Comorbid conditions appear to be common among individuals hospitalised with coronavirus disease 2019 (COVID-19) but estimates of prevalence vary and little is known about the prior medication use of patients. Here, we describe the characteristics of adults hospitalised with COVID-19 and compare them with influenza patients. We include 34,128 (US: 8362, South Korea: 7341, Spain: 18,425) COVID-19 patients, summarising between 4811 and 11,643 unique aggregate characteristics. COVID-19 patients have been majority male in the US and Spain, but predominantly female in South Korea. Age profiles vary across data sources. Compared to 84,585 individuals hospitalised with influenza in 2014-19, COVID-19 patients have more typically been male, younger, and with fewer comorbidities and lower medication use. While protecting groups vulnerable to influenza is likely a useful starting point in the response to COVID-19, strategies will likely need to be broadened to reflect the particular characteristics of individuals being hospitalised with COVID-19.

BackgroundTraumatic placement of a needle during a neuraxial blockade has been related to many complications such as postdural puncture headache, trauma to neural structures and even spinal hematoma, causing permanent neurologic deficits. Although efforts to minimize the complications caused by traumatic neuraxial blockade have been made, nothing was found to be clear. The authors investigated the predictors of difficult neuraxial blockade using the first puncture success and number of attempts as measures to assess the difficulty.MethodsIn this prospective observational study, 253 patients scheduled for elective surgery underwent spinal or epidural anesthesia. Patient data (age, sex, height, weight, body mass index, and quality of anatomical landmarks), the provider's level of experience, type of blockade (spinal or epidural), needle type/gauge and the distance from skin to subarachnoid or epidural space were recorded. Significant variables were first determined by Student's t-test and Pearson's chi square test and then logistic and Poisson regression tested the association of the first puncture success and number of attempts with the significant variables.ResultsThe provider's level of experience and the distance from skin to subarachnoid or epidural space were significant in logistic and Poisson regression. Body mass index was significant only in Poisson regression and the quality of anatomical landmarks was significant only in logistic regression.ConclusionsProvider's level of experience and the distance from skin to subarachnoid or epidural space influenced the difficulty in performing a neuraxial blockade.

Background

NCT 02955680.

Sudden, profound hypotensive and bradycardic events (HBEs) have been reported in more than 20% of patients undergoing shoulder arthroscopy in the sitting position. Although HBEs may be associated with the adverse effects of interscalene brachial plexus block (ISBPB) in the sitting position, the underlying mechanisms responsible for HBEs during the course of shoulder surgery are not well understood. The basic mechanisms of HBEs may be associated with the underlying mechanisms responsible for vasovagal syncope, carotid sinus hypersensitivity or orthostatic syncope. In this review, we discussed the possible mechanisms of HBEs during shoulder arthroscopic surgery, in the sitting position, under ISBPB. In particular, we focused on the relationship between HBEs and various types of syncopal reactions, the relationship between HBEs and the Bezold-Jarisch reflex, and the new contributing factors for the occurrence of HBEs, such as stellate ganglion block or the intraoperative administration of intravenous fentanyl.