Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4-1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0-2 weeks, 3-4 weeks and 5-6 weeks of the diagnosis (odds ratio (95%CI) 4.1 (3.3-4.8), 3.9 (2.6-5.1) and 3.6 (2.0-5.2), respectively). Surgery performed ≥ 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5 (0.9-2.1)). After a ≥ 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2-8.7) vs. 2.4% (95%CI 1.4-3.4) vs. 1.3% (95%CI 0.6-2.0), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay.
SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS-CoV-2 diagnosis was defined as peri-operative (7 days before to 30 days after surgery); recent (1-6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre-operative anti-coagulation for baseline comorbidities was not available. Postoperative venous thromboembolism rate was 0.5% (666/123,591) in patients without SARS-CoV-2; 2.2% (50/2317) in patients with peri-operative SARS-CoV-2; 1.6% (15/953) in patients with recent SARS-CoV-2; and 1.0% (11/1148) in patients with previous SARS-CoV-2. After adjustment for confounding factors, patients with peri-operative (adjusted odds ratio 1.5 (95%CI 1.1-2.0)) and recent SARS-CoV-2 (1.9 (95%CI 1.2-3.3)) remained at higher risk of venous thromboembolism, with a borderline finding in previous SARS-CoV-2 (1.7 (95%CI 0.9-3.0)). Overall, venous thromboembolism was independently associated with 30-day mortality ). In patients with SARS-CoV-2, mortality without venous thromboembolism was 7.4% (319/4342) and with venous thromboembolism was 40.8% (31/76). Patients undergoing surgery with peri-operative or recent SARS-CoV-2 appear to be at increased risk of postoperative venous thromboembolism compared with patients with no history of SARS-CoV-2 infection. Optimal venous thromboembolism prophylaxis and treatment are unknown in this cohort of patients, and these data should be interpreted accordingly.
With the massive spike in the use of Online Social Network Sites (OSNSs) platforms such as Web 2.0, microblogs services and online blogs, etc., valuable information in the form of sentiment, thoughts, opinions, as well as epidemic outbreaks, etc. are transferred. With the OSNSs being widely accessible, this work aims at proposing a novel approach for disease (dengue or flu) detection based on social media posts. For this purpose, an automated approach is designed with the help of LSTM (Long Short Term Memory) and word embedding techniques. Then the performance of the proposed approach is validated using a set of standard evaluation matrices. In addition, the effectiveness of the selected models is evaluated with performance measurement techniques. The accuracy of the proposed research approach is evaluated using two word embedding techniques; Word2Vec with Skip-gram (SG) and Word2Vec with Continuous-bag-ofwords (CBOW). Based on the results conducted in this paper the LSTM Word2Vec with CBOW achieved better results compared to LSTM with Word2Vec SG features embedding technique. Our findings prove that the proposed method yields 94% accuracy compared to state-of-the-art approaches. Consequently, LSTM performed better than other leading methods in the detection of disease-infected people in tweets. In the end, spatial analysis is performed to identify the disease infected region.
Social networking services (SNSs) provide massive data that can be a very influential source of information during pandemic outbreaks. This study shows that social media analysis can be used as a crisis detector (e.g., understanding the sentiment of social media users regarding various pandemic outbreaks). The novel Coronavirus Disease-19 (COVID-19), commonly known as coronavirus, has affected everyone worldwide in 2020. Streaming Twitter data have revealed the status of the COVID-19 outbreak in the most affected regions. This study focuses on identifying COVID-19 patients using tweets without requiring medical records to find the COVID-19 pandemic in Twitter messages (tweets). For this purpose, we propose herein an intelligent model using traditional machine learning-based approaches, such as support vector machine (SVM), logistic regression (LR), naïve Bayes (NB), random forest (RF), and decision tree (DT) with the help of the term frequency inverse document frequency (TF-IDF) to detect the COVID-19 pandemic in Twitter messages. The proposed intelligent traditional machine learning-based model classifies Twitter messages into four categories, namely, confirmed deaths, recovered, and suspected. For the experimental analysis, the tweet data on the COVID-19 pandemic are analyzed to evaluate the results of traditional machine learning approaches. A benchmark dataset for COVID-19 on Twitter messages is developed and can be used for future research studies. The experiments show that the results of the proposed approach are promising in detecting the COVID-19 pandemic in Twitter messages with overall accuracy, precision, recall, and F1 score between 70% and 80% and the confusion matrix for machine learning approaches (i.e., SVM, NB, LR, RF, and DT) with the TF-IDF feature extraction technique.
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