ABSTRACT
BackgroundThe novel coronavirus (SARS-CoV-2) has infected a large number of healthcare workers in Hubei province, China. In addition to infectious and respiratory disease physicians, many doctors in other medical fields have been infected. MethodsWe prospectively collected epidemiological data on medical staff members who are working in neurosurgery departments in 107 hospitals in Hubei province through self-reported questionnaires or telephone interviews. Data of medical staff members with laboratory-confirmed coronavirus disease 2019 (COVID-19) were analysed. The final follow-up date was 1 March 2020. FindingsA total of 5,442 neurosurgery department medical staff members were surveyed. One hundred and twenty cases, involving 54 doctors and 66 nurses, were found to have been infected with SARS-CoV-2. The overall incidence was 2.2%. These cases were concentrated in 26 centres, 16 of which had admitted a total of 59 patients with COVID-19 complicated by craniocerebral disease. Medical staff members in centres receiving COVID-19 patients had a higher risk of contracting infection than those in centres not receiving COVID-19 patients (relative risk: 19.6; 95% confidence interval: 12.6-30.6). Contact with either COVID-19 patients (62.5%, 75/120) or infected colleagues (30.8%, 37/120) was the most common mode of transmission. About 78.3% (94/120) of the infected cases wore surgical masks, whereas 20.8% (25/120) failed to use protection when exposed to the source of infection. Severe infections were observed in 11.7% (14/120) of the cases, with one death (0.8%, 1/120). All the infected medical staff members had been discharged from the hospital. A total of 1,287 medical staff members were dispatched to participate in the frontline response to COVID-19 under level 2 protection of whom one was infected. Medical staff members who took inadequate protection had a higher risk of contracting infection than those using level 2 protection (relative risk: 36.9; 95% confidence interval: 5.2-263.6). ConclusionsNeurosurgical staff members in Hubei province were seriously affected by COVID-19. Level 2 protection and strengthening of protective measures are likely to be effective in preventing medical workers from being infected.
ABSTRACT
ObjectiveThe mean hospitalization time and outcome among patients with coronavirus disease 2019 (COVID-19) was estimated with the purpose of providing evidence for decision-making in medical institutions and governments in epidemic areas. MethodThe data of COVID-19 patients in china were collected from the websites of provincial and municipal health commissions. The mean hospitalization time and mortality in the mild or severe patients and the mean time from severe to mild illness were calculated by Gaussian mixture modeling. ResultsThe mean hospitalization time among mild patients in Hubei province, other areas except Hubei province, and the national areas was 20.71{+/-} 9.30, 16.86 {+/-} 8.24, and 19.34 {+/-} 9.29 days, respectively. The mean transition time from severe to mild group in the above three areas were 15.00, 17.00, and 14.99 days, respectively. The death rate of mild and severe patients in Hubei province and the national areas were 1.10% and 18.14%, and 1.10% and 17.70%, respectively. Among those patients who died of COVID-19, the mean time from severe transition to death in Hubei province and the national areas was 6.22 {+/-} 5.12 and 6.35 {+/-} 5.27 days, respectively. ConclusionThere were regional differences in the average length of stay between Hubei province and other regions, which may be related to different medical configurations. For those severe patients who died of COVID-19, the average time from hospitalization to death was about one week, and proper and effective treatments in the first week were critical.
ABSTRACT
Objective:To analyze the related risk factors for vertebral artery tortuosity, and explore the mechanism of vertebral artery tortuosity.Methods:Two hundred and eighty-two patients accepted head/neck and MR angiography in our hospital from October 2016 to October 2017 were selected. The tortuosity degrees of vertebral artery were measured and calculated by PACS system. The differences of tortuosity degrees of vertebral arteries in different age groups were compared. Correlation analysis was performed to determine the correlation between vertebral artery tortuosity and both clinical data and and biochemical levels, and multivariate linear regression analysis was performed to determine the independent risk factors for vertebral artery tortuosity.Results:The tortuosity degrees of the left and right vertebral arteries in these patients ranged from 5.1% to 72.6%. The tortuosity degrees of vertebral arteries in patients aged 40-49 years were significantly higher than those in patients aged 20-29 years and 30-39 years ( P<0.05). Correlation analysis showed that the tortuosity degree of the right vertebral artery was positively correlated with age and triglyceride level ( r=0.232, P=0.000; r=0.172, P=0.004); the tortuosity degree of the left vertebral artery was positively correlated with triglyceride level ( r=0.123, P=0.043). Multivariate regression analysis showed that age ( 95%CI: 0.059-0.194, P=0.000) and triglyceride level ( 95%CI: 0.173-1.942, P=0.019) were independent risk factors for right vertebral artery tortuosity. Triglyceride level ( 95%CI: 0.041-2.559, P=0.043) was independent risk factor for left vertebral artery tortuosity. Conclusion:There are congenital developmental factors associated with vertebral artery tortuosity; some nurture factor, as triglyceride level, may promote its development.