A worldwide outbreak of coronavirus disease 2019 (COVID-19), identified as being caused by the severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), was classified as a Public Health Emergency of International Concern by the World Health Organisation (WHO) on January 30, 2020. Initial sex-disaggregated mortality data emerging from the Wuhan province of China identified male sex as a risk factor for increased COVID-19 mortality. In this systematic review, we aimed to assess the role of sex in the risk of mortality from COVID-19 in adult patients through comparison of clinical markers and inflammatory indexes. A systematic search was conducted on the following databases:PubMed, WHO COVID-19 database, Ovid MEDLINE, andWeb of Science between the dates of June 15, 2020, and June 30, 2020.Key search terms used included: "sex", "gender", "SARS-COV-2","COVID" and "mortality".We accepted the following types of studiesconcerning adult COVID-19 patients: retrospectivecohort, observationalcohort, case series, and applied research.Further studies were extracted from referencesearching.The risk of bias was determined using theNational Institutes of Health Quality Assessment Tool for Observational Cohort, Cross-Sectional Studies, and Case Series. We identified a total of 16 studies published between January 2020 and June 2020 for analysis in this systematic review. Our study population consisted of 11 cohort studies,four case series, andonegenetic study, including a total of 76,555 participants. Ten of the studiesincluded in this review observeda higher risk of mortality amongmalescompared to females, and eight of these studies found this risk to be statistically significant.

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Purpose During the COVID-19 pandemic, appendicitis was more commonly managed conservatively, resulting in shorter hospital stays without increased short-term complications. The long-term outcome of this change remains unknown. Methods We conducted a multicentre, prospective, observational study including adult patients diagnosed with appendicitis after the implementation of the new surgical guidelines during the COVID-19 pandemic. Outcomes included initial management failure, re-admission rate, appendicitis recurrence and interval appendicectomy. A historical cohort prior to the COVID-19 pandemic was used for comparison. Patients were followed up for two-years post index admission. Results 63 and 79 patients with appendicitis were included from four NHS trusts, before (A) and after (B) the new intercollegiate guidelines respectively. Operative management was used less frequently in cohort B (28/79 vs 52/63; p < 0.001). More patients represented in cohort B (14/79 vs 3/63; p = 0.020), but not when comparing only those managed conservatively (2/11 vs 13/52; p = 1.000). A similar trend was observed for appendicitis recurrence although without statistical significance (2/63 vs 9/79; p = 0.112); with loss of trend when comparing those managed conservatively (2/11 vs 9/52; p = 1.000). Among all patients, four (2.8%) were found to have underlying neoplasia of which three were initially managed conservatively (3/63; 4.8%). Conclusion Conservative management of appendicitis had short-term benefits in expedited hospital discharge without early complications, but with higher readmission and appendicitis recurrence rates. The risks of this alongside missed/delayed management of neoplasia needs to be considered alongside the benefits including avoidance of aerosol-generating general anaesthesia and laparoscopy during the COVID-19 pandemic or similar future health crises.

Purpose: Continuous wave transscleral cyclophotocoagulation (CW‐TSCPC), is reserved for refractory glaucoma with poor visual potential due to its complication rate, attributed to continuous energy damaging adjacent tissues. Micropulse (MP‐TSCPC), however, utilizes short energy pulses separated by ‘off’ periods, and is associated with a lower complication rate. The National Institute for Health and Care Excellence has deemed evidence surrounding MP‐TSCPC as inadequate, limiting its use to research purposes. This study aims to evaluate the efficacy and safety of MP‐TSCPC compared to CW‐TSCPC. It also aims to investigate whether glaucoma type affects treatment outcomes. Methods: This retrospective study included 86 CW‐TSCPC eyes and 188 MP‐TSCPC eyes at a London tertiary centre. Follow‐up was conducted for 24‐months. Primary outcome was overall treatment success defined as success at the last available follow‐up. Success required at least 20% IOP reduction, with the same or fewer medications, and IOP between 6–18 mmHg (complete success)/19–21 mmHg (qualified success). Secondary outcomes were retinal nerve fibre layer (RNFL) thickness progression, and visual field (VF) change. Safety outcomes were visual acuity (VA) and complication rate. Results: 24‐months success rate was 27.6% for CW‐TSCPC and 30.1% for MP‐TSCPC, p = 0.96. Average IOP was reduced by 44.8% (CW‐TSCPC) and 26.5% (MP‐TSCPC) from baseline 19.0 ± 3.0 mmHg and 19.1 ± 2.2 mmHg, respectively. Both interventions significantly reduced glaucoma medications at 24‐months (p ≤ 0.05). The proportion of patients experiencing complication(s) was significantly higher after CW‐TSCPC (32.9%) vs MP‐TSCPC (16.2%, p = 0.002). Both procedures displayed VA worsening. RNFL thickening rate was greater following CW‐TSCPC (p = 0.31). MP‐TSCPC reduced VF loss rate significantly among severe disease (p = 0.04). Conclusions: Both interventions demonstrated similar success rates, and reduced IOP and glaucoma medications. MP‐TSCPC displayed minimal complications. There was no clear association between glaucoma type and treatment outcomes. Further prospective studies, with measures of medication compliance, are required to further evaluate MP‐TSCPC efficacy and safety compared to CW‐TSCPC.