14 days for the household. 1 Dialysis patients can be considered as immunocompromised and display a decreased ability to develop seroconversion to infectious diseases. 2 Therefore, 7 to 14 days may not be an appropriate threshold in a dialysis population. In our center, we provide dialysis in 2 hospital-based and 6 satellite units, for a total of 664 patients (see Supplementary Methods). We isolated our COVID-19-positive dialysis outpatients in a dedicated unit and followed a pathway for de-escalation of stable patients with serial COVID-19 swabs, starting 7 days after confirmed diagnosis (Figure 1, Supplementary Table S1). Thirtyfour COVID-19-positive patients who had at least 3 swabs were included: 20 patients were de-isolated in less than 14 days (59%) with 9% on day 9. By day 12, 35% of patients could be dialyzed in their base unit (which is crucial for capacity). However, by day 15, 14 patients (41%) had not cleared the virus and could not be repatriated: 5 patients cleared the virus later (median of 18 days [range, 16-21]) and 9 patients were still positive or had only one negative swab at the end of follow-up. It is unclear whether detection of viral RNA represents the ability to transmit the virus, 3,4 but until more evidence is available, it would be prudent to isolate patients as discussed to prevent cross-contamination in this high-risk population.

In a simulated environment, early intervention enabled by RTM reduced healthcare resource utilization and associated costs.

Background/Aims: Aim of our study was to describe the association between natremia (Na) fluctuation and hospital mortality in a general population admitted to a tertiary medical center. Methods: We performed a retrospective observational cohort study on the patient population admitted to the Fondazione Policlinico A. Gemelli IRCCS Hospital between January 2010 and December 2014 with inclusion of adult patients with at least 2 Na values available and with a normonatremic condition at hospital admission. Patients were categorized according to all Na values recorded during hospital stay in the following groups: normonatremia, hyponatremia, hypernatremia, and mixed dysnatremia. The difference between the highest or the lowest Na value reached during hospital stay and the Na value read at hospital admission was used to identify the maximum Na fluctuation. Cox proportional hazards models were used to estimate hazard ratios (HRs) for in-hospital death in the groups with dysnatremias and across quartiles of Na fluctuation. Covariates assessed were age, sex, highest and lowest Na level, Charlson/Deyo score, cardiovascular diseases, cerebrovascular diseases, dementia, congestive heart failure, severe kidney disease, estimated glomerular filtration rate, and number of Na measurements during hospital stay. Results: 46,634 admissions matched inclusion criteria. Incident dysnatremia was independently associated with in-hospital mortality (hyponatremia: HR 3.11, 95% CI 2.53, 3.84, p < 0.001; hypernatremia: HR 5.12, 95% CI 3.94, 6.65, p < 0.001; mixed-dysnatremia: HR 4.94, 95% CI 3.08, 7.92, p < 0.001). We found a higher risk of in-hospital death by linear increase of quartile of Na fluctuation (p trend <0.001) irrespective of severity of dysnatremia (HR 2.34, 95% CI 1.55, 3.54, p < 0.001, for the highest quartile of Na fluctuation compared with the lowest). Conclusions: Incident dysnatremia is associated with higher hospital mortality. Fluctuation of Na during hospital stay is a prognostic marker for hospital death independent of dysnatremia severity.

Background: The global Phase 3 study RATIONALE 302 (NCT03430843) evaluated the efficacy and safety of second-line tislelizumab, an anti-PD-1 antibody, in patients with advanced or metastatic esophageal squamous cell carcinoma (ESCC). Here, we report data from the overall and Europe/North America (EU/NA) populations. Conclusions:The final safety and efficacy results of the HEPANOVA trial are currently under final analyses. Our hypothesis is that treatment with TTFields as a novel modality for HCC will be efficacious and safe in treatment of advanced HCC. Clinical trial identification: NCT03606590.Legal entity responsible for the study: Novocure.