly for the prediction of early NIV failure (< 48 h). In high-risk patients, early intubation was associated with decreased hospital mortality.

Efficacy and safety of ondansetron in preventing postanesthesia shivering: a meta-analysis of randomized controlled trials.

BACKGROUND: Shivering is a very common complication in the postanesthesia period. Increasing studies have reported ondansetron may be effective in prevention of postanesthesia shivering (PAS). However, the results remained controversial; hence we conducted a meta-analysis of randomized controlled trials to evaluate the efficacy and safety of ondansetron on the prevention of postanesthesia shivering. METHODS: PubMed and Embase databases were searched to identify the eligible randomized controlled trials assessing the effect of ondansetron on the prevention of PAS. Results were expressed as risk ratios (RRs) with accompanying 95% confidence intervals (CIs). The meta-analysis was performed with fixed-effect model or random-effect model according to the heterogeneity. RESULTS: Six trials including 533 subjects were included. Compared with placebo, ondansetron was associated with a significant reduction of PAS (RR 0.43, 95% CI, 0.27-0.70), without an increased risk of bradycardia (RR 0.37, 95% CI, 0.12-1.15). Compared with meperidine, no difference was observed in the incidence of PAS (RR 0.68, 95% CI, 0.39-1.19) and bradycardia (RR 2.0, 95% CI, 0.38-10.64). CONCLUSIONS: Ondansetron has a preventive effect on PAS without a paralleled side effect of bradycardia.