Background and objectives: Reports comparing the characteristics of patients and their clinical outcomes between community-acquired (CA) and hospital-acquired (HA) COVID-19 have not yet been reported in the literature. We aimed to characterise and compare clinical, biochemical and haematological features, in addition to clinical outcomes, between these patients. Methods: This multi-centre, retrospective, observational study enrolled 488 SARS-CoV-2 positive patients -339 with CA infection and 149 with HA infection. All patients were admitted to a hospital within the University Hospitals of Morecambe Bay NHS Foundation Trust between March 7th and May 18th , 2020. Results: The CA cohort comprised of a significantly younger population, median age 75 years, versus 80 years in the HA cohort (P = 0⋅0002). Significantly less patients in the HA group experienced fever (P = 0⋅03) and breathlessness (P < 0⋅0001). Furthermore, significantly more patients had anaemia and hypoalbuminaemia in the HA group, compared to the CA group (P < 0⋅0001 for both). Hypertension and a lower median BMI were also significantly more pronounced in the HA cohort (P = 0⋅03 and P = 0⋅0001, respectively). The mortality rate was not significantly different between the two cohorts (34% in the CA group and 32% in the HA group, P = 0⋅64). However, the CA group required significantly greater ICU care (10% versus 3% in the HA group, P = 0⋅009). Conclusion: Hospital-acquired and community-acquired COVID-19 display similar rates of mortality despite significant differences in baseline characteristics of the respective patient populations. Delineation of community-and hospital-acquired COVID-19 in future studies on COVID-19 may allow for more accurate interpretation of results.

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cal records that I reviewed and received, involving nearly 20 years of office notes and references from multiple glaucoma specialists, the implanted device was described as being a Molteno implant. I therefore requested copies of the original operative report because there was some concern by Dr Molteno that we may be dealing with a counterfeit device. However, to my surprise, I received 2 operative reports. The first describes a Molteno implant being placed in 1996, and the second operative report describes placement of a Krupin valve in 1998, in the same eye. This was the first time I became aware that the patient had 2 implants in the eye. Ever since I have cared for the patient (ie, since October 2011), his affected cornea has been opaque, and the only implant evident on examination is the one that was removed and labeled as "Molteno Implant Functioning as a Culture Plate" (which should be changed to "Krupin Valve Functioning as Culture Plate" 2 ) in the June 2013 issue. 1 I apologize for this error and for my assumption that this was a Molteno implant. I should have checked the appearance of the implant more closely, and if I would have noted the inconsistencies, I would have investigated this prior to publication.

ResultsThe total number of respondents was 57, with 65% of questionnaires (n=38) completed. Responses came from 17 different hospitals and 18 different graduation countries, 52% (n=30) non EU. 28% (n=13) worked at SHO level and the remainder as registrars. 57% (n=33) were eligible for training schemes. 55% (n=32) did not have a supervisor or named trainer. 86% had the opportunity to avail of internal CPD points and 83% for external, with 83% able to complete an audit every year. Only 34% (n-28) were given an opportunity to undertake research each year, 68% are planning to stay in Ireland long-term. Open ended answers indicated that doctors don't like being excluded from training and it causes them to either switch to GP or leave Ireland altogether to complete their paediatric training. Conclusion The majority of doctors who are not on a BST/ HST scheme have the opportunity to perform an audit yearly and to get the required internal/external CPD points. Access to a named trainer/mentor was patchy and those eligible for training schemes have a more positive response and tend to have a much higher preference to stay in Ireland long-term than non-eligible doctors.With EWTD pressures we may need to consider more sustainable ways of recruiting and retaining this vital workforce.

Congenital junctional ectopic tachycardia is a rare but serious cardiac arrhythmia seen in neonates and young infants. It is frequently resistant and refractory to first-line treatment options such as cardioversion with adenosine and direct current shock, and it carries a high morbidity and mortality rate. The aim of this article is to present the case of congenital junctional ectopic tachycardia observed in a 14-day-old neonate, highlighting the role of ivabradine in the management, followed by a discussion about current approaches to treatment.