High incidence of pulmonary thromboembolism in hospitalized SARS-CoV-2 infected patients despite thrombo-prophylaxis.

BACKGROUND: SARS-CoV-2 infected patients present thrombotic complications caused by direct endothelial cells injury of the microvessels. Pulmonary thromboembolism (PE) has been reported by Computed Tomography pulmonary angiogram (CTPA) in patients with COVID-19 pneumonia with high D-dimer levels. OBJECTIVES: We present the characteristics of SARS-CoV-2 infected patients diagnosed of PE by CTPA in our hospital. We also present the comparison of these findings with non-infected patients with PE data. METHODS: Retrospective observational cohort study that included patients over 18 years of age hospitalised consecutively between 26th February and 20th May 2020 in an European Hospital with SARS-CoV2 virus infection, and with suspected infection at beginning of admission but with negative PCR, who were studied with CTPA for suspicion of VTE, during their hospitalization. RESULTS: During the study period, 52 CTPA were performed in our hospital, sixteen in SARS-CoV-2 infected patients, with 4 cases (33%) of PE in the infected group, and 11 (44%) in the non-infected group. No significant differences in age (p = 0.43) and sex (p = 0.31) were found between the two groups, infected and non-infected patients. In the infected group, the patients who had PE had a much lower median age (47.8 years) than those without PE (73.3 years). No differences between infected and non-infected patients were detected in the diagnosis of PE with CTPA, 28.6% versus 27.8% (p = 1.00). Overall patient mortality was 1.9%; one patient died (6.3%) in the infected group, and none in the non-infected group (p = 0.31). CONCLUSION: A considerable incidence of PE diagnosed by CTPA in SARS-CoV-2 infected patients has been observed, despite thrombo-prophylaxis.

Cirugía ambulatoria en tumores cervicales / Ambulatory surgery for cervical tumours

TIPO DE ESTUDIO: Descriptivo PACIENTES Y MÉTODO: Se presentan 10casos de Tumoraciones Cervicales: 3 nódulos tiroideos, 2 quistes tiroglosos,2 adenomas parotídeos,1 Tumor submaxilar, 1 litiasis/abceso submaxilary 1 quiste branquial tratadas en régimen de Cirugía Mayor Ambulatoria. Los criterios de selección varían poco con respecto a los convencionales, así como el tratamiento quirúrgico, ya que solo en las hemitiroidectomías se trataba de evitar la extensión del cuello; y la vigilancia postoperatoria en el Hospital era igual a la que se aplica a cualquier otra patología. Se ha realizado un seguimiento postoperatorio personalizado, en el que el paciente tenía acceso directo a su equipo quirúrgico durante las primeras 24horas postoperatorias. RESULTADOS: Los resultados han sido buenos, ya que no se han producido complicaciones. Se hace una valoración de la actitud con respecto a las complicaciones mas graves que se podían haber producido. Conclusiones: Se concluye que este grupo de patología nodular tiroidea se puede incluir entre las entidades de CMA (AU)

KIND OF STUDY: Descriptive. SETTING: A Public General Hospital. MATERIAL AND METHODS: We present 10cases of Cervical Tumours: 3 thyroid nodules, 2thyroglossal cysts, 2 parotid adenomas, 1 submaxillary tumour, 1 submaxillary lithiasis/abscess and 1 branchial cyst. All these tumours were treated in a Day Surgery Unit (DSU). Both the selection criteria and the surgical treatment hardly differed from that used in conventional procedures except in hemithyroidectomies where we tried to avoid extension of the neck. Postoperative observation during hospital stay was the same as that applied to any other pathology. Personalized postoperative monitoring was carried out allowing the patient to have direct access to his surgical team during the 24 hours following the operation. RESULTS: The results are good as there have been no complications. We evaluated the attitude towards possible complications which mayarise. CONCLUSION: We concluded that this group of nodular thyroid pathology may be included among Ambulatory procedures (AU)