A Gastroenterologist' clinical experience in COVID 19 and in-hospital mortality and length of stay analysis.

OBJECTIVES: COVID19 pandemic has forced physicians from different specialties to assist cases overload. Our aim is to assess gastroenterologist's assistance in COVID-19 by assessing mortality, ICU admission, and length of stay, and seek for risk factors for in-hospital mortality and longer hospital stay. METHODS: A total of 41 COVID-19 patients assisted by gastroenterologist (GI cohort) and 137 assisted by pulmonologist, internal medicine practitioners, and infectious disease specialists (COVID expert cohort) during October-November 2020 were prospectively collected. Clinical, demographic, imaging, and laboratory markers were collected and compared between both cohorts. Bivariate analysis and logistic regression were performed to search for risk factors of mortality and longer hospital stays. RESULTS: A total of 27 patients died (15.1%), 11 were admitted to ICU (6.1%). There were no differences between cohorts in mortality (14.6% vs 15.4%;p = 0.90), ICU admission (12.1% vs 4%;p = 0.13), and length of stay (6.67 ± 4 vs 7.15 ± 4.5 days; p = 0.58). PaO2/FiO2 on admission (OR 0.991;CI95% 0.984-0.998) and age > 70 (OR 17.54;CI95% 3.93-78.22) were independently related to mortality. Age > 70, history of malignancy, diabetes, and cardiovascular disease were related to longer hospital stays (p < 0.001, p = 0.03, p = 0.04, p = 0.02 respectively). CONCLUSIONS: COVID-19 assistance was similar between gastroenterologist and COVID experts when assessing mortality, ICU admission, and length of stay. Age>70 and decreased PaO2/FiO2 on admission were independent risk factors of mortality. Age and several comorbidities were related to longer hospital stay.

Endocarditis secundaria a corynebacterium tras implante de válvula aórtica transcatéter: Informe de un caso / Endocarditis due to corynebacterium after transcatheter aortic valve implantation: A case report

RESUMEN Se presenta un caso de endocarditis valvular protésica secundaria a un organismo infrecuente (Corynebacterium sp.) tras la implantación de una protésis valvular aórtica percutánea. La menor sensibilidad del ecocardiograma transesofágico para detectar signos de endocarditis en éstos pacientes puede retrasar el diagnóstico. El uso de otras técnicas de imagen complementarias como la tomografía por emisión de positrones, puede ser de utilidad. El aumento de implantes de prótesis percutánea en los últimos años va asociado a un aumento de complicaciones como la endocarditis.

ABSTRACT We present a case of prosthetic valve endocarditis secondary to an infrequent organism (Corynebacterium sp.) after percutaneous aortic valve implantation. The lower sensitivity of transesophageal echocardiogram to detect signs of endocarditis in these patients may delay diagnosis. Implementing other ancillary imaging techniques such as positron emission tomography may be helpful. The increase in percutaneous prosthetic implants in recent years is associated with an upsurge in complications such as endocarditis