Author: "Clinical Centre of Serbia" / Topic: covid-19 - Searchworks@Jio Institute Digital Library Search Results

48 results on '"Clinical Centre of Serbia"'

1. Onset of leukocytoclastic vasculitis following covid-19 vaccination: case based comprehensive review.

Author: Miskovic R, Radovic S, Arandjelovic S, Plavsic A, Reljic V, Peric J, Brkovic V, and Stojanovic M
Subjects: Humans, Female, Aged, SARS-CoV-2, Vaccination adverse effects, BNT162 Vaccine adverse effects, Vasculitis, Leukocytoclastic, Cutaneous etiology, Vasculitis, Leukocytoclastic, Cutaneous chemically induced, COVID-19 Vaccines adverse effects, COVID-19 prevention & control, COVID-19 complications
Abstract: With the global introduction and widespread administration of COVID-19 vaccines, there have been emerging reports of associated vasculitis, including leukocytoclastic cutaneous vasculitis (LCV). In this paper, we present a case of a 68-year-old female patient who developed painful purpuric skin lesions on her feet 12 days after administration of the inactivated COVID-19 vaccine BBIBP Cor-V with histopathological confirmation of LCV and no signs of systemic involvement. The case is followed by a comprehensive literature review of documented LCV cases associated with COVID-19 vaccination with overall 39 articles and 48 cases of LCV found in total. In the majority of cases (56.3%) the first symptom occurred after the first dose of the COVID-19 vaccine, with symptoms manifesting within an average of seven days (6.8 ± 4.8) post-vaccination. The adenoviral vaccine Oxford-AstraZeneca (41.7%) and the mRNA vaccine Pfizer-BioNTech (27.1%) were most frequently associated with LCV occurrences. On average, LCV resolved within 2.5 (± 1.5) weeks. The preferred treatment modality were glucocorticoids, used in 70.8% of cases, resulting in a positive outcome in most cases, including our patient. While the safety of a subsequent dose appears favorable based on our review, individual risk-benefit assessment is crucial. This review emphasis the importance of considering COVID-19 vaccination as a potential trigger for the development of cutaneous vasculitis. Despite rare adverse events, the benefits of the COVID-19 vaccination outweigh the risks, highlighting the importance of immunization programs., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Published: 2024
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2. Changes in the epidemiology of kidney replacement therapy across Europe in 2020-the first year of the COVID-19 pandemic: an ERA Registry study.

Author: Kramer A, Jager KJ, Chesnaye NC, Kerschbaum J, Hommel K, Comas Farnés J, Trujillo Alemán S, Santamaria R, Finne P, Hemmelder MH, Åsberg A, Nitsch D, Ambühl P, Sørensen SS, Sánchez-Alvarez JE, Segelmark M, Resic H, Ots-Rosenberg M, Radunovic D, Palsson R, Santiuste de Pablos C, Rodríguez Arévalo OL, Legeai C, Lausevic M, Bakkaloglu SA, Ortiz A, and Stel VS
Subjects: Humans, Europe epidemiology, Male, Female, Middle Aged, Aged, Adult, SARS-CoV-2, Incidence, Prevalence, Pandemics, Kidney Failure, Chronic epidemiology, Kidney Failure, Chronic therapy, Kidney Failure, Chronic surgery, COVID-19 epidemiology, Registries, Renal Replacement Therapy statistics & numerical data, Kidney Transplantation
Abstract: Background: In 2020, the coronavirus disease 2019 (COVID-19) pandemic caused disruptions in kidney replacement therapy (KRT) services worldwide. The aim of this study was to assess the effect of the COVID-19 pandemic in 2020 on the incidence of KRT, kidney transplantation activity, mortality and prevalence of KRT across Europe., Methods: Patients receiving KRT were included from 17 countries providing data to the European Renal Association Registry. The epidemiology of KRT in 2020 was compared with average data from the period 2017-2019. Changes occurring during the first and second waves of the pandemic were also explored., Results: The incidence of KRT was 6.2% lower in 2020 compared with 2017-2019, with the lowest point (-22.7%) during the first wave in April. The decrease varied across countries, was smaller in males (-5.2%) than in females (-8.2%) and was moderate for peritoneal dialysis (-3.7%) and haemodialysis (-5.4%) but substantial for pre-emptive kidney transplantation (-23.6%). The kidney transplantation rate decreased by 22.5%, reaching a nadir of -80.1% during the first wave, and was greatest for living donor kidney transplants (-30.5%). While in most countries the kidney transplantation rate decreased, in the Nordic/Baltic countries and Greece there was no clear decrease. In dialysis patients, mortality increased by 11.4% and was highest in those 65-74 years of age (16.1%), in those with diabetes as the primary renal disease (15.1%) and in those on haemodialysis (12.4%). In transplant recipients, the mortality was 25.8% higher, but there were no subgroups that stood out. In contrast to the rising prevalence of KRT observed over the past decades across Europe, the prevalence at the end of 2020 (N = 317 787) resembled that of 2019 (N = 317 077)., Conclusion: The COVID-19 pandemic has had a substantial impact on the incidence of KRT, kidney transplant activity, mortality of KRT and prevalence of KRT in Europe with variations across countries., (© The Author(s) 2024. Published by Oxford University Press on behalf of the ERA.)
Published: 2024
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3. Factors associated with COVID-19 among hospitalized patients with severe acute respiratory infections in Serbia, 2022-2023: A test negative case-control study.

Author: Stosic M, Plavsa D, Jovanovic V, Veljkovic M, Babic D, Knezevic A, Saponjic V, Dimitrijevic D, Rancic M, Milic M, and Adzic-Vukicevic T
Subjects: Child, Humans, Case-Control Studies, SARS-CoV-2, Serbia epidemiology, COVID-19 Vaccines, COVID-19 epidemiology, Pneumonia
Abstract: Severe acute respiratory infections (SARI) are estimated to be the cause of death in about 19% of all children younger than 5 years globally. The outbreak of coronaviral disease (COVID-19) caused by SARS-CoV-2, increased considerably the burden of SARI worldwide. We used data from a vaccine effectiveness study to identify the factors associated with SARS CoV-2 infection among hospitalized SARI patients. We recruited SARI patients at 3 hospitals in Serbia from 7 April 2022-1 May 2023. We collected demographic and clinical data from patients using a structured questionnaire, and all SARI patients were tested for SARS-CoV-2 by RT-PCR. We conducted an unmatched test negative case-control study. SARS-CoV-2 infected SARI patients were considered cases, while SARS CoV-2 negative SARI patients were controls. We conducted bivariate and multivariable logistic regression analysis in order to identify variables associated with SARS-CoV-2 infection. We included 110 SARI patients: 74 were cases and 36 controls. We identified 5 factors associated with SARS-CoV-2 positivity, age (OR = 1.04; 95% CI = 1.01-1.07), having received primary COVID-19 vaccine series (OR = 0.28; 95% CI = 0.09-0.88), current smoking (OR = 8.64; 95% CI = 2.43-30.72), previous SARS CoV-2 infection (OR = 3.48; 95% CI = 1.50-8.11) and number of days before seeking medical help (OR = 0.81; 95% CI = 0.64-1.02). In Serbia during a period of Omicron circulation, we found that older age, unvaccinated, hospitalized SARI patients, previously infected with SARS CoV-2 virus and those who smoked, were more likely to be SARS-CoV-2-positive; these patient populations should be prioritized for COVID vaccination., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Stosic et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Published: 2024
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4. Antithrombotic Therapy in Arterial Thrombosis and Thromboembolism in COVID-19: An American College of Chest Physicians Expert Panel Report.

Author: Potpara T, Angiolillo DJ, Bikdeli B, Capodanno D, Cole O, Yataco AC, Dan GA, Harrison S, Iaccarino JM, Moores LK, Ntaios G, and Lip GYH
Subjects: Humans, Anticoagulants therapeutic use, Fibrinolytic Agents therapeutic use, Pandemics, COVID-19 complications, Physicians, Thromboembolism etiology, Thromboembolism prevention & control, Thrombosis drug therapy, Thrombosis etiology, Thrombosis prevention & control, Venous Thromboembolism prevention & control
Abstract: Background: Evidence increasingly shows that the risk of thrombotic complications in COVID-19 is associated with a hypercoagulable state. Several organizations have released guidelines for the management of COVID-19-related coagulopathy and prevention of VTE. However, an urgent need exists for practical guidance on the management of arterial thrombosis and thromboembolism in this setting., Research Question: What is the current available evidence informing the prevention and management of arterial thrombosis and thromboembolism in patients with COVID-19?, Study Design and Methods: A group of approved panelists developed key clinical questions by using the Population, Intervention, Comparator, and Outcome (PICO) format that address urgent clinical questions regarding prevention and management of arterial thrombosis and thromboembolism in patients with COVID-19. Using MEDLINE via PubMed, a literature search was conducted and references were screened for inclusion. Data from included studies were summarized and reviewed by the panel. Consensus for the direction and strength of recommendations was achieved using a modified Delphi survey., Results: The review and analysis of the literature based on 11 PICO questions resulted in 11 recommendations. Overall, a low quality of evidence specific to the population with COVID-19 was found. Consequently, many of the recommendations were based on indirect evidence and prior guidelines in similar populations without COVID-19., Interpretation: The existing evidence and panel consensus do not suggest a major departure from the management of arterial thrombosis according to recommendations predating the COVID-19 pandemic. Data on the optimal strategies for prevention and management of arterial thrombosis and thromboembolism in patients with COVID-19 are sparse. More high-quality evidence is needed to inform management strategies in these patients., Competing Interests: Financial/Nonfinancial Disclosures The authors have reported to CHEST the following: B. B. is a consulting expert, on behalf of the plaintiff, for litigation related to two specific brand models of IVC filters. D. J. A. has received consulting fees or honoraria from Abbott, Amgen, AstraZeneca, Bayer, Biosensors, Boehringer Ingelheim, Bristol-Myers Squibb, Chiesi, Daiichi-Sankyo, Eli Lilly, Haemonetics, Janssen, Merck, PhaseBio, PLx Pharma, Pfizer, and Sanofi and his institution has received research grants from Amgen, AstraZeneca, Bayer, Biosensors, CeloNova, CSL Behring, Daiichi-Sankyo, Eisai, Eli Lilly, Gilead, Janssen, Matsutani Chemical Industry Co., Merck, Novartis, Osprey Medical, Renal Guard Solutions, and the Scott R. MacKenzie Foundation. None declared (T. P., D. C., O. C., A. C. Y., G.-A. D., S. H., J. M. I., L. K. M., G. N., G. Y. H. L.)., (Copyright © 2023 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.)
Published: 2023
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5. A Rare Case of Isolated Hepatocellular Carcinoma Metastasis in Left Mandibular Region in a Patient with Hepatitis C Virus Liver Cirrhosis Diagnosed after the Onset of COVID-19 Infection.

Author: Mašulović D, Igić A, Filipović A, Zakošek M, Bulatović D, Mijović K, Micev M, and Galun D
Subjects: Female, Humans, Aged, Hepacivirus, Liver Cirrhosis complications, Carcinoma, Hepatocellular pathology, Liver Neoplasms pathology, COVID-19 complications, Hepatitis C complications
Abstract: Background and Objectives: Hepatocellular carcinoma (HCC) most frequently metastasizes in the lungs, abdominal lymph nodes and adrenal glands. Metastatic spread to the head and neck area is extremely rare. In the presented case, an uncommon site of solitary metastatic spread of HCC to the mandible confirmed after the core biopsy of the lesion is reported. There have been only about 80 cases of mandibular HCC metastases described in the literature to date. We contribute our experience to the pool of data. Case presentation: A 65-year-old female with HCV-related liver cirrhosis was diagnosed with an HCC that was successfully treated with liver resection. Subsequently, the patient had developed COVID-19 disease, which was associated with a painless swelling in the left jaw. A neck MDCT scan demonstrated an osteolytic soft-tissue mass in the left mandible, with the characteristics consistent for the metastasis of HCC. In order to confirm the diagnosis, a core biopsy of the mandibular mass was performed. The pathohistological evaluation confirmed the presence of a metastatic HCC in the mandible. No other sites of disease dissemination were identified in extensive MDCT scans. Despite considering various treatments, including symptomatic and palliative, the patient's overall prognosis remained poor. Conclusions: Isolated metastases of HCC to the orofacial region are extremely rare; however, it should be considered in patients with known risk factors for HCC development. Early diagnosis is critical, and clinicians should consider this possibility of HCC spread when assessing patients with orofacial swelling, among those patients with risk factors for HCC. The overall prognosis for such patients remains poor, emphasizing the challenges in managing these cases.
Published: 2023
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6. GPX3 Variant Genotype Affects the Risk of Developing Severe Forms of COVID-19.

Author: Markovic M, Ranin J, Bukumiric Z, Jerotic D, Savic-Radojevic A, Pljesa-Ercegovac M, Djukic T, Ercegovac M, Asanin M, Milosevic I, Stevanovic G, Simic T, Coric V, and Matic M
Subjects: Humans, SARS-CoV-2, Genotype, Polymorphism, Genetic, Fibrinogen genetics, Glutathione Peroxidase genetics, Glutathione Transferase genetics, COVID-19 genetics
Abstract: In SARS-CoV-2 infection, excessive activation of the immune system intensively increases reactive oxygen species levels, causing harmful hyperinflammatory and oxidative state cumulative effects which may contribute to COVID-19 severity. Therefore, we assumed that antioxidant genetic profile, independently and complemented with laboratory markers, modulates COVID-19 severity. The study included 265 COVID-19 patients. Polymorphism of G STM1 , GSTT1 , Nrf2 rs6721961 , GSTM3 rs1332018 , GPX3 rs8177412, GSTP1 rs1695 , GSTO1 rs4925 , GSTO2 rs156697 , SOD2 rs4880 and GPX1 rs1050450 genes was determined with appropriate PCR-based methods. Inflammation (interleukin-6, CRP, fibrinogen, ferritin) and organ damage (urea, creatinine, transaminases and LDH) markers, complete blood count and coagulation status (d-dimer, fibrinogen) were measured. We found significant association for COVID-19 progression for patients with lymphocytes below 1.0 × 10 9 /L (OR = 2.97, p = 0.002). Increased IL-6 and CRP were also associated with disease progression (OR = 8.52, p = 0.001, and OR = 10.97, p < 0.001, respectively), as well as elevated plasma AST and LDH (OR = 2.25, p = 0.021, and OR = 4.76, p < 0.001, respectively). Of all the examined polymorphisms, we found significant association with the risk of developing severe forms of COVID-19 for GPX3 rs8177412 variant genotype (OR = 2.42, p = 0.032). This finding could be of particular importance in the future, complementing other diagnostic tools for prediction of COVID-19 disease course.
Published: 2023
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7. Changes in physical activity participation during the COVID-19 pandemic in people with multiple sclerosis: An international survey study.

Author: van der Linden ML, Kos D, Moumdjian L, Kalron A, Coote S, Smedal T, Arntzen EC, Tayfur SN, Pedullà L, Tacchino A, Jonsdottir J, Santoyo-Medina C, Novotna K, Yazgan YZ, Nedeljkovic U, and Learmonth YC
Subjects: Humans, Pandemics, Exercise, Quality of Life, COVID-19, Multiple Sclerosis complications, Multiple Sclerosis epidemiology
Abstract: Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests.
Published: 2023
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8. Metabolic Associated Fatty Liver Disease (MAFLD) and COVID-19 Infection: An Independent Predictor of Poor Disease Outcome?

Author: Milivojević V, Bogdanović J, Babić I, Todorović N, and Ranković I
Subjects: Humans, SARS-CoV-2, Interleukin-6, COVID-19 complications, COVID-19 epidemiology, Diabetes Mellitus, Type 2, Non-alcoholic Fatty Liver Disease
Abstract: Background and Objectives : Early reports on COVID-19 infection suggested that the SARS-CoV-2 virus solely attacks respiratory tract cells. As the pandemic spread, it became clear that the infection is multiorganic. Metabolic associated fatty liver disease (MAFLD) is a chronic liver disease strongly associated with insulin resistance and diabetes. The aim of this study was to assess a possible interplay between MAFLD and COVID-19 infection and its implication in COVID-19 outcome. Materials and Methods : A retrospective observational study, including 130 COVID-19 positive patients was conducted. MAFLD diagnosis was made based on the International Consensus criteria. Patients were divided into two groups, group A (MAFLD) and group B (nonMAFLD). Anthropometric and laboratory analysis were obtained. COVID-19 severity was assessed using the NEWS2 score. Disease outcome was threefold and regarded as discharged, patients who required mechanical ventilation (MV), and deceased patients. Results : MAFLD prevalence was 42%, 67% of patients were discharged, and 19% needed MV. Mortality rate was 14%. MAFLD patients were significantly younger ( p < 0.001), and had higher body mass index ( p < 0.05), respiratory rate ( p < 0.05) and systolic blood pressure ( p < 0.05) than nonMAFLD patients. Regarding metabolic syndrome and inflammatory markers: group A had significantly higher glycemia at admission ( p = 0.008), lower HDL-c ( p < 0.01), higher triglycerides ( p < 0.01), CRP ( p < 0.001), IL-6 ( p < 0.05) and ferritin ( p < 0.05) than group B. MAFLD was associated with more prevalent type 2 diabetes ( p = 0.035) and hypertension ( p < 0.05). MAFLD patients had a more severe disease course (NEWS2 score, 6.5 ± 0.5 vs. 3 ± 1.0, p < 0.05). MAFLD presence was associated with lower patient discharge ( p < 0.01) and increased need for MV ( p = 0.024). Multiple regression analysis showed that BMI ( p = 0.045), IL-6 ( p = 0.03), and MAFLD ( p < 0.05) are significant independent risk factors for a poor COVID-19 outcome. Conclusions : The prevalence of MAFLD is relatively high. MAFLD patients had a more severe COVID-19 clinical course and worse disease outcome. Our results imply that early patient stratification and risk assessment are mandatory in order to avoid poor outcomes.
Published: 2023
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9. Relationship Between Azithromycin and Cardiovascular Outcomes in Unvaccinated Patients With COVID-19 and Preexisting Cardiovascular Disease.

Author: Bergami M, Manfrini O, Nava S, Caramori G, Yoon J, Badimon L, Cenko E, David A, Demiri I, Dorobantu M, Fabin N, Gheorghe-Fronea O, Jankovic R, Kedev S, Ladjevic N, Lasica R, Loncar G, Mancuso G, Mendieta G, Miličić D, Mjehović P, Pašalić M, Petrović M, Poposka L, Scarpone M, Stefanovic M, van der Schaar M, Vasiljevic Z, Vavlukis M, Vega Pittao ML, Vukomanovic V, Zdravkovic M, and Bugiardini R
Subjects: Humans, Azithromycin adverse effects, COVID-19 Drug Treatment, SARS-CoV-2, Cardiovascular Diseases epidemiology, Cardiovascular Diseases chemically induced, COVID-19 complications
Abstract: Background Empiric antimicrobial therapy with azithromycin is highly used in patients admitted to the hospital with COVID-19, despite prior research suggesting that azithromycin may be associated with increased risk of cardiovascular events. Methods and Results This study was conducted using data from the ISACS-COVID-19 (International Survey of Acute Coronavirus Syndromes-COVID-19) registry. Patients with a confirmed diagnosis of SARS-CoV-2 infection were eligible for inclusion. The study included 793 patients exposed to azithromycin within 24 hours from hospital admission and 2141 patients who received only standard care. The primary exposure was cardiovascular disease (CVD). Main outcome measures were 30-day mortality and acute heart failure (AHF). Among 2934 patients, 1066 (36.4%) had preexisting CVD. A total of 617 (21.0%) died, and 253 (8.6%) had AHF. Azithromycin therapy was consistently associated with an increased risk of AHF in patients with preexisting CVD (risk ratio [RR], 1.48 [95% CI, 1.06-2.06]). Receiving azithromycin versus standard care was not significantly associated with death (RR, 0.94 [95% CI, 0.69-1.28]). By contrast, we found significantly reduced odds of death (RR, 0.57 [95% CI, 0.42-0.79]) and no significant increase in AHF (RR, 1.23 [95% CI, 0.75-2.04]) in patients without prior CVD. The relative risks of death from the 2 subgroups were significantly different from each other ( P =0.01). Statistically significant association was observed between AHF and death (odds ratio, 2.28 [95% CI, 1.34-3.90]). Conclusions These findings suggest that azithromycin use in patients with COVID-19 and prior history of CVD is significantly associated with an increased risk of AHF and all-cause 30-day mortality. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT05188612.interaction =0.01). Statistically significant association was observed between AHF and death (odds ratio, 2.28 [95% CI, 1.34-3.90]). Conclusions These findings suggest that azithromycin use in patients with COVID-19 and prior history of CVD is significantly associated with an increased risk of AHF and all-cause 30-day mortality. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT05188612.
Published: 2023
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10. Influence of chronic liver diseases on the course and outcome of COVID-19.

Author: Mitrovic N, Sabanovic M, Vujovic A, Jovanovic J, Nikolic N, Jug M, Todorovic N, Filipovic A, and Milosevic I
Subjects: Humans, Liver Cirrhosis etiology, COVID-19 complications, Liver Diseases complications, Liver Diseases epidemiology, Liver Diseases, Alcoholic complications, Non-alcoholic Fatty Liver Disease complications, Liver Neoplasms complications
Abstract: Introduction: Coronavirus disease of 2019 (COVID-19) is a global health problem. The impact of chronic liver diseases on the course and outcome of COVID-19 is still the subject of research. The aim of this study was to show the characteristics of COVID-19 patients with chronic liver diseases, and to establish the risk factors for unfavourable outcome., Methods: A retrospective observational study was conducted at the Infectious Disease Clinic in Belgrade, Serbia, and included 80 patients with chronic liver diseases and COVID-19 within a time frame of two years (between 15 March 2020 and 15 March 2022). Characteristics of the affected persons, as well as the risk factors for a fatal outcome, were analyzed., Results: Of the 80 subjects in the study, 23.8% had chronic viral hepatitis, 12.5% autoimmune liver diseases and alcoholic liver disease respectively, 30% had non-alcoholic fatty liver disease, while 11.2% had chronic liver diseases of unknown aetiology. A total of 33.7% had cirrhosis, 6.3% hepatocellular carcinoma and 5% had liver transplants. A total of 92.5% of respondents had pneumonia (21.2% were critically ill). A deterioration of chronic liver disease was registered among 33.7% of patients, and decompensation in 3.8%; 76.3% patients recovered, while 23.7% had a lethal outcome. Risk factors for lethal outcome by univariate analysis were: alcoholic liver disease, cirrhosis, increased transaminases values prior to COVID-19, malignancy, severe pneumonia and dyspnea. In a multivariate analysis, the presence of liver cirrhosis (OR = 69.1, p = 0.001) and severe pneumonia (OR = 22.3, p = 0.006) remained independently predictive for lethal outcome., Conclusion: These findings will help with the evaluation of COVID-19 patients who have chronic liver diseases and will improve their risk stratification., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Mitrovic et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Published: 2023
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11. Myotonic dystrophy type 1 in the COVID-19 era.

Author: Ilic Zivojinovic J, Djurdjevic K, Bozovic I, Meola G, Peric M, Azanjac Arsic A, Basta I, Rakocevic-Stojanovic V, and Peric S
Subjects: Adult, Humans, Male, Middle Aged, Female, COVID-19 Vaccines, Cross-Sectional Studies, SARS-CoV-2, Myotonic Dystrophy epidemiology, COVID-19
Abstract: Introduction: Myotonic dystrophy type 1 (DM1) is the most prevalent muscular dystrophy in adults. People with DM1 might represent a high-risk population for respiratory infections, including COVID-19. Our aim was to evaluate the characteristics of COVID-19 infection and vaccination rate in DM1 patients., Methods: This cross-sectional cohort study included 89 patients from the Serbian registry for myotonic dystrophies. Mean age at testing was 48.4 ± 10.4 years with 41 (46.1%) male patients. Mean duration of the disease was 24.0 ± 10.3 years., Results: COVID-19 infection was reported by 36 (40.4%) DM1 patients. Around 14% of patients had a more severe form of COVID-19 requiring hospitalization. The severity of COVID-19 was in accordance with the duration of DM1. A severe form of COVID-19 was reported in 20.8% of patients who were not vaccinated against SARS-CoV-2 and in none of the vaccinated ones. The majority of 89 tested patients (66.3%) were vaccinated against SARS-CoV-2. About half of them (54.2%) received three doses and 35.6% two doses of vaccine. Mild adverse events after vaccination were recorded in 20.3% of patients., Conclusions: The percentage of DM1 patients who suffered from COVID-19 was like in general population, but with more severe forms in DM1, especially in patients with longer DM1 duration. The study indicated an overall favorable safety profile of COVID-19 vaccines among individuals with DM1 and its ability to protect them from severe COVID-19., (© 2023. The Author(s).)
Published: 2023
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12. Antioxidant Genetic Variants Modify Echocardiography Indices in Long COVID.

Author: Asanin M, Ercegovac M, Krljanac G, Djukic T, Coric V, Jerotic D, Pljesa-Ercegovac M, Matic M, Milosevic I, Viduljevic M, Stevanovic G, Ranin J, Simic T, Bukumiric Z, and Savic-Radojevic A
Subjects: Humans, Post-Acute COVID-19 Syndrome, NF-E2-Related Factor 2, Glutathione Peroxidase genetics, Glutathione Peroxidase metabolism, Glutathione Peroxidase GPX1, Superoxide Dismutase metabolism, Echocardiography, Antioxidants, COVID-19 diagnostic imaging, COVID-19 genetics
Abstract: Although disturbance of redox homeostasis might be responsible for COVID-19 cardiac complications, this molecular mechanism has not been addressed yet. We have proposed modifying the effects of antioxidant proteins polymorphisms (superoxide dismutase 2 ( SOD2 ), glutathione peroxidase 1 ( GPX1 ), glutathione peroxidase 3 ( GPX3 ) and nuclear factor erythroid 2-related factor 2, ( Nrf2 )) in individual susceptibility towards the development of cardiac manifestations of long COVID-19. The presence of subclinical cardiac dysfunction was assessed via echocardiography and cardiac magnetic resonance imaging in 174 convalescent COVID-19 patients. SOD2, GPX1 , GPX3 and Nrf2 polymorphisms were determined via the appropriate PCR methods. No significant association of the investigated polymorphisms with the risk of arrhythmia development was found. However, the carriers of variant GPX1 *T, GPX3 *C or Nrf2 *A alleles were more than twice less prone for dyspnea development in comparison with the carriers of the referent ones. These findings were even more potentiated in the carriers of any two variant alleles of these genes (OR = 0.273, and p = 0.016). The variant GPX alleles were significantly associated with left atrial and right ventricular echocardiographic parameters, specifically LAVI, RFAC and RV-EF ( p = 0.025, p = 0.009, and p = 0.007, respectively). Based on the relation between the variant SOD2 *T allele and higher levels of LV echocardiographic parameters, EDD, LVMI and GLS, as well as troponin T ( p = 0.038), it can be proposed that recovered COVID-19 patients, who are the carriers of this genetic variant, might have subtle left ventricular systolic dysfunction. No significant association between the investigated polymorphisms and cardiac disfunction was observed when cardiac magnetic resonance imaging was performed. Our results on the association between antioxidant genetic variants and long COVID cardiological manifestations highlight the involvement of genetic propensity in both acute and long COVID clinical manifestations.
Published: 2023
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13. The role of acute rehabilitation in COVID-19 patients.

Author: Filipović T, Gajić I, Gimigliano F, Backović A, Hrković M, Nikolić D, and Filipović A
Subjects: Aged, Female, Humans, Male, Middle Aged, Dyspnea, Exercise Therapy methods, Prospective Studies, Treatment Outcome, COVID-19 epidemiology
Abstract: Background: In the published literature there is scarce data on the importance of acute rehabilitation in patients suffering from COVID-19 disease., Aim: Evaluation of the feasibility of respiratory and neuromuscular rehabilitation treatment in stable acute COVID-19 inpatients., Design: The study was designed as an observational prospective investigation of two cohorts respectively identified as Mild/Moderate and Stable Severe COVID-19 disease. All patients received a rehabilitation treatment consisting of breathing exercises, range of motion exercises and strengthening exercises, with the main difference in intensity and progression of treatment, depending on individual capacity of patient., Setting: Inpatients with diagnosed mild to moderate, or stable severe COVID-19 infection were included in the study., Population: Acute COVID-19 inpatients., Methods: Patients were divided into two groups depending on the severity of disease: "mild to moderate group" (MMG) and "stable severe group" (SSG). Functional outcomes included the Barthel Index (BI), Six Minute Walk Test (6MWT), Borg Scale for dyspnea, "Time Up and Go" Test (TUG), "Sit To Stand" test (STS), "One Leg Stance Test" (OLST) and Beck Depression Inventory (BDI) were evaluated at baseline and after rehabilitative treatment, on discharge., Results: We included 147 acute COVID-19 inpatients (75 male and 72 female), mean aged 63.90±13.76 years. There were noticeable statistically significant improvements in all observed measurements in both groups. Comparison between groups showed significant difference in MMG compared to SSG in all functional outcomes: TUG (P<0.001), STS (P<0.001), OLST (P<0.001), BDI (P=0.008), BI (P<0.001), and Borg scale for dyspnea (P<0.001). Despite the significant improvements of BI in SSG, the obtained values showed that the patients were still not functionally independent., Conclusions: Acute respiratory and neuromuscular rehabilitation program is a feasibile, but also effective and safe method for improving functional status in patients with COVID-19 infection., Clinical Rehabilitation Impact: Results of the present study implicate that a supervised early rehabilitation program, implemented in the treatment of patients with COVID-19 disease in the acute phasis a feasible way for significant improvement of patient's functional outcomes. Early rehabilitation should be included into clinical protocols for the treatment of patients with COVID-19.
Published: 2023
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14. Sex differences and disparities in cardiovascular outcomes of COVID-19.

Author: Bugiardini R, Nava S, Caramori G, Yoon J, Badimon L, Bergami M, Cenko E, David A, Demiri I, Dorobantu M, Fronea O, Jankovic R, Kedev S, Ladjevic N, Lasica R, Loncar G, Mancuso G, Mendieta G, Miličić D, Mjehović P, Pašalić M, Petrović M, Poposka L, Scarpone M, Stefanovic M, van der Schaar M, Vasiljevic Z, Vavlukis M, Vega Pittao ML, Vukomanovic V, Zdravkovic M, and Manfrini O
Subjects: Humans, Female, Male, SARS-CoV-2, Retrospective Studies, Sex Characteristics, Cross-Sectional Studies, Risk Factors, COVID-19 complications, COVID-19 therapy, Acute Kidney Injury diagnosis, Acute Kidney Injury epidemiology, Acute Kidney Injury therapy
Abstract: Aims: Previous analyses on sex differences in case fatality rates at population-level data had limited adjustment for key patient clinical characteristics thought to be associated with coronavirus disease 2019 (COVID-19) outcomes. We aimed to estimate the risk of specific organ dysfunctions and mortality in women and men., Methods and Results: This retrospective cross-sectional study included 17 hospitals within 5 European countries participating in the International Survey of Acute Coronavirus Syndromes COVID-19 (NCT05188612). Participants were individuals hospitalized with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from March 2020 to February 2022. Risk-adjusted ratios (RRs) of in-hospital mortality, acute respiratory failure (ARF), acute heart failure (AHF), and acute kidney injury (AKI) were calculated for women vs. men. Estimates were evaluated by inverse probability weighting and logistic regression models. The overall care cohort included 4499 patients with COVID-19-associated hospitalizations. Of these, 1524 (33.9%) were admitted to intensive care unit (ICU), and 1117 (24.8%) died during hospitalization. Compared with men, women were less likely to be admitted to ICU [RR: 0.80; 95% confidence interval (CI): 0.71-0.91]. In general wards (GWs) and ICU cohorts, the adjusted women-to-men RRs for in-hospital mortality were of 1.13 (95% CI: 0.90-1.42) and 0.86 (95% CI: 0.70-1.05; pinteraction = 0.04). Development of AHF, AKI, and ARF was associated with increased mortality risk (odds ratios: 2.27, 95% CI: 1.73-2.98; 3.85, 95% CI: 3.21-4.63; and 3.95, 95% CI: 3.04-5.14, respectively). The adjusted RRs for AKI and ARF were comparable among women and men regardless of intensity of care. In contrast, female sex was associated with higher odds for AHF in GW, but not in ICU (RRs: 1.25; 95% CI: 0.94-1.67 vs. 0.83; 95% CI: 0.59-1.16, pinteraction = 0.04)., Conclusions: Women in GW were at increased risk of AHF and in-hospital mortality for COVID-19 compared with men. For patients receiving ICU care, fatal complications including AHF and mortality appeared to be independent of sex. Equitable access to COVID-19 ICU care is needed to minimize the unfavourable outcome of women presenting with COVID-19-related complications., Competing Interests: Conflicts of interests: The authors declare that they have no competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Published: 2023
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15. Significance of 1,25-Dihydroxyvitamin D 3 on Overall Mortality in Peritoneal Dialysis Patients with COVID-19.

Author: Baralić M, Robajac D, Penezić A, Brković V, Gligorijević N, Bontić A, Pavlović J, Nikolić J, Miljuš G, Dobrijević Z, Šunderić M, Pažitná L, Katrlík J, Nedić O, and Laušević M
Subjects: Humans, Calcitriol, Pandemics, SARS-CoV-2, Fibrinogen, COVID-19, Peritoneal Dialysis adverse effects, Hemostatics
Abstract: In previous publications, we pointed out the importance of mannosylation of fibrinogen for the development of cardiovascular complications and fucosylation as a predictor of peritoneal membrane dysfunction in patients on peritoneal dialysis (PD). After a follow-up period of 30 months from the onset of the COVID-19 pandemic, we evaluated the significance of 1,25-dihydroxyvitamin D 3 (calcitriol) therapy, primary disease, biochemical and hematologic analyzes, and previously performed glycan analysis by lectin-based microarray as predictors of mortality in this patient group. After univariate Cox regression analysis, diabetes mellitus (DM) and calcitriol therapy were found to be potential predictors of mortality. Additional multivariate Cox regression analysis confirmed that only DM was a predictor of mortality. Nevertheless, the use of calcitriol in therapy significantly reduced mortality in this patient group, as shown by the Kaplan-Meier survival curve. The presence of DM as a concomitant disease proved to be a strong predictor of fatal outcome in PD patients infected with SARS-CoV-2. This is the first study to indicate the importance and beneficial effect of calcitriol therapy on survival in PD patients with COVID-19 infection. In addition, this study points to the possibility that adverse thrombogenic events observed in PD patients during the pandemic may be caused by aberrant fibrinogen glycosylation.
Published: 2023
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16. Incremental costs of hospital-acquired infections in COVID-19 patients in an adult intensive care unit of a tertiary hospital from a low-resource setting.

Author: Despotović A, Milić N, Cirković A, Milošević B, Jovanović S, Mioljević V, Obradović V, Kovačević G, and Stevanović G
Subjects: Humans, Adult, Tertiary Care Centers, Retrospective Studies, Intensive Care Units, COVID-19 epidemiology, Cross Infection microbiology
Abstract: Background: Hospital-acquired infections (HAIs) are a global public health problem and put patients at risk of complications, including death. HAIs increase treatment costs, but their financial impact on Serbia's healthcare system is unknown. Our goal was to assess incremental costs of HAIs in a tertiary care adult intensive care unit (ICU) that managed COVID-19 patients., Methods: A retrospective study from March 6th to December 31st, 2020 included patients with microbiologically confirmed COVID-19 (positive rapid antigen test or real-time polymerase chain reaction) treated in the ICU of the Teaching Hospital for Infectious and Tropical Diseases, University Clinical Centre of Serbia. Demographic and HAI-specific data acquired in our ICU were collected, including total and stratified medical costs (services, materials, laboratory testing, medicines, occupancy costs). Median total and stratified costs were compared in relation to HAI acquisition. Linear regression modelling was used to assess incremental costs of HAIs, adjusted for age, biological sex, prior hospitalisation, Charlson Comorbidity Index (CCI), and Glasgow Coma Scale (GCS) on admission. Outcome variables were length of stay (LOS) in days and mortality., Results: During the study period, 299 patients were treated for COVID-19, of which 214 were included. HAIs were diagnosed in 56 (26.2%) patients. Acinetobacter spp. was the main pathogen in respiratory (38, 45.8%) and bloodstream infections (35, 42.2%), the two main HAI types. Median total costs were significantly greater in patients with HAIs (€1650.4 vs. €4203.2, p < 0.001). Longer LOS (10.0 vs. 18.5 days, p < 0.001) and higher ICU mortality (51.3% vs. 89.3%, p < 0.001) were seen if HAIs were acquired. Patients with ≥ 2 HAIs had the highest median total costs compared to those without HAIs or with a single HAI (€1650.4 vs. €3343.4 vs. €7336.9, p < 0.001). Incremental costs in patients with 1 and ≥ 2 HAIs were €1837.8 (95% CI 1257.8-2417.7, p < 0.001) and €5142.5 (95% CI 4262.3-6022.7, p < 0.001), respectively., Conclusions: This is the first economic evaluation of HAIs in Serbia, showing significant additional costs to our healthcare system. HAIs prolong LOS and influence ICU mortality rates. Larger economic assessments are needed to enhance infection control practices., (© 2023. The Author(s).)
Published: 2023
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17. SARS-CoV-2-associated myopathy with positive anti-Mi-2 antibodies: a case report.

Author: Plavsic A, Arandjelovic S, Peric Popadic A, Bolpacic J, Raskovic S, and Miskovic R
Subjects: Humans, SARS-CoV-2, Autoantibodies, Antibodies, Viral, COVID-19 complications, Muscular Diseases etiology
Abstract: Competing Interests: All authors have disclosed no conflicts of interest.
Published: 2023
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18. Physical Activity in Multiple Sclerosis: Meeting the Guidelines at the Time of the COVID-19 Pandemic.

Author: Pedullà L, Santoyo-Medina C, Novotna K, Moumdjian L, Smedal T, Arntzen EC, van der Linden ML, Learmonth Y, Kalron A, Güngör F, Nedeljkovic U, Kos D, Jonsdottir J, Coote S, and Tacchino A
Subjects: Humans, Pandemics, Quality of Life, Exercise, Multiple Sclerosis, COVID-19 prevention & control
Abstract: Background and Purpose: Regular physical activity (PA) helps to reduce the severity of physical and mental symptoms and improves quality of life in people with multiple sclerosis (PwMS). Based on current evidence and expert opinion, the recent multiple sclerosis guidelines recommend at least 150 minutes/week of PA. This study presents the results of a survey analyzing whether and how PwMS met the guidelines before and during the pandemic., Methods: We developed and disseminated an international online survey between December 2020 and July 2021, investigating changes in self-reported PA type, duration, frequency, and intensity due to the COVID-19 outbreak in PwMS with differing disability levels., Results: Among respondents (n = 3810), 3725 were eligible. The proportion of those who conducted at least one activity decreased with increasing disability level at both time points (pre and during). Overall 60% of respondents met the guidelines before the pandemic (mild: 64.43%; moderate: 51.53%; severe: 39.34%; χ 2(2) = 109.13, P < 0.01); a reduction of approximately 10% occurred during the pandemic in all disability groups (mild: 54.76%; moderate: 42.47%; severe: 29.48%; χ 2(2) = 109.67, P < 0.01). Respondents with higher disability participated more in physical therapy and less in walking, cycling, and running at both time points. Most respondents reported practicing PA at a moderate intensity at both time points; frequency and duration of sessions decreased as disability level increased., Discussion and Conclusions: The percentage of those meeting the guidelines reduced with increasing disability level and during the pandemic. PA type and intensity varied widely across the disability categories. Interventions accounting for disability level are required to enable more PwMS to reap the benefits of PA.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A415 )., Competing Interests: The authors declare no conflict of interest., (Copyright © 2023 Academy of Neurologic Physical Therapy, APTA.)
Published: 2023
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19. COVID-19 infection and vaccination against SARS-CoV-2 in myasthenia gravis.

Author: Peric S, Rankovic M, Bozovic I, Radosavljevic V, Marjanovic I, Basta I, and Lavrnic D
Subjects: Female, Humans, Aged, Male, SARS-CoV-2, Autoantibodies, Vaccination adverse effects, COVID-19 prevention & control, Myasthenia Gravis diagnosis
Abstract: Introduction: Myasthenia gravis (MG) is an autoimmune disease of the neuromuscular junction which is typically presented with muscle weakness and excessive fatigability. Majority of MG patients require long-term immune suppression. Our aim was to analyze the frequency and severity of COVID-19 infection in MG patients, as well as the frequency of vaccinated MG patients against SARS-CoV-2., Methods: We included 125 MG patients from the central Belgrade municipalities-60% females, age at MG onset 50.1 ± 19.7 years, age at testing 61.7 ± 16.8 years, anti-acetylcholine receptor (anti-AChR) positive 78% and muscle specific tyrosine kinase (MuSK) positive 8.6%., Results: One-third of our MG patients had a COVID-19 infection and they were younger compared to those without verified COVID-19. Severe COVID-19 infection was registered in 28% of MG patients, mostly in elder subjects with comorbidities such as cardiac diseases and malignancies. MG worsening was noted in 21% of patients during/after COVID-19 and 42% had COVID-19 sequelae. Majority of MG patients were vaccinated against SARS-CoV-2 (almost 70%). Vaccination was more common among MG patients with diabetes and in those with a milder form of MG. The most common types of vaccines were Sinopharm (42%) and Pfizer-BioNTech (25.6%). Adverse events were observed in 36% of vaccinated patients, with flu-like symptoms (77%) and local reactions (13%) being the most common ones. MG worsening was noticed in 5 (5.8%) patients after vaccination., Conclusion: COVID-19 has placed a significant new burden for MG patients. Elder MG patients and patients with comorbidities are in higher risk of having adverse outcome following SARS-CoV-2 infection. Percentage of vaccinated MG patients was higher than in general Serbian population., (© 2022. The Author(s) under exclusive licence to Belgian Neurological Society.)
Published: 2023
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20. SOD2 rs4880 and GPX1 rs1050450 polymorphisms do not confer risk of COVID-19, but influence inflammation or coagulation parameters in Serbian cohort.

Author: Jerotic D, Ranin J, Bukumiric Z, Djukic T, Coric V, Savic-Radojevic A, Todorovic N, Asanin M, Ercegovac M, Milosevic I, Pljesa-Ercegovac M, Stevanovic G, Matic M, and Simic T
Subjects: Blood Coagulation, Humans, Inflammation genetics, Polymorphism, Single Nucleotide, Serbia, COVID-19 enzymology, COVID-19 genetics, Glutathione Peroxidase genetics, Superoxide Dismutase genetics
Abstract: Objectives: Due to the role of oxidative stress in the pathophysiology of COVID-19, it is biologically plausible that inter-individual differences in patients' clinical manifestations might be affected by antioxidant genetic profile. The aim of our study was to assess the distribution of antioxidant genetic polymorphisms Nrf2 rs6721961, SOD2 rs4880, GPX1 rs1050450, GPX3 rs8177412, and GSTP1 (rs1695 and rs1138272) haplotype in COVID-19 patients and controls, with special emphasis on their association with laboratory biochemical parameters. Methods: The antioxidant genetic polymorphisms were assessed by appropriate PCR methods in 229 COVID-19 patients and 229 matched healthy individuals. Results: Among examined polymorphisms, only GSTP1 haplotype was associated with COVID-19 risk ( p = 0.009). Polymorphisms of SOD2 and GPX1 influenced COVID-19 patients' laboratory biochemical profile: SOD2 *Val allele was associated with increased levels of fibrinogen ( p = 0.040) and ferritin ( p = 0.033), whereas GPX1 *Leu allele was associated with D-dimmer ( p = 0.009). Discussion: Our findings regarding the influence of SOD2 and GPX1 polymorphisms on inflammation and coagulation parameters might be of clinical importance. If confirmed in larger cohorts, these developments could provide a more personalized approach for better recognition of patients prone to thrombosis and those for the need of targeted antiox-idant therapy.
Published: 2022
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21. Impact of the COVID-19 Pandemic on the Outcomes of Transarterial Chemoembolization in Patients with Hepatocellular Carcinoma: A Single Center Experience from a Developing Country.

Author: Filipović A, Mašulović D, Živanović M, Filipović T, Bulatović D, Zakošek M, Nikolić D, and Galun D
Subjects: Humans, Pandemics, Prospective Studies, Developing Countries, Treatment Outcome, Retrospective Studies, Carcinoma, Hepatocellular therapy, Carcinoma, Hepatocellular pathology, Liver Neoplasms therapy, Liver Neoplasms pathology, Chemoembolization, Therapeutic adverse effects, COVID-19 therapy
Abstract: Background and Objectives: Treatment of cancer patients during the COVID-19 pandemic has been a challenge worldwide. In accordance with the current recommendations for hepatocellular carcinoma (HCC) management during the COVID-19 pandemic, loco-regional therapy such as transarterial chemoembolization (TACE) was proposed with the purpose of achieving local tumor control and improving overall survival. The aim of this prospective cohort study was to evaluate the outcomes of TACE treatment in patients with HCC during the COVID-19 pandemic in comparison with the outcomes of patients treated in the pre-pandemic period. Materials and Methods: Between September 2018 and December 2021, 154 patients were managed by serial TACE procedures for different liver tumors. Ninety-seven patients met the study criteria and were divided into two groups: the study group n = 49 (patients treated from May 2020 to December 2021); the control group n = 48 (patients treated from September 2018 to May 2020). Results: The mean waiting time for TACE was significantly longer in the study group compared to the control group (p < 0.001). No significant difference in survival between the groups is noted (log-rank test p = 0.823). In multivariate analysis, the MELD score (HR 1.329, 95% CI 1.140−1.548, p < 0.001) remained a significant predictor of mortality. Conclusions: COVID-19 pandemic did not affect the final outcome of TACE treatment.
Published: 2022
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22. Alteration in Redox Status and Lipoprotein Profile in COVID-19 Patients with Mild, Moderate, and Severe Pneumonia.

Author: Lalosevic M, Kotur-Stevuljevic J, Vekic J, Rizzo M, Kosanovic T, Blagojevic IP, Zeljkovic A, Jeremic D, Mihajlovic M, Petkovic A, Hajdarpasic L, Djordjevic M, Dobrilovic V, Erceg S, Vujcic S, Marjanovic J, Jovanovic JM, Saponjski J, and Bogavac-Stanojevic N
Subjects: Humans, Prospective Studies, SARS-CoV-2, Lipoproteins, Oxidation-Reduction, Antioxidants, COVID-19
Abstract: Background: Metabolic alterations, particularly disorders of lipoprotein metabolism in COVID-19, may affect the course and outcome of the disease. This study aims at evaluating the lipoprotein profile and redox status in SARS-CoV-2 infected patients with different pneumonia severity and their association with lethal outcomes., Methods: The prospective cohort study was performed on 98 COVID-19 patients with mild, moderate, and severe pneumonia. Lipid and inflammatory parameters, lipoprotein subclasses, and redox status biomarkers were determined at the study entry and after one week., Results: Compared to patients with mild and moderate pneumonia, severely ill patients had higher oxidised low-density lipoprotein (oxLDL) and malondialdehyde levels and lower high-density lipoprotein cholesterol (HDL-C) concentrations and paraoxonase 1 activity. Reduction in the proportion of large HDL 2a subclasses with a concomitant increase in the proportion of smallest HDL 3c and small dense LDL (sdLDL) particles was observed in patients with severe disease during the time. However, these changes were reversed in the mild and moderate groups. The results showed a positive association between changes in oxLDL and total antioxidative status. However, prooxidants and antioxidants in plasma were lower in patients with lethal outcomes., Conclusions: Increased levels of oxLDL and sdLDL particles may contribute to the severity of COVID-19. The role of oxidative stress should be clarified in further studies, mainly its association with lethal outcomes., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Miodrag Lalosevic et al.)
Published: 2022
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23. Impact of the COVID-19 Pandemic on Physical Activity and Associated Technology Use in Persons With Multiple Sclerosis: An International RIMS-SIG Mobility Survey Study.

Author: Moumdjian L, Smedal T, Arntzen EC, van der Linden ML, Learmonth Y, Pedullà L, Tacchino A, Novotna K, Kalron A, Yazgan YZ, Nedeljkovic U, Kos D, Jonsdottir J, Santoyo-Medina C, and Coote S
Subjects: Exercise, Humans, Pandemics, Surveys and Questionnaires, Technology, COVID-19, Multiple Sclerosis
Abstract: Objective: To investigate the impact of the COVID-19 pandemic on physical activity in persons with multiple sclerosis (PwMS)., Design: Multicenter international online survey study., Setting: The survey was conducted within 11 participating countries. Each country launched the survey using online platforms from May to July 2021., Participants: This was an electronic survey study targeting PwMS (N=3725)., Intervention: Not applicable., Main Outcome Measures: The survey ascertained physical activity performance and its intensity, the nature of the activities conducted, and the use of technology to support home-based physical activity before and during the pandemic., Results: A total of 3725 respondents completed the survey. Prepandemic, the majority (83%) of respondents reported being physically active, and this decreased to 75% during the pandemic. This change was significant for moderate- and high-intensity activity (P<.0001). Activities carried out in physiotherapy centers, gyms, or pools decreased the most. Walking was the most frequently performed activity prepandemic (27%) and increased during the pandemic (33%). A total of 24% of those inactive during the pandemic had no intention of changing their physical activity behavior post pandemic. A total of 58% of the respondents did not use technology to support physical activity during the pandemic. Of those who did use technology, wearables were most used (24%). Of those currently nonactive (25%) expressed a preference for an in-person format to conduct physical activity post pandemic., Conclusions: Physical activity performance, especially activities at moderate and high intensities, decreased during the pandemic in PwMS compared with prepandemic. Walking and using wearables gained popularity as ways to stay active. As we move toward an endemic COVID-19, a call for action to develop interventions focused on walking programs with specific emphasis on increasing physical activity of PwMS is proposed., (Copyright © 2022 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)
Published: 2022
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24. Thrombosis risk assessment in patients with congenital thrombophilia during COVID - 19 infection.

Author: Kovac M, Mitic G, Milenkovic M, Basaric D, Tomic B, Markovic O, Zdravkovic M, and Ignjatovic V
Subjects: Anticoagulants therapeutic use, COVID-19 Testing, Case-Control Studies, Fibrinolytic Agents therapeutic use, Humans, Prospective Studies, Risk Assessment, COVID-19 complications, Hemostatics therapeutic use, Thrombophilia complications, Thrombosis drug therapy
Abstract: Background: Coagulation dysfunction represents a serious complication in patients during the COVID-19 infection, while fulminant thrombotic complications emerge as critical issues in individuals with severe COVID-19. In addition to a severe clinical presentation, comorbidities and age significantly contribute to the development of thrombotic complications in this disease. However, there is very little data on association of congenital thrombophilia and thrombotic events in the setting of COVID-19. Our study aimed to evaluate the risk of COVID-19 associated thrombosis in patients with congenital thrombophilia., Methods: This prospective, case-control study included patients with confirmed COVID-19 infection, followed 6 months post-confirmation. The final outcome was a symptomatic thrombotic event. In total, 90 COVID-19 patients, 30 with known congenital thrombophilia and 60 patients without thrombophilia within the period July 2020-November 2021, were included in the study. Evaluation of hemostatic parameters including FVIII activity and D-dimer was performed for all patients at 1 month, 3 months and 6 months post-COVID-19 diagnosis., Results: Symptomatic thrombotic events were observed in 7 out of 30 (23 %) COVID-19 patients with thrombophilia, and 12 out of 60 (20 %) without thrombophilia, P = 0.715. In addition, the two patient groups had comparable localization of thrombotic events, time to thrombotic event, effect of antithrombotic treatment and changes in FVIII activity, while D-dimer level were significantly increased in patients without thrombophilia., Conclusion: Our findings suggest that patients with congenital thrombophilia, irrespective of their age, a mild clinical picture and absence of comorbidities, should receive anticoagulant prophylaxis, adjusted based on the specific genetic defect., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)
Published: 2022
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25. Survival of critically ill patients with COVID-19 pneumonia-a single-center experience.

Author: Stojanović M, Miličić B, Purić N, Jeremić J, Jović M, Stojčić M, Omčikus M, Trboljevac N, and Velickovic J
Subjects: Adrenal Cortex Hormones, Critical Illness, Humans, Interleukin-6, Methylprednisolone, Retrospective Studies, COVID-19 mortality, Respiratory Insufficiency therapy, COVID-19 Drug Treatment
Abstract: Introduction: The aim of the study was to determine the survival probability of critically ill patients with COVID-19 infection who needed mechanical ventilation and to determine the efficacy of Tocilizumab use., Methodology: The study was designed as a retrospective analysis of consecutive patients older than 18 years, treated in an intensive care unit. The criteria for admission to the intensive care unit was severe respiratory failure requiring mechanical ventilation. All patients received corticosteroid therapy (methylprednisolone 1-2 mg/kg). Tocilizumab was used at a dose of 8 mg/kg in patients with a severe form of the disease (onset, or developed ARDS), followed by cytokine storm (IL-6 ≥ 40 ng/L and CRP ≥ 50 mg/L)., Results: 88 patients were included in the study. Intrahospital mortality was 48.86%. No statistically significant difference was observed between patients with and without tocilizumab therapy. In the group of patients in whom this therapy was applied, the values of intrahospital survival were 45.7%, while in the group without this therapy the probability of intrahospital survival was only 0.93%. The probability of survival in the group with noninvasive mechanical ventilation (NIV) was 94.7%, while in the group with invasive mechanical ventilation (IMV) 0.78%. The duration of symptoms before hospitalization (RR-1.088 CI 1.025-1.155, p < 0.05), as well as the duration of IMV (RR-0.906 CI 0.841-0.976, p < 0.05), were shown to be an independent predictor of poor outcome., Conclusions: The mortality of patients with the most severe form of respiratory failure caused by COVID-19 infection remains high. Independent predictors of poor outcomes were needed for invasive mechanical ventilation and the duration of symptoms before hospitalization or late initiation of appropriate therapy., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2022 Marina Stojanovic, Biljana Milicic, Nemanja Puric, Jelena Jeremic, Marko Jovic, Milan Stojcic, Maja Omcikus, Nikola Trboljevac, Jelena Velickovic.)
Published: 2022
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26. For Those Who Fight, Fall and Raise Again - Impact of COVID-19 Pandemic on Mental Health of Health Care Providers.

Author: Dunjic-Kostić B, Pantović-Stefanović M, Cvetić T, and Jašović-Gašić M
Subjects: Humans, Mental Health, Cross-Sectional Studies, Health Personnel psychology, Pandemics, COVID-19
Abstract: Background: During the COVID-19 pandemic health care providers found themselves under increased demands in the work environment and in their professional and personal lives which created both physical and mental health challenges. Thus, we aim to provide an integrative review that identifies and summarizes the research published regarding mental health functioning in health care providers, in Serbia, since the beginning of the pandemic., Subjects and Methods: A search of the published literature was conducted using Medline and SCIndex databases, applying key words "COVID-19" and "Serbia". The search was limited to papers published since the beginning of the COVID-19 pandemic until January 2022. Two reviewers independently screened the retrieved papers. The study used pre-defined inclusion and exclusion criteria., Results: We identified eight papers on the subject of mental health functioning in health care providers. The studies were all original research papers with predominantly cross-sectional study design, using online assessments. Sample size varied in number of participants and profile of medical providers (physicians, nurses and medical technicians, community pharmacists). Dominantly, focus of interests of researchers were exploration of levels of anxiety, depression, sleep disturbances, burnout, as well as behavioural changes and environmental influences., Conclusions: The studies related to mental health of medical professionals show the importance of recognizing the psychological challenges posed by health crises caused by COVID-19. They raise awareness of recognizing differences and difficulties between wide range of medical sectors, and appeal for necessity for accessible and professional psychological support. Further studies should address the detailed exploration of the mental health of this specific population, as well as propose strategies needed to balance the challenges posed by the pandemic.
Published: 2022
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27. Post pandemic research priorities: A consensus statement from the HL-PIVOT.

Author: Faghy MA, Arena R, Babu AS, Christle JW, Marzolini S, Popovic D, Vermeesch A, Pronk NP, Stoner L, and Smith A
Subjects: Consensus, Humans, Public Health, Research, COVID-19 epidemiology, Pandemics prevention & control
Abstract: We have been amid unhealthy living and related chronic disease pandemics for several decades. These longstanding crises have troublingly synergized with the coronavirus disease 2019 (COVID-19) pandemic. The need to establish research priorities in response to COVID-19 can be used to address broad health and wellbeing, social and economic impacts for the future is emerging. Accordingly, this paper sets out a series of research priorities that could inform interdisciplinary collaboration between clinical sciences, public health, business, technology, economics, healthcare providers, and the exercise science/sports medicine communities, among others. A five-step methodology was used to generate and evaluate the research priorities with a focus on broad health and well-being impacts. The methodology was deployed by an international and interdisciplinary team from the Healthy Living for Pandemic Event Protection (HL- PIVOT) network. This team were all engaged in responding to the Pandemic either on the 'front-line' and/or in leadership positions ensuring the currency and authenticity of the process. Eight research priorities were identified clustered into two groups: i) Societal & Environmental, and ii) Clinical. Our eight research priorities are presented with insight from previously published research priorities from other groups., Competing Interests: Declaration of Competing Interest Andy Smith is Chair of the Climate Action Change Team of the British Association of Sport and Exercise Sciences. No other authors have conflicts to declare., (Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)
Published: 2022
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28. Proper death certification in the time of the COVID-19 pandemic: Forensic perspective.

Author: Bogdanović M, Atanasijević T, Popović V, Mihailović Z, Radnić B, Petrović T, and Barać A
Subjects: Autopsy, Cause of Death, Humans, Pandemics, SARS-CoV-2, COVID-19 epidemiology, Death Certificates
Abstract: It is well known that the quality of death certificates determines the accuracy of public health mortality data. In the light of a pandemic, forensic pathologists must understand the true definition of a COVID-19 death and the requirements for filling out the death certificate, as these are critical for maintaining accurate and trustworthy mortality data. To determine the scope and evolution of the COVID-19 epidemic, accurate death certification is critical. We believe that COVID-19 should be enlisted under part II or section "note" (if it exists in DC form in a particular country) of the DC in all suicide instances and putrefied bodies with positive autopsy swabs for SARS-CoV-2. In addition to our suggestions for the completion of the DC in some COVID-19 instances, we feel that forensic pathologists should follow the WHO criteria for proper DC completion in COVID-19 cases. Better physician education at this stage of the pandemic would increase adherence to existing (WHO and CDC) standards. As a result, forensic pathologists with competence in death certification could help by teaching treating physicians in this area., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2022 Milenko Bogdanovic, Tatjana Atanasijevic, Vesna Popovic, Zoran Mihailovic, Bojana Radnic, Tijana Petrovic, Aleksandra Barac.)
Published: 2022
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29. Successful Immunomodulatory Treatment of COVID-19 in a Patient With Severe ACTH-Dependent Cushing's Syndrome: A Case Report and Review of Literature.

Author: Popovic B, Radovanovic Spurnic A, Velickovic J, Plavsic A, Jecmenica-Lukic M, Glisic T, Ilic D, Jeremic D, Vratonjic J, Samardzic V, Gluvic Z, and Adzic-Vukicevic T
Subjects: Adrenocorticotropic Hormone, Aged, Female, Humans, Immunoglobulins, Intravenous therapeutic use, Pandemics, COVID-19 complications, Cushing Syndrome complications, Cushing Syndrome diagnosis, Cushing Syndrome drug therapy, COVID-19 Drug Treatment
Abstract: Introduction: Patients with Cushing's syndrome (CS) represent a highly sensitive group during corona virus disease 2019 (COVID-19) pandemic. The effect of multiple comorbidities and immune system supression make the clinical picture complicated and treatment challenging., Case Report: A 70-year-old female was admitted to a covid hospital with a severe form of COVID-19 pneumonia that required oxygen supplementation. Prior to her admission to the hospital she was diagnosed with adrenocorticotropic hormone (ACTH)-dependent CS, and the treatment of hypercortisolism had not been started yet. Since the patient's condition was quickly deteriorating, and with presumend immmune system supression due to CS, we decided on treatement with intraveonus immunoglobulins (IVIg) that enabled quick onset of immunomodulatory effect. All comorbidities were treated with standard of care. The patient's condition quickly stabilized with no direct side effects of a given treatment., Conclusion: Treatment of COVID-19 in patients with CS faces many challenges due to the complexity of comorbidity effects, immunosupression and potential interactions of available medications both for treatment of COVID-19 and CS. So far, there are no guidelines for treatment of COVID-19 in patients with active CS. It is our opinion that immunomodulating therapies like IVIg might be an effective and safe treatment modality in this particularly fragile group of patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Popovic, Radovanovic Spurnic, Velickovic, Plavsic, Jecmenica-Lukic, Glisic, Ilic, Jeremic, Vratonjic, Samardzic, Gluvic and Adzic-Vukicevic.)
Published: 2022
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30. Associations of lockdown stringency and duration with Google searches for mental health terms during the COVID-19 pandemic: A nine-country study.

Author: de la Rosa PA, Cowden RG, de Filippis R, Jerotic S, Nahidi M, Ori D, Orsolini L, Nagendrappa S, Pinto da Costa M, Ransing R, Saeed F, Shoib S, Turan S, Ullah I, Vadivel R, and Ramalho R
Subjects: Communicable Disease Control, Humans, Mental Health, Pandemics, SARS-CoV-2, Search Engine, COVID-19 prevention & control
Abstract: Objectives: We examined the associations of lockdown stringency and duration with Google searches for four mental health concepts (i.e., "Anxiety," "Depression," "Suicide," "Mental Health") in nine countries (i.e., Hungary, India, Iran, Italy, Paraguay, Serbia, South Africa, Spain, Turkey) during the COVID-19 pandemic., Methods: We retrieved national-level data for each country from Google Trends and the Global Panel Database of Pandemic Policies. In our primary analysis, we used data from all countries to estimate a set of multilevel regression models examining associations of overall lockdown stringency and lockdown duration with relative search volumes for each mental health term. We repeated the models after replacing overall lockdown stringency with each of the lockdown stringency components., Results: A negative association was found between overall lockdown stringency and "Depression." Lockdown duration and the most stringent stay-at-home requirements were negatively associated with "Anxiety." Policies that recommended or required the cancelation of public events evidenced negative associations with "Depression," whereas associations between policies that required some or all levels of schooling to close and "Depression" were positive. Policies that recommended or required workplaces to close and those that enforced quarantines on non-citizens arriving from high-risk regions or closed borders entirely were negatively associated with "Suicide.", Conclusions: Lockdown duration and some lockdown policies during the COVID-19 pandemic were generally associated with significantly lower, rather than higher, Google searches for selected mental health terms. These findings could be used alongside other evidence to develop future lockdown strategies that are sensitive to mental health issues during public health crises., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Published: 2022
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31. European Society of Cardiology guidance for the diagnosis and management of cardiovascular disease during the COVID-19 pandemic: part 1-epidemiology, pathophysiology, and diagnosis.

Author: Baigent C, Windecker S, Andreini D, Arbelo E, Barbato E, Bartorelli AL, Baumbach A, Behr ER, Berti S, Bueno H, Capodanno D, Cappato R, Chieffo A, Collet JP, Cuisset T, de Simone G, Delgado V, Dendale P, Dudek D, Edvardsen T, Elvan A, González-Juanatey JR, Gori M, Grobbee D, Guzik TJ, Halvorsen S, Haude M, Heidbuchel H, Hindricks G, Ibanez B, Karam N, Katus H, Klok FA, Konstantinides SV, Landmesser U, Leclercq C, Leonardi S, Lettino M, Marenzi G, Mauri J, Metra M, Morici N, Mueller C, Petronio AS, Polovina MM, Potpara T, Praz F, Prendergast B, Prescott E, Price S, Pruszczyk P, Rodríguez-Leor O, Roffi M, Romaguera R, Rosenkranz S, Sarkozy A, Scherrenberg M, Seferovic P, Senni M, Spera FR, Stefanini G, Thiele H, Tomasoni D, Torracca L, Touyz RM, Wilde AA, and Williams B
Subjects: Humans, Pandemics, Prospective Studies, COVID-19 diagnosis, COVID-19 epidemiology, Cardiology, Cardiovascular Diseases diagnosis, Cardiovascular Diseases epidemiology, Cardiovascular Diseases therapy
Abstract: Aims: Since its emergence in early 2020, the novel severe acute respiratory syndrome coronavirus 2 causing coronavirus disease 2019 (COVID-19) has reached pandemic levels, and there have been repeated outbreaks across the globe. The aim of this two-part series is to provide practical knowledge and guidance to aid clinicians in the diagnosis and management of cardiovascular disease (CVD) in association with COVID-19., Methods and Results: A narrative literature review of the available evidence has been performed, and the resulting information has been organized into two parts. The first, reported here, focuses on the epidemiology, pathophysiology, and diagnosis of cardiovascular (CV) conditions that may be manifest in patients with COVID-19. The second part, which will follow in a later edition of the journal, addresses the topics of care pathways, treatment, and follow-up of CV conditions in patients with COVID-19., Conclusion: This comprehensive review is not a formal guideline but rather a document that provides a summary of current knowledge and guidance to practicing clinicians managing patients with CVD and COVID-19. The recommendations are mainly the result of observations and personal experience from healthcare providers. Therefore, the information provided here may be subject to change with increasing knowledge, evidence from prospective studies, and changes in the pandemic. Likewise, the guidance provided in the document should not interfere with recommendations provided by local and national healthcare authorities., (This article has been co-published with permission in the European Heart Journal and Cardiovascular Research. © The European Society of Cardiology 2021. All rights reserved. The articles are identical except for minor stylistic and spelling differences in keeping with each journal's style. Either citation can be used when citing this article.)
Published: 2022
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32. The use of remote monitoring of cardiac implantable devices during the COVID-19 pandemic: an EHRA physician survey.

Author: Simovic S, Providencia R, Barra S, Kircanski B, Guerra JM, Conte G, Duncker D, Marijon E, Anic A, and Boveda S
Subjects: Humans, Pandemics, SARS-CoV-2, Surveys and Questionnaires, COVID-19 epidemiology, Defibrillators, Implantable, Physicians
Abstract: It is unclear to what extent the COVID-19 pandemic has influenced the use of remote monitoring (RM) of cardiac implantable electronic devices (CIEDs). The present physician-based European Heart Rhythm Association (EHRA) survey aimed to assess the influence of the COVID-19 pandemic on RM of CIEDs among EHRA members and how it changed the current practice. The survey comprised 27 questions focusing on RM use before and during the pandemic. Questions focused on the impact of COVID-19 on the frequency of in-office visits, data filtering, reasons for initiating in-person visits, underutilization of RM during COVID-19, and RM reimbursement. A total of 160 participants from 28 countries completed the survey. Compared to the pre-pandemic period, there was a significant increase in the use of RM in patients with pacemakers (PMs) and implantable loop recorders (ILRs) during the COVID-19 pandemic (PM 24.2 vs. 39.9%, P = 0.002; ILRs 61.5 vs. 73.5%, P = 0.028), while there was a trend towards higher utilization of RM for cardiac resynchronization therapy-pacemaker (CRT-P) devices during the pandemic (44.5 vs. 55%, P = 0.063). The use of RM with implantable cardioverter-defibrillators (ICDs) and CRT-defibrillator (CRT-D) did not significantly change during the pandemic (ICD 65.2 vs. 69.6%, P = 0.408; CRT-D 65.2 vs. 68.8%, P = 0.513). The frequency of in-office visits was significantly lower during the pandemic (P < 0.001). Nearly two-thirds of participants (57 out of 87 respondents), established new RM connections for CIEDs implanted before the pandemic with 33.3% (n = 29) delivering RM transmitters to the patient's home address, and the remaining 32.1% (n = 28) activating RM connections during an in-office visit. The results of this survey suggest that the crisis caused by COVID-19 has led to a significant increase in the use of RM of CIEDs., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.)
Published: 2022
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33. D-dimer, CRP, PCT, and IL-6 Levels at Admission to ICU Can Predict In-Hospital Mortality in Patients with COVID-19 Pneumonia.

Author: Milenkovic M, Hadzibegovic A, Kovac M, Jovanovic B, Stanisavljevic J, Djikic M, Sijan D, Ladjevic N, Palibrk I, Djukanovic M, Velickovic J, Ratkovic S, Brajkovic M, Popadic V, Klasnja S, Toskovic B, Zdravkovic D, Crnokrak B, Markovic O, Bjekic-Macut J, Aleksic A, Petricevic S, Memon L, Milojevic A, and Zdravkovic M
Subjects: Aged, Female, Humans, Male, Middle Aged, Retrospective Studies, C-Reactive Protein metabolism, COVID-19 blood, COVID-19 mortality, COVID-19 therapy, Fibrin Fibrinogen Degradation Products metabolism, Hospital Mortality, Intensive Care Units, Interleukin-6 blood, Patient Admission, SARS-CoV-2 metabolism
Abstract: Introduction: Health care workers have had a challenging task since the COVID-19 outbreak. Prompt and effective predictors of clinical outcomes are crucial to recognize potentially critically ill patients and improve the management of COVID-19 patients. The aim of this study was to identify potential predictors of clinical outcomes in critically ill COVID-19 patients., Methods: The study was designed as a retrospective cohort study, which included 318 patients treated from June 2020 to January 2021 in the Intensive Care Unit (ICU) of the Clinical Hospital Center "Bezanijska Kosa" in Belgrade, Serbia. The verified diagnosis of COVID-19 disease, patients over 18 years of age, and the hospitalization in ICU were the criteria for inclusion in the study. The optimal cutoff value of D-dimer, CRP, IL-6, and PCT for predicting hospital mortality was determined using the ROC curve, while the Kaplan-Meier method and log-rank test were used to assess survival., Results: The study included 318 patients: 219 (68.9%) were male and 99 (31.1%) female. The median age of patients was 69 (60-77) years. During the treatment, 195 (61.3%) patients died, thereof 130 male (66.7%) and 65 female (33.3%). 123 (38.7%) patients were discharged from hospital treatment. The cutoff value of IL-6 for in-hospital death prediction was 74.98 pg/mL (Sn 69.7%, Sp 62.7%); cutoff value of CRP was 81 mg/L (Sn 60.7%, Sp 60%); cutoff value of procalcitonin was 0.56 ng/mL (Sn 81.1%, Sp 76%); and cutoff value of D-dimer was 760 ng/mL FEU (Sn 63.4%, Sp 57.1%). IL-6 ≥ 74.98 pg/mL, CRP ≥ 81 mg/L, PCT ≥ 0.56 ng/mL, and D-dimer ≥ 760 ng/mL were statistically significant predictors of in-hospital mortality., Conclusion: IL-6 ≥ 74.98 pg/mL, CRP values ≥ 81 mg/L, procalcitonin ≥ 0.56 ng/mL, and D-dimer ≥ 760 ng/mL could effectively predict in-hospital mortality in COVID-19 patients., Competing Interests: The authors declare that there is no conflict of interest regarding the publication of this paper., (Copyright © 2022 Marija Milenkovic et al.)
Published: 2022
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34. SARS-CoV-2 behavior, through the eyes of a perinatologist?

Author: Gojnić M
Subjects: Humans, Perinatology, COVID-19, SARS-CoV-2
Published: 2022
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35. ESCMID COVID-19 living guidelines: drug treatment and clinical management.

Author: Bartoletti M, Azap O, Barac A, Bussini L, Ergonul O, Krause R, Paño-Pardo JR, Power NR, Sibani M, Szabo BG, Tsiodras S, Verweij PE, Zollner-Schwetz I, and Rodríguez-Baño J
Subjects: Adult, Antibodies, Monoclonal, Humanized therapeutic use, Antibodies, Neutralizing therapeutic use, Humans, Immunization, Passive, Practice Guidelines as Topic, SARS-CoV-2, COVID-19 Serotherapy, Antiviral Agents therapeutic use, COVID-19 therapy, COVID-19 Drug Treatment
Abstract: Scope: In January 2021, the ESCMID Executive Committee decided to launch a new initiative to develop ESCMID guidelines on several COVID-19-related issues, including treatment of COVID-19., Methods: An ESCMID COVID-19 guidelines task force was established by the ESCMID Executive Committee. A small group was established, half appointed by the chair, and the remaining selected with an open call. Each panel met virtually once a week. For all decisions, a simple majority vote was used. A long list of clinical questions using the PICO (population, intervention, comparison, outcome) format was developed at the beginning of the process. For each PICO, two panel members performed a literature search with a third panellist involved in case of inconsistent results. Voting was based on the GRADE approach., Questions Addressed by the Guideline and Recommendations: A synthesis of the available evidence and recommendations is provided for each of the 15 PICOs, which cover use of hydroxychloroquine, bamlanivimab alone or in combination with etesevimab, casirivimab combined with imdevimab, ivermectin, azithromycin and empirical antibiotics, colchicine, corticosteroids, convalescent plasma, favipiravir, remdesivir, tocilizumab and interferon β-1a, as well as the utility of antifungal prophylaxis and enoxaparin. In general, the panel recommended against the use of hydroxychloroquine, ivermectin, azithromycin, colchicine and interferon β-1a. Conditional recommendations were given for the use of monoclonal antibodies in high-risk outpatients with mild-moderate COVID-19, and remdesivir. There was insufficient evidence to make a recommendation for use of favipiravir and antifungal prophylaxis, and it was recommended that antibiotics should not be routinely prescribed in patients with COVID-19 unless bacterial coinfection or secondary infection is suspected or confirmed. Tocilizumab and corticosteroids were recommended for treatment of severe COVID-19 but not in outpatients with non-severe COVID-19., Scope: The aim of the present guidance is to provide evidence-based recommendations for management of adults with coronavirus disease 2019 (COVID-19). More specifically, the goal is to aid clinicians managing patients with COVID-19 at various levels of severity including outpatients, hospitalized patients, and those admitted to intensive care unit. Considering the composition of the panel, mostly clinical microbiologists or infectious disease specialists with no pulmonology or intensive care background, we focus only on pharmacological treatment and do not give recommendations on oxygen supplement/support. Similarly, as no paediatricians were included in the panel; the recommendations are only for adult patients with COVID-19. Considering the current literature, no guidance was given for special populations such as the immunocompromised., (Copyright © 2021 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)
Published: 2022
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36. Prevalence of Gastrointestinal Symptoms in Severe Acute Respiratory Syndrome Coronavirus 2 Infection: Results of the Prospective Controlled Multinational GI-COVID-19 Study.

Author: Marasco G, Cremon C, Barbaro MR, Salvi D, Cacciari G, Kagramanova A, Bordin D, Drug V, Miftode E, Fusaroli P, Mohamed SY, Ricci C, Bellini M, Rahman MM, Melcarne L, Santos J, Lobo B, Bor S, Yapali S, Akyol D, Sapmaz FP, Urun YY, Eskazan T, Celebi A, Kacmaz H, Ebik B, Binicier HC, Bugdayci MS, Yağcı MB, Pullukcu H, Kaya BY, Tureyen A, Hatemi İ, Koc ES, Sirin G, Calıskan AR, Bengi G, Alıs EE, Lukic S, Trajkovska M, Hod K, Dumitrascu D, Pietrangelo A, Corradini E, Simren M, Sjolund J, Tornkvist N, Ghoshal UC, Kolokolnikova O, Colecchia A, Serra J, Maconi G, De Giorgio R, Danese S, Portincasa P, Di Stefano M, Maggio M, Philippou E, Lee YY, Venturi A, Borghi C, Zoli M, Gionchetti P, Viale P, Stanghellini V, and Barbara G
Subjects: Egypt epidemiology, Europe epidemiology, Female, Gastroenteritis etiology, Humans, Interviews as Topic, Male, Middle Aged, Prevalence, Prospective Studies, Russia epidemiology, Surveys and Questionnaires, COVID-19 complications, Gastroenteritis epidemiology, SARS-CoV-2
Abstract: Introduction: Gastrointestinal (GI) symptoms in coronavirus-19 disease (COVID-19) have been reported with great variability and without standardization. In hospitalized patients, we aimed to evaluate the prevalence of GI symptoms, factors associated with their occurrence, and variation at 1 month., Methods: The GI-COVID-19 is a prospective, multicenter, controlled study. Patients with and without COVID-19 diagnosis were recruited at hospital admission and asked for GI symptoms at admission and after 1 month, using the validated Gastrointestinal Symptom Rating Scale questionnaire., Results: The study included 2036 hospitalized patients. A total of 871 patients (575 COVID+ and 296 COVID-) were included for the primary analysis. GI symptoms occurred more frequently in patients with COVID-19 (59.7%; 343/575 patients) than in the control group (43.2%; 128/296 patients) (P < 0.001). Patients with COVID-19 complained of higher presence or intensity of nausea, diarrhea, loose stools, and urgency as compared with controls. At a 1-month follow-up, a reduction in the presence or intensity of GI symptoms was found in COVID-19 patients with GI symptoms at hospital admission. Nausea remained increased over controls. Factors significantly associated with nausea persistence in COVID-19 were female sex, high body mass index, the presence of dyspnea, and increased C-reactive protein levels., Discussion: The prevalence of GI symptoms in hospitalized patients with COVID-19 is higher than previously reported. Systemic and respiratory symptoms are often associated with GI complaints. Nausea may persist after the resolution of COVID-19 infection., (Copyright © 2021 by The American College of Gastroenterology.)
Published: 2022
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37. Demographic and Clinical Factors Associated with Reactivity of Anti-SARS-CoV-2 Antibodies in Serbian Convalescent Plasma Donors.

Author: Grujić J, Bujandrić N, Budakov-Obradović Z, Dolinaj V, Bogdan D, Savić N, Cabezas-Cruz A, Mijatović D, Simin V, Anđelić N, and Banović P
Subjects: Aged, Antibodies, Viral, Blood Donors, Demography, Humans, Immunization, Passive, Male, SARS-CoV-2, COVID-19 Serotherapy, COVID-19 therapy
Abstract: Passive immunotherapy with convalescent COVID-19 plasma (CCP) is used as a therapeutic procedure in many countries, including Serbia. In this study, we analyzed the association between demographic factors, COVID-19 severity and the reactivity of anti-SARS-CoV-2 antibodies (Abs) in Serbian CCP donors. Individuals ( n = 468) recovered from confirmed SARS-CoV-2 infection, and who were willing to donate their plasma for passive immunization of COVID-19 patients were enrolled in the study. Plasma samples were tested for the presence of IgG reactive to SARS-CoV-2 spike glycoprotein (S1) and nucleocapsid antigens. Individuals were characterized according to age, gender, comorbidities, COVID-19 severity, ABO blood type and RhD factor. Total of 420 candidates (420/468; 89.74%) reached the levels of anti-SARS-CoV-2 IgG that qualified them for inclusion in CCP donation program. Further statistical analysis showed that male individuals ( p = 0.034), older age groups ( p < 0.001), existence of hypertension ( p = 0.008), and severe COVID-19 ( p = 0.000) are linked with higher levels of anti-SARS-CoV-2 Abs. These findings will guide the selection of CCP donors in Serbia. Further studies need to be conducted to assess the neutralization potency and clinical efficiency of CCP collected from Serbian donors with high anti-SARS-CoV-2 IgG reactivity.
Published: 2021
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38. Cardiovascular disease and COVID-19: a consensus paper from the ESC Working Group on Coronary Pathophysiology & Microcirculation, ESC Working Group on Thrombosis and the Association for Acute CardioVascular Care (ACVC), in collaboration with the European Heart Rhythm Association (EHRA).

Author: Cenko E, Badimon L, Bugiardini R, Claeys MJ, De Luca G, de Wit C, Derumeaux G, Dorobantu M, Duncker DJ, Eringa EC, Gorog DA, Hassager C, Heinzel FR, Huber K, Manfrini O, Milicic D, Oikonomou E, Padro T, Trifunovic-Zamaklar D, Vasiljevic-Pokrajcic Z, Vavlukis M, Vilahur G, and Tousoulis D
Subjects: Angiotensin-Converting Enzyme 2 metabolism, COVID-19 enzymology, COVID-19 etiology, COVID-19 physiopathology, COVID-19 therapy, Cardiometabolic Risk Factors, Cardiovascular Diseases enzymology, Cardiovascular Diseases physiopathology, Clinical Trials as Topic, Humans, Inflammation complications, Inflammation virology, Microcirculation, Sex Characteristics, Post-Acute COVID-19 Syndrome, COVID-19 complications, Cardiovascular Diseases virology
Abstract: The cardiovascular system is significantly affected in coronavirus disease-19 (COVID-19). Microvascular injury, endothelial dysfunction, and thrombosis resulting from viral infection or indirectly related to the intense systemic inflammatory and immune responses are characteristic features of severe COVID-19. Pre-existing cardiovascular disease and viral load are linked to myocardial injury and worse outcomes. The vascular response to cytokine production and the interaction between severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and angiotensin-converting enzyme 2 receptor may lead to a significant reduction in cardiac contractility and subsequent myocardial dysfunction. In addition, a considerable proportion of patients who have been infected with SARS-CoV-2 do not fully recover and continue to experience a large number of symptoms and post-acute complications in the absence of a detectable viral infection. This conditions often referred to as 'post-acute COVID-19' may have multiple causes. Viral reservoirs or lingering fragments of viral RNA or proteins contribute to the condition. Systemic inflammatory response to COVID-19 has the potential to increase myocardial fibrosis which in turn may impair cardiac remodelling. Here, we summarize the current knowledge of cardiovascular injury and post-acute sequelae of COVID-19. As the pandemic continues and new variants emerge, we can advance our knowledge of the underlying mechanisms only by integrating our understanding of the pathophysiology with the corresponding clinical findings. Identification of new biomarkers of cardiovascular complications, and development of effective treatments for COVID-19 infection are of crucial importance., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.)
Published: 2021
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39. COVID-19 pandemic and allergen immunotherapy-an EAACI survey.

Author: Pfaar O, Agache I, Bonini M, Brough HA, Chivato T, Del Giacco SR, Gawlik R, Gelincik A, Hoffmann-Sommergruber K, Jutel M, Klimek L, Knol EF, Lauerma A, Ollert M, O'Mahony L, Mortz CG, Palomares O, Riggioni C, Schwarze J, Skypala I, Torres MJ, Untersmayr E, Walusiak-Skorupa J, Chaker A, Giovannini M, Heffler E, Jensen-Jarolim E, Quecchia C, Sandoval-Ruballos M, Sahiner U, Tomić Spirić V, and Alvaro-Lozano M
Subjects: Desensitization, Immunologic, Humans, Retrospective Studies, SARS-CoV-2, Surveys and Questionnaires, COVID-19, Pandemics
Abstract: Background: As in many fields of medical care, the coronavirus disease 2019 (COVID-19) resulted in an increased uncertainty regarding the safety of allergen immunotherapy (AIT). Therefore, the European Academy of Allergy and Clinical Immunology (EAACI) aimed to analyze the situation in different countries and to systematically collect all information available regarding tolerability and possible amendments in daily practice of sublingual AIT (SLIT), subcutaneous AIT (SCIT) for inhalant allergies and venom AIT., Methods: Under the framework of the EAACI, a panel of experts in the field of AIT coordinated by the Immunotherapy Interest Group set-up a web-based retrospective survey (SurveyMonkey ® ) including 27 standardized questions on practical and safety aspects on AIT in worldwide clinical routine., Results: 417 respondents providing AIT to their patients in daily routine answered the survey. For patients (without any current symptoms to suspect COVID-19), 60% of the respondents informed of not having initiated SCIT (40% venom AIT, 35% SLIT) whereas for the maintenance phase of AIT, SCIT was performed by 75% of the respondents (74% venom AIT, 89% SLIT). No tolerability concern arises from this preliminary analysis. 16 physicians reported having performed AIT despite (early) symptoms of COVID-19 and/or a positive test result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)., Conclusions: This first international retrospective survey in atopic diseases investigated practical aspects and tolerability of AIT during the COVID-19 pandemic and gave no concerns regarding reduced tolerability under real-life circumstances. However, the data indicate an undertreatment of AIT, which may be temporary, but could have a long-lasting negative impact on the clinical care of allergic patients., (© 2021 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.)
Published: 2021
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40. COVID-19 Presented with Deep Vein Thrombosis in a Patient with Paroxysmal Nocturnal Haemoglobinuria.

Author: Pravdic Z, Mitrovic M, Bogdanovic A, Virijevic M, Sabljic N, Pantic N, and Vukovic NS
Subjects: Adult, Antibodies, Monoclonal, Humanized therapeutic use, Anticoagulants therapeutic use, Complement Inactivating Agents therapeutic use, Hemoglobinuria, Paroxysmal drug therapy, Humans, Male, Venous Thrombosis diagnosis, Warfarin therapeutic use, COVID-19 complications, COVID-19 diagnosis, Hemoglobinuria, Paroxysmal complications, SARS-CoV-2, Venous Thrombosis complications
Abstract: Paroxysmal nocturnal haemoglobinuria (PNH) is a rare, acquired clonal haematological disease characterized by complement-mediated haemolysis, bone marrow failure and venous thrombosis. Anticomplement therapy eculizumab improves survival and reduces complications. Severe acute respiratory distress syndrome corona virus 2 (SARS-CoV-2) disease 2019 (COVID-19) is associated with high incidence of both venous and arterial thrombosis in hospitalized patients with pneumonia. Deep venous thrombosis (DVT) as the presenting symptom of COVID-19 is a rare event. We describe a well-controlled PNH patient on eculizumab for more than 5 years who presented with DVT, while on warfarin, as the first sign of COVID-19. To our knowledge, this is the first described case of DVT in a PNH patient with COVID-19., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)
Published: 2021
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41. Acute stroke care during the COVID-19 pandemic.

Author: Padjen V
Subjects: Humans, Pandemics, SARS-CoV-2, Thrombectomy, COVID-19, Stroke epidemiology, Stroke therapy
Published: 2021
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42. Mucormycosis in patients with COVID-19: A cross-sectional descriptive multicentre study from Iran.

Author: Pakdel F, Ahmadikia K, Salehi M, Tabari A, Jafari R, Mehrparvar G, Rezaie Y, Rajaeih S, Alijani N, Barac A, Abdollahi A, and Khodavaisy S
Subjects: Adolescent, Adult, Aged, Amphotericin B therapeutic use, COVID-19 pathology, Caspofungin therapeutic use, Comorbidity, Cross-Sectional Studies, Diabetes Complications microbiology, Diabetes Complications mortality, Diabetes Mellitus pathology, Drug Therapy, Combination, Female, Humans, Iran, Male, Middle Aged, Mucormycosis pathology, Respiratory Distress Syndrome microbiology, Respiratory Distress Syndrome pathology, Triazoles therapeutic use, Young Adult, COVID-19 Drug Treatment, Antifungal Agents therapeutic use, COVID-19 complications, Coinfection, Mucormycosis drug therapy, Mucormycosis mortality, Respiratory Distress Syndrome mortality
Abstract: Purpose: The aim of the study was to report clinical features, contributing factors and outcome of patients with coronavirus disease 2019 (COVID-19)-associated mucormycosis (CAM)., Methods: A cross-sectional descriptive multicentre study was conducted on patients with biopsy-proven mucormycosis with RT-PCR-confirmed COVID-19 from April to September 2020. Demographics, the time interval between COVID-19 and mucormycosis, underlying systemic diseases, clinical features, course of disease and outcomes were collected and analysed., Results: Fifteen patients with COVID-19 and rhino-orbital mucormycosis were observed. The median age of patients was 52 years (range 14-71), and 66% were male. The median interval time between COVID-19 disease and diagnosis of mucormycosis was seven (range: 1-37) days. Among all, 13 patients (86%) had diabetes mellitus, while 7 (46.6%) previously received intravenous corticosteroid therapy. Five patients (33%) underwent orbital exenteration, while seven (47%) patients died from mucormycosis. Six patients (40%) received combined antifungal therapy and none that received combined antifungal therapy died., Conclusion: Clinicians should be aware that mucormycosis may be complication of COVID-19 in high-risk patients. Poor control of diabetes mellitus is an important predisposing factor for CAM. Systematic surveillance for control of diabetes mellitus and educating physician about the early diagnosis of CAM are suggested., (© 2021 Wiley-VCH GmbH.)
Published: 2021
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43. Maintenance of Acute Stroke Care Service During the COVID-19 Pandemic Lockdown.

Author: Altersberger VL, Stolze LJ, Heldner MR, Henon H, Martinez-Majander N, Hametner C, Nordanstig A, Zini A, Nannoni S, Gonçalves B, Nolte CH, Baumgartner P, Kastrup A, Papanagiotou P, Kägi G, Leker RR, Zedde M, Padovani A, Pezzini A, Padjen V, Cereda CW, Ntaios G, Bonati LH, Rinkel LA, Fischer U, Scheitz JF, Wegener S, Turc G, Michel P, Gentile M, Rentzos A, Ringleb PA, Curtze S, Cordonnier C, Arnold M, Nederkoorn PJ, Engelter ST, and Gensicke H
Subjects: Aged, Aged, 80 and over, Cardiology organization & administration, Cohort Studies, Critical Care, Europe epidemiology, Female, Humans, Male, Middle Aged, Pandemics, Physical Distancing, Registries, Severity of Illness Index, Stroke prevention & control, Thrombolytic Therapy, Time-to-Treatment, Treatment Outcome, COVID-19 epidemiology, Hospitalization, Stroke epidemiology, Stroke therapy
Abstract: [Figure: see text].
Published: 2021
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44. Clinical management of patients with genetic obesity during COVID-19 pandemic: position paper of the ESE Growth & Genetic Obesity COVID-19 Study Group and Rare Endo-ERN main thematic group on Growth and Obesity.

Author: De Groot CJ, Poitou Bernert C, Coupaye M, Clement K, Paschou SA, Charmandari E, Kanaka-Gantenbein C, Wabitsch M, Buddingh EP, Nieuwenhuijsen B, Marina L, Johannsson G, and Van Den Akker ELT
Subjects: Anxiety, Healthy Lifestyle, Humans, Obesity epidemiology, Obesity genetics, COVID-19, Disease Management, Obesity therapy, Pandemics
Abstract: This article aims to provide guidance on prevention and treatment of COVID-19 in patients with genetic obesity. Key principals of the management of patients with genetic obesity during COVID-19 pandemic for patients that have contracted COVID-19 are to be aware of: possible adrenal insufficiency (e.g., POMC deficiency, PWS); a more severe course in patients with concomitant immunodeficiency (e.g., LEP and LEPR deficiency), although defective leptin signalling could also be protective against the pro-inflammatory phenotype of COVID-19; disease severity being masked by insufficient awareness of symptoms in syndromic obesity patients with intellectual deficit (in particular PWS); to adjust medication dose to increased body size, preferably use dosing in m2; the high risk of malnutrition in patients with Sars-Cov2 infection, even in case of obesity. Key principals of the obesity management during the pandemic are to strive for optimal obesity management and a healthy lifestyle within the possibilities of the regulations to prevent weight (re)gain and to address anxiety within consultations, since prevalence of anxiety for COVID-19 is underestimated.
Published: 2021
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45. Clinical and molecular practice of European thoracic pathology laboratories during the COVID-19 pandemic. The past and the near future.

Author: Hofman P, Ilié M, Chamorey E, Brest P, Schiappa R, Nakache V, Antoine M, Barberis M, Begueret H, Bibeau F, Bonnetaud C, Boström P, Brousset P, Bubendorf L, Carvalho L, Cathomas G, Cazes A, Chalabreysse L, Chenard MP, Copin MC, Côté JF, Damotte D, de Leval L, Delongova P, Thomas de Montpreville V, de Muret A, Dema A, Dietmaier W, Evert M, Fabre A, Forest F, Foulet A, Garcia S, Garcia-Martos M, Gibault L, Gorkiewicz G, Jonigk D, Gosney J, Hofman A, Kern I, Kerr K, Kossai M, Kriegsmann M, Lassalle S, Long-Mira E, Lupo A, Mamilos A, Matěj R, Meilleroux J, Ortiz-Villalón C, Panico L, Panizo A, Papotti M, Pauwels P, Pelosi G, Penault-Llorca F, Pop O, Poté N, Cajal SRY, Sabourin JC, Salmon I, Sajin M, Savic-Prince S, Schildhaus HU, Schirmacher P, Serre I, Shaw E, Sizaret D, Stenzinger A, Stojsic J, Thunnissen E, Timens W, Troncone G, Werlein C, Wolff H, Berthet JP, Benzaquen J, Marquette CH, Hofman V, and Calabrese F
Subjects: Biological Specimen Banks organization & administration, Biological Specimen Banks statistics & numerical data, COVID-19 epidemiology, COVID-19 virology, Clinical Laboratory Services trends, Containment of Biohazards statistics & numerical data, Disease Outbreaks, Europe epidemiology, Forecasting, Humans, Pandemics, Pathology, Clinical methods, Pathology, Clinical trends, Pathology, Molecular methods, Pathology, Molecular trends, SARS-CoV-2 isolation & purification, SARS-CoV-2 physiology, Specimen Handling methods, Specimen Handling statistics & numerical data, Thoracic Diseases therapy, COVID-19 prevention & control, Clinical Laboratory Services statistics & numerical data, Pathology, Clinical statistics & numerical data, Pathology, Molecular statistics & numerical data, Surveys and Questionnaires, Thoracic Diseases diagnosis
Abstract: Background: This study evaluated the consequences in Europe of the COVID-19 outbreak on pathology laboratories orientated toward the diagnosis of thoracic diseases., Materials and Methods: A survey was sent to 71 pathology laboratories from 21 European countries. The questionnaire requested information concerning the organization of biosafety, the clinical and molecular pathology, the biobanking, the workload, the associated research into COVID-19, and the organization of education and training during the COVID-19 crisis, from 15 March to 31 May 2020, compared with the same period in 2019., Results: Questionnaires were returned from 53/71 (75%) laboratories from 18 European countries. The biosafety procedures were heterogeneous. The workload in clinical and molecular pathology decreased dramatically by 31% (range, 3%-55%) and 26% (range, 7%-62%), respectively. According to the professional category, between 28% and 41% of the staff members were not present in the laboratories but did teleworking. A total of 70% of the laboratories developed virtual meetings for the training of residents and junior pathologists. During the period of study, none of the staff members with confirmed COVID-19 became infected as a result of handling samples., Conclusions: The COVID-19 pandemic has had a strong impact on most of the European pathology laboratories included in this study. Urgent implementation of several changes to the organization of most of these laboratories, notably to better harmonize biosafety procedures, was noted at the onset of the pandemic and maintained in the event of a new wave of infection occurring in Europe., Competing Interests: Disclosure The authors have declared no conflicts of interest. Data sharing Anonymized participant-level data are available for investigators. Ethical approval The study complied with the law of January 1978 (78-17) relating to computing, data, and freedom known as ‘computing and freedoms’ and with rules 2016/679 of the European Parliament (of 25 May 2018) concerning the general data protection regulation (GDPR; MR004). The study was registered by the Nice University Hospital (R04-39) and filed on the Health Data Hub website (7 July 2020) (www.health-data-hub.fr/depot)., (Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Published: 2021
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46. Impact of the COVID-19 Pandemic on Surgical Oncology in Europe: Results of a European Survey.

Author: Stöss C, Steffani M, Pergolini I, Hartmann D, Radenkovic D, Novotny A, Friess H, and Müller MW
Subjects: Adult, Ambulatory Care statistics & numerical data, COVID-19 diagnosis, Chemotherapy, Adjuvant statistics & numerical data, Cross-Sectional Studies, Europe epidemiology, Female, Humans, Male, Middle Aged, Neoplasms diagnosis, Neoplasms drug therapy, Operating Rooms statistics & numerical data, Surveys and Questionnaires, Survival Rate, Time-to-Treatment statistics & numerical data, COVID-19 epidemiology, Hospital Bed Capacity statistics & numerical data, Neoplasms surgery, Oncology Service, Hospital statistics & numerical data, Surgical Oncology statistics & numerical data
Abstract: Background: The first COVID-19 pandemic wave hit most of the health-care systems worldwide. The present survey aimed to provide a European overview on the COVID-19 impact on surgical oncology., Methods: This anonymous online survey was accessible from April 24 to May 11, 2020, for surgeons (n = 298) who were contacted by the surgical society European Digestive Surgery. The survey was completed by 88 surgeons (29.2%) from 69 different departments. The responses per department were evaluated., Results: Of the departments, 88.4% (n = 61/69) reported a lower volume of patients in the outpatient clinic; 69.1% (n = 47/68) and 75.0% (n = 51/68) reported a reduction in hospital bed and the operating room capacity, respectively. As a result, the participants reported an average reduction of 29.3% for all types of oncological resections surveyed in this questionnaire. The strongest reduction was observed for oncological resections of hepato-pancreatico-biliary (HPB) cancers. Of the interviewed surgeons, 68.7% (n = 46/67) agreed that survival outcomes will be negatively impacted by the pandemic., Conclusion: The first COVID-19 pandemic wave had a significant impact on surgical oncology in Europe. The surveyed surgeons expect an increase in the number of unresectable cancers as well as poorer survival outcomes due to cancellations of follow-ups and postponements of surgeries., (© 2021 S. Karger AG, Basel.)
Published: 2021
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47. Guidance for the Management of Patients with Vascular Disease or Cardiovascular Risk Factors and COVID-19: Position Paper from VAS-European Independent Foundation in Angiology/Vascular Medicine.

Author: Gerotziafas GT, Catalano M, Colgan MP, Pecsvarady Z, Wautrecht JC, Fazeli B, Olinic DM, Farkas K, Elalamy I, Falanga A, Fareed J, Papageorgiou C, Arellano RS, Agathagelou P, Antic D, Auad L, Banfic L, Bartolomew JR, Benczur B, Bernardo MB, Boccardo F, Cifkova R, Cosmi B, De Marchi S, Dimakakos E, Dimopoulos MA, Dimitrov G, Durand-Zaleski I, Edmonds M, El Nazar EA, Erer D, Esponda OL, Gresele P, Gschwandtner M, Gu Y, Heinzmann M, Hamburg NM, Hamadé A, Jatoi NA, Karahan O, Karetova D, Karplus T, Klein-Weigel P, Kolossvary E, Kozak M, Lefkou E, Lessiani G, Liew A, Marcoccia A, Marshang P, Marakomichelakis G, Matuska J, Moraglia L, Pillon S, Poredos P, Prior M, Salvador DRK, Schlager O, Schernthaner G, Sieron A, Spaak J, Spyropoulos A, Sprynger M, Suput D, Stanek A, Stvrtinova V, Szuba A, Tafur A, Vandreden P, Vardas PE, Vasic D, Vikkula M, Wennberg P, and Zhai Z
Subjects: Anticoagulants therapeutic use, COVID-19 epidemiology, Cardiovascular Diseases drug therapy, Cardiovascular Diseases epidemiology, Europe, Heparin, Low-Molecular-Weight therapeutic use, Humans, Inflammation, Practice Guidelines as Topic, Risk Factors, Rivaroxaban therapeutic use, Societies, Medical, Thrombophilia, Thrombosis, COVID-19 Drug Treatment, COVID-19 diagnosis, Cardiology, Cardiovascular Diseases diagnosis, SARS-CoV-2 physiology
Abstract: COVID-19 is also manifested with hypercoagulability, pulmonary intravascular coagulation, microangiopathy, and venous thromboembolism (VTE) or arterial thrombosis. Predisposing risk factors to severe COVID-19 are male sex, underlying cardiovascular disease, or cardiovascular risk factors including noncontrolled diabetes mellitus or arterial hypertension, obesity, and advanced age. The VAS-European Independent Foundation in Angiology/Vascular Medicine draws attention to patients with vascular disease (VD) and presents an integral strategy for the management of patients with VD or cardiovascular risk factors (VD-CVR) and COVID-19. VAS recommends (1) a COVID-19-oriented primary health care network for patients with VD-CVR for identification of patients with VD-CVR in the community and patients' education for disease symptoms, use of eHealth technology, adherence to the antithrombotic and vascular regulating treatments, and (2) close medical follow-up for efficacious control of VD progression and prompt application of physical and social distancing measures in case of new epidemic waves. For patients with VD-CVR who receive home treatment for COVID-19, VAS recommends assessment for (1) disease worsening risk and prioritized hospitalization of those at high risk and (2) VTE risk assessment and thromboprophylaxis with rivaroxaban, betrixaban, or low-molecular-weight heparin (LMWH) for those at high risk. For hospitalized patients with VD-CVR and COVID-19, VAS recommends (1) routine thromboprophylaxis with weight-adjusted intermediate doses of LMWH (unless contraindication); (2) LMWH as the drug of choice over unfractionated heparin or direct oral anticoagulants for the treatment of VTE or hypercoagulability; (3) careful evaluation of the risk for disease worsening and prompt application of targeted antiviral or convalescence treatments; (4) monitoring of D-dimer for optimization of the antithrombotic treatment; and (5) evaluation of the risk of VTE before hospital discharge using the IMPROVE-D-dimer score and prolonged post-discharge thromboprophylaxis with rivaroxaban, betrixaban, or LMWH., Competing Interests: None declared., (Thieme. All rights reserved.)
Published: 2020
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48. Elective Cancer Surgery in COVID-19-Free Surgical Pathways during the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study

Author: Writing Group (denotes joint first author) James, C Glasbey (UK), Dmitri Nepogodiev (UK), Joana FF Simoes (Portugal), Omar Omar (UK), Elizabeth Li (UK), Mary, L Venn (UK), Mohammad Abou Chaar (Jordan), Vita Capizzi (Italy), Daoud Chaudhry (UK), Anant Desai (UK), Jonathan, G Edwards (UK), Jonathan, P Evans (UK), Marco Fiore (Italy), Jose Flavio Videria (Portugal), Samuel, J Ford (UK), Ian Ganyli (USA), Ewen, A Griffiths (UK), Rohan, R Gujjuri (UK), Angelos, G Kolias (UK), Haytham MA Kaafarani (USA), Ana Minaya-Bravo (Spain), Siobhan, C McKay (UK), Helen, M Mohan (Ireland), Keith Roberts (UK), Carlos San Miguel-M&#233, ndez (Spain), Peter Pockney (Australia), Richard Shaw (UK), Neil, J Smart (UK), Grant, D Stewart (UK), Sudha Sundar (UK), Raghavan Vidya (UK), Aneel, A Bhangu (UK, Statistical analysis Glasbey JC, Overall guarantor)., Omar, O (Lead statistician), Bhangu, A CovidSurg Operations Committee Kwabena Siaw-Acheampong, Ruth, A Benson, Edward, Bywater, Daoud, Chaudhry, Brett, E Dawson, Jonathan, P Evans, James, C Glasbey, Rohan, R Gujjuri, Emily, Heritage, Conor, S Jones, Sivesh, K Kamarajah, Chetan, Khatri, Rachel, A Khaw, James, M Keatley, Andrew, Knight, Samuel, Lawday, Elizabeth, Li, Harvinder, S Mann, Ella, J Marson, Kenneth, A McLean, Siobhan, C Mckay, Emily, C Mills, Dmitri, Nepogodiev, Gianluca, Pellino, Maria, Picciochi, Elliott, H Taylor, Abhinav, Tiwari, Joana FF Simoes, Isobel, M Trout, Mary, L Venn, Richard JW Wilkin, International Cancer Leads (denotes specialty Principal Investigators) James C Glasbey (Chair), Aneel Bhangu., Colorectal: Neil, J Smart, Ana, Minaya-Bravo, Susan, Moug, Dale, Vimalchandran, Abigail, Vallance, Peter, Pockney, Oesophagogastric: Ewen, A Griffiths, Richard PT Evans, Philip, Townend, Hepatopancreatobilary: Keith Roberts, Siobhan, McKay, John, Isaac, Sohei, Satoi, Thoracic: John Edwards, Aman, S Coonar, Adrian, Marchbank, Edward, J Caruana, Georgia, R Layton, Akshay, Patel, Alessandro, Brunelli, Sarcoma: Samuel Ford, Anant, Desai, Alessandro, Gronchi, Marco, Fiore, Max, Almond, Fabio, Tirotta, Sinziana, Dumitra, Neurosurgery: Angelos Kolias, Stephen, J Price, Daniel, M Fountain, Michael, D Jenkinson, Peter, Hutchinson, Hani, J Marcus, Rory, J Piper, Laura, Lippa, Franco, Servadei, Ignatius, Esene, Christian, Freyschlag, Iuri, Neville, Gail, Rosseau, Karl, Schaller, Andreas, K Demetriades, Faith, Robertson, Alex, Alamri, Head and neck: Richard Shaw, Andrew, G Schache, Stuart, C Winter, Michael, Ho, Paul, Nankivell, Juan Rey Biel, Martin, Batstone, Ian, Ganly, Breast: Raghavan Vidya, Alex, Wilkins, Jagdeep, K Singh, Dinesh, Thekinkattil, Gynaecology: Sudha Sundar, Christina, Fotopoulou, Elaine, Leung, Tabassum, Khan, Luis, Chiva, Jalid, Sehouli, Anna, Fagotti, Paul, Cohen, Murat, Gutelkin, Rahel, Ghebre, Thomas, Konney, Rene, Pareja, Rob, Bristow, Sean, Dowdy, Shylasree TS Rajkumar, Joe, Ng, Keiiji, Fujiwara, Urology: Grant, D Stewart, Benjamin, Lamb, Krishna, Narahari, Alan, McNeill, Alexandra, Colquhoun, John, McGrath, Steve, Bromage, Ravi, Barod, Veeru, Kasivisvanathan, Dissemination Committee Joana FF Simoes (Chair), Tobias Klatte., Tom EF Abbott, Michel, Adamina, Adesoji, O Ademuyiwa, Arnav, Agarwal, Ehab, Alameer, Derek, Alderson, Felix, Alakaloko, Markus, Albertsmeiers, Osaid, Alser, Muhammad, Alshaar, Sattar, Alshryda, Alexis, P Arnaud, Knut Magne Augestad, Faris, Ayasra, Jos&#233, Azevedo, Brittany, K Bankhead-Kendall, Emma, Barlow, Ruth, Blanco-Colino, Amanpreet, Brar, Kerry, A Breen, Chris, Bretherton, Igor Lima Buarque, Joshua, Burke, Mohammad, Chaar, Sohini, Chakrabortee, Peter, Christensen, Daniel, Cox, Moises, Cukier, Miguel, F Cunha, Giana, H Davidson, Salomone Di Saverio, Thomas, M Drake, John, G Edwards, Muhammed, Elhadi, Sameh, Emile, Shebani, Farik, J Edward Fitzgerald, Samuel, Ford, Tatiana, Garmanova, Gaetano, Gallo, Dhruv, Ghosh, Gustavo Mendon&#231, a Ata&#237, de Gomes, Gustavo, Grecinos, Ewen, A Griffiths, Madalegna, Gr&#252, ndl, Constantine, Halkias, Ewen, M Harrison, Intisar, Hisham, Peter, J Hutchinson, Shelley, Hwang, Arda, Isik, Pascal, Jonker, Haytham MA Kaafarani, Angelos, Kolias, Schelto, Kruijff, Ismail, Lawani, Hans, Lederhuber, Sezai, Leventoglu, Andrey, Litvin, Andrew, Loehrer, Markus, W L&#246, ffler, Maria Aguilera Lorena, Maria Marta Madolo, Piotr, Major, Janet, Martin, Hassan, N Mashbari, Dennis, Mazingi, Symeon, Metallidis, Helen, M Mohan, Rachel, Moore, David, Moszkowicz, Joshua, S Ng-Kamstra, Mayaba, Maimbo, Milagros, Niquen, Faustin, Ntirenganya, Maricarmen, Olivos, Kacimi, Oussama, Oumaima, Outani, Marie Dione Parreno-Sacdalanm, Francesco, Pata, Carlos Jose Perez Rivera, Thomas, D Pinkney, Willemijn van der Plas, Ahmad, Qureshi, Dejan, Radenkovic, Antonio Ramos- De la Medina, Keith, Roberts, April, C Roslani, Martin, Ruteg&#229, Ir&#232, ne, Santos, Raza, Sayyed, Andrew, Schache, Andreas, A Schnitzbauer, Seyi-Olajide, Justina O., Neil, Sharma, Richard, Shaw, Sebastian, Shu, Kjetil, Soreide, Antonino, Spinelli, Grant, D Stewart, Malin, Sund, Sudha, Sundar, Stephen, Tabiri, Georgios, Tsoulfas, Gabrielle, H van Ramshorst, Raghavan, Vidya, Dale, Vimalachandran, Oliver, J Warren, Duane, Wedderburn, Naomi, Wright, EuroSurg, European Society of Coloproctology (ESCP), Global Initiative for Children&#8217, s Surgery (GICS), GlobalSurg, GlobalPaedSurg, ItSURG, PTSurg, SpainSurg, Italian Society of Colorectal Surgery (SICCR), Association of Surgeons in Training (ASiT), Irish Surgical Research Collaborative (ISRC), Transatlantic Australasian Retroperitoneal Sarcoma Working Group (TARPSWG), Collaborators (denotes Site Principal Investigators) Argentina: Allemand C, Italian Society of Surgical Oncology (SICO)., Boccalatte, L, Figari, M, Lamm, M, Larra&#241, aga, J, Marchitelli, C, Noll, F, Odetto, D, Perrotta, M, Saadi, J, Zamora, L (Hospital Italiano De Buenos Aires), Alurralde, C, Caram, El, Eskinazi, D, Mendoza, Jp, Usandivaras M (Sanatorio, 9 De Julio Sa), Badra, R, Esteban, A, Garc&#237, a, Js, a, Pm, Gerchunoff, Ji, Lucchini, Sm, NIgra, Ma, Armenia: Hovhannisyan T, Vargas L (Sanatorio Allende)., Australia: Gould T, Stepanyan A (Nairi Medical Center)., Gourlay, R, Griffiths, B (Calvary Mater Newcastle), Gananadha S, McLaren M (Canberra Hospital), Cecire, J, Joshi, N, Salindera, S, Sutherland, A (Coffs Harbour Health Campus), Ahn, Jh, Charlton, G, Chen, S, Gauri, N, Hayhurst, R, Jang, S, Jia, F, Mulligan, C, Yang, W, Ye, G, Zhang, H (Concord Repatriation General Hospital), Ballal, M, Gibson, D, Hayne, D, Moss, J, Richards, T, Viswambaram, P, Vo UG (Fiona Stanley Hospital), Bennetts, J, Bright, T, Brooke-Smith, M, Fong, R, Gricks, B, Lam, Yh, Ong, Bs, Szpytma, M, Watson, D (Flinders Medical Centre), Bagraith, K, Caird, S, Chan, E, Dawson, C, Ho, D, Jeyarajan, E, Jordan, S, Lim, A, Nolan, Gj, Oar, A, Parker, D, Puhalla, H, Quennell, A, Rutherford, L, Townend, P, Von Papen, M, Wullschleger, M (Gold Coast University Hospital), Blatt, A, Cope, D, Egoroff, N, Fenton, M, Gani, J, Lott, N, Pockney, P, Shugg, N (John Hunter Hospital), Elliott M, Phung D (Lifehouse), Phan D, Townend D (Lismore Base Hospital), Bong C, Gundara J (Logan Hospital), Frankel, A (Princess Alexandra Hospital), Bowman S, Guerra GR (Queen Elizabeth Ii Jubilee Hospital), Bolt, J, Buddingh, K, Dudi-Venkata, Nn, Jog, S, Kroon, Hm, Sammour, T, Smith, R, Stranz, C (Royal Adelaide Hospital), Batstone, M, Lah, K, McGahan, W, Mitchell, D, Morton, A, Pearce, A, Roberts, M, Sheahan, G, Swinson, B (Royal Brisbane And Women&#8217, s Hospital), Alam, N, Banting, S, Chong, L, Choong, P, Clatworthy, S, Foley, D, Fox, A, Hii, Mw, Knowles, B, Mack, J, Read, M, Rowcroft, A, Ward, S, Austria: Lanner M (Kardinal Schwarzenberg Klinikum), Wright G (St Vincent&#8217, s Hospital)., K&#246, nigsrainer, I (Landeskrankenhaus Feldkirch), Bauer, M, Freyschlag, C, Kafka, M, Messner, F, 214, fner, D, Tsibulak, I (Medical University Of Innsbruck), Emmanuel, K, Grechenig, M, Gruber, R, Harald, M, hlberger, L, Presl, J, Azerbaijan: Namazov &#304, Wimmer A (Paracelsus Medical University Salzburg)., Barbados: Barker D, Samadov E (Leyla Medical Centerl)., Boyce, R, Corbin, S, Doyle, A, Eastmond, A, Gill, R, Haynes, A, Millar, S, O&#8217, Shea, M, Padmore, G, Paquette, N, Phillips, E, John S, St., Belgium: Flamey N, Walkes K (Queen Elizabeth Hospital)., Pattyn, P (Az Delta), Oosterlinck, W, Van den Eynde, J, Brazil: Gatti A, Van den Eynde R (Uz Leuven)., Nardi, C, Oliva, R (Hospital Geral De Pirajussara), De Cicco, R (Instituto De C&#226, ncer Dr Arnaldo Vieira De Carvalho), Cecconello, I, Gregorio, P, Pontual Lima, L, Ribeiro Junior, U, Takeda, F, Canada: Kidane B, Terra RM (Instituto Do C&#226, ncer De Estado De S&#227, o Paulo). Bulgaria: Sokolov M (University Hospital Alexandrovska)., Srinathan, S (Health Sciences Centre), Boutros, M, Caminsky, N, Ghitulescu, G, Jamjoum, G, Moon, J, Pelletier, J, Vanounou, T, Wong, S (Jewish General Hospital), Dumitra, S, Kouyoumdjian, A (Mcgill University Health Center), Johnston B, Russell C (Saint John Regional Hospital), Demyttenaere, S, Mary&#8217, s Hospital), Garfinkle R (St., Abou-Khalil, J, Nessim, C, Colombia: Almeciga A, Stevenson J (The Ottawa Hospital). Chile: Heredia F (Cl&#237, nica Universitaria De Concepci&#243, n)., Fletcher, A, Merchan A (Centro De Investigaciones Oncol&#243, gicas Cl&#237, nica San Diego, - Ciosad), Puentes LO (Hospital San Jos&#233, Croatia: Ba&#269, i&#263, G, Mendoza Quevedo J (Subred Sur Occidente De Kennedy (Hospital De Kennedy))., Karlovi&#263, D, Kr&#353, ul, D, Zeli&#263, M (University Hospital Center Rijeka), Luksic I, Mamic M (University Hospital Dubrava), Bakmaz, B, 262, oza, I, Dijan, E, Katusic, Z, Mihanovic, J, Cyprus: Frantzeskou K, Rakvin I (Zadar General Hospital)., Gouvas, N, Kokkinos, G, Papatheodorou, P, Pozotou, I, Stavrinidou, O, Czechia: Martinek L, Yiallourou A (Nicosia General Hospital)., Skrovina, M, Szubota, I (Hospital &amp, amp, Oncological Centre Novy Jicin), 381, ateck&#253, J (Slezsk&#225, Nemocnice V Opav&#283, P. o. ), Javurkova, V, Denmark: Avlund T, Klat J (University Hospital Ostrava)., Christensen, P, Harbjerg, Jl, Iversen, Lh, Kjaer, Dw, Kristensen, H&#248, Mekhael, M (Aarhus University Hospital), Ebbeh&#248, j, Al, Krarup, P, Schlesinger, N, Egypt: Abdelsamed A, Smith H (Bispebjerg Hospital)., Azzam, Ay, Salem, H, Seleim, A (Al Azhar University Hospitals), Abdelmajeed, A, Abdou, M, Abosamak, Ne, AL Sayed, M, Ashoush, F, Atta, R, Elazzazy, E, Elhoseiny, M, Elnemr, M, Elqasabi, Ms, Elsayed Hewalla ME, Elsherbini, I, Essam, E, Eweda, M, Ghallab, I, Hassan, E, Ibrahim, M, Metwalli, M, Mourad, M, Qatora, Ms, Ragab, M, Sabry, A, Saifeldin, H, Saleh Mesbah Mohamed Elkaffas, M, Samih, A, Samir Abdelaal, A, Shehata, S, Shenit, K (Alexandria Main University Hospital), Attia, D, Kamal, N, Osman, N (Alexandria Medical Research Institute), Abbas, Am, Abd Elazeem HAS, Abdelkarem, Mm, Alaa, S, Ali, Ak, Ayman, A, Azizeldine, Mg, Elkhayat, H, elghazaly S, M., Monib, Fa, Nageh, Ma, Saad, Mm, Salah, M, Shahine, M, Yousof, Ea, Youssef, A (Assiut University Hospital), Eldaly, A (El-Menshawy Hospital), ElFiky, M, Nabil, A (Kasr Alainy Faculty Of Medicine, Cairo, University), Amira, G, Sallam, I, Sherief, M, Sherif, A (Misr Cancer Center), Abdelrahman, A, Aboulkassem, H, Ghaly, G, Hamdy, R, Morsi, A, Sherif, G (National Cancer Institute), Abdeldayem, H, Abdelkader Salama, I, Balabel, M, Fayed, Y, Sherif AE (National Liver Institute, Finland: Kauppila J, Menoufia University). Ethiopia: Bekele D (Maddawalabu University Goba Referral Hospital)., Sarjanoja, E (L&#228, nsi-Pohja Central Hospital), Helminen, O, Huhta, H, France: Beyrne C, Kauppila JH (Oulu University Hospital)., Jouffret, L, Lugans, L, Marie-Macron, L (Centre Hospitalier Avignon), Chouillard E, De Simone B (Centre Hospitalier Intercommunal Poissy Saint Germain En Laye), Bettoni, J, Dakp&#233, S, Devauchelle, B, Lavagen, N, Testelin, S (Chu Amiens), Boucher, S, Breheret, R, Gueutier, A, Kahn, A, K&#252, n-Darbois, J (Chu Angers), Barrabe, A, Lakkis, Z, Louvrier, A, Manfredelli, S, Mathieu, P (Chu Besan&#231, on), Chebaro, A, Drubay, V, El amrani, M, Eveno, C, Lecolle, K, Legault, G, Martin, L, Piessen, G, Pruvot, Fr, Truant, S, Zerbib, P (Chu Lille), Ballouhey, Q, Barrat, B, Laloze, J, Salle, H, Taibi, A, Usseglio, J (Chu Limoges), Bergeat D, Merdrignac A (Chu Rennes - General Surgery), Le Roy, B, Perotto, Lo, Scalabre, A (Chu Saint Etienne), Aim&#233, A, Ezanno, A, Malgras, B (Hia Begin), Bouche P, Tzedakis S (H&#244, pital Cochin - Aphp), Cotte, E, Glehen, O, Lifante, J (Hopital Lyon Sud), D&#8217, Urso, A, Felli, E, Mutter, D, Pessaux, P, Seeliger, B (Hus, Pole H&#233, pato-Digestif, / Ihu- Strasbourg), Bardet, J, Berry, R, Boddaert, G, Bonnet, S, Brian, E, Denet, C, Fuks, D, Gossot, D, Grigoroiu, M, Laforest, A, Levy-Zauberman, Y, Louis-Sylvestre, C, Moumen, A, Pourcher, G, Seguin-givelet, A, Tribillon, E (Institut Mutualiste Montsouris), Duchalais, E, Espitalier, F, Ferron, C, Germany: Bork U, Malard O (Nantes University Hospital)., Distler, M, Fritzmann, J, Kirchberg, J, Praetorius, C, Riediger, C, Weitz, J, Welsch, T, Wimberger, P (Carl-Gustav-Carus University, Dresden), Tu, Beyer, K, Kamphues, C, Lauscher, J, Loch, Fn, Schineis, C (Charit&#233, University Medicine, Campus Benjamin Franklin), Albertsmeier, M, Angele, M, Kappenberger, A, Niess, H, Schiergens, T, Werner, J (Department of General, Visceral and Transplantation Surgery, Ludwig- Maximilians-Universitat Munich), Becker R, Jonescheit J (Heilig-Geist Hospital Bensheim), Pergolini I, Reim D (Klinikum Rechts Der Isar Tum School Of Medicine), Boeker, C, Hakami, I, Mall, J (Krh Nordstadt-Siloah Hospitals), Liokatis P, Smolka W (LMU Klinikum Campus Innenstadt), Nowak K, Reinhard T (Romed Klinikum Rosenheim), H&#246, lzle, F, Modabber, A, Winnand, P (University Hospital Aachen), Knitschke, M (University Hospital Giessen And Marburg), Kauffmann P, Wolfer S (University Hospital Goettingen / Universit&#228, tsmedizin Goettingen), Kleeff, J, Lorenz, K, Michalski, C, Ronellenfitsch, U, Schneider, R (University Hospital Halle (Saale)), Bertolani, E, nigsrainer, A, L&#246, ffler, Mw, Quante, M, Steidle, C, 220, berr&#252, ck, L, Yurttas, C (University Hospital Tuebingen), Betz, Cs, Bewarder, J, B&#246, ttcher, A, Burg, S, Busch, C, Gosau, M, Heuer, A, Izbicki, J, Klatte, To, Koenig, D, Moeckelmann, N, Nitschke, C, Priemel, M, Smeets, R, Speth, U, Thole, S, Uzunoglu, Fg, Vollkommer, T, Zeller, N (University Medical Center Hamburg- Eppendorf), Battista, Mj, Gillen, K, Hasenburg, A, Krajnak, S, Linz, V, Schwab, R (University Of Mainz, Greece: Angelou K, Department Of Gynaecology And Obstetrics)., Haidopoulos, D, Rodolakis, A (Alexandra General Hospital), Antonakis, P, Bramis, K, Chardalias, L, Contis, I, Dafnios, N, Dellaportas, D, Fragulidis, G, Gklavas, A, Konstadoulakis, M, Memos, N, Papaconstantinou, I, Polydorou, A, Theodosopoulos, T, Vezakis, A (Aretaieion Hospital), Antonopoulou, Mi, Manatakis, Dk, Tasis, N (Athens Naval And Veterans Hospital), Arkadopoulos, N, Danias, N, Economopoulou, P, Kokoropoulos, P, Larentzakis, A, Michalopoulos, N, Selmani, J, Sidiropoulos, T, Tsaousis, V, Vassiliu, P (Attikon University General Hospital), Bouchagier, K, Klimopoulos, S, Paspaliari, D, Stylianidis, G (Evaggelismos General Hospital), Baxevanidou, K, Bouliaris, K, Chatzikomnitsa, P, Efthimiou, M, Giaglaras, A, Kalfountzos, C, Koukoulis, G, Ntziovara, Am, Petropoulos, K, Soulikia, K, Tsiamalou, I, Zervas, K, Zourntou, S (General Hospital Of Larissa &#8220, Koutlimpaneio And Triantafylleio&#8221, Baloyiannis, I, Diamantis, A, Gkrinia, E, Hajiioannou, J, Korais, C, Koukoura, O, Perivoliotis, K, Saratziotis, A, Skoulakis, C, Symeonidis, D, Tepetes, K, Tzovaras, G, Zacharoulis, D (General University Hospital Of Larissa), Alexoudi, V, Antoniades, K, Astreidis, I, Christidis, P, Deligiannidis, D, Grivas, T, Ioannidis, O, Kalaitsidou, I, Loutzidou, L, Mantevas, A, Michailidou, D, Paraskevopoulos, K, Politis, S, Stavroglou, A, Tatsis, D, Tilaveridis, I, Vahtsevanos, K, Venetis, G (George Papanikolaou General Hospital Of Thessaloniki), Karaitianos I, Tsirlis T (Henry Dunant Hospital Center), Charalabopoulos, A, Liakakos, T, Mpaili, E, Schizas, D, Spartalis, E, Syllaios, A, Zografos, C (Laiko University Hospital), Anthoulakis, C, Christou, C, Papadopoulos, V, Tooulias, A, Tsolakidis, D, Tsoulfas, G, Zouzoulas, D (Papageorgiou General Hospital), Athanasakis, E, Chrysos, E, Tsiaousis, J, Xenaki, S, Hong Kong: Futaba K, Xynos E (University Hospital Of Heraklion Crete And Interclinic Hospital Of Crete)., Ho, Mf, Hon, Sf, Mak, Twc, Ng SSM (Prince Of Wales Hospital), Hungary: Banky B, Foo CC (Queen Mary Hospital)., Ireland: Aremu M, Suszt&#225, k N (Szent Borb&#225, la K&#243, rh&#225, z)., Canas-Martinez, A, Cullivan, O, Murphy, C, Owens, P, Pickett, L (Connolly Hospital Blanchardstown), Akmenkalne, L, Byrne, J, Corrigan, M, Cullinane, C, Daly, A, Fleming, C, Jordan, P, Killeen, S, Lynch, N, McCarthy, A, Mustafa, H, Brien, S, Leary, P, Syed, Was, Vernon, L (Cork University Hospital), Callanan, D, Huang, L, Ionescu, A, Sheahan, P (South Infirmary Victoria University Hospital), Balasubramanian, I, Boland, M, Conlon, K, Evoy, D, Fearon, N, Gallagher, T, Geraghty, J, Heneghan, H, Kennedy, N, Maguire, D, McCartan, D, McDermott, Ew, Prichard, Rs, Winter, D (St Vincent&#8217, s University Hospital), Alazawi, D, Barry, C, Boyle, T, Butt, W, Connolly, Em, Donlon, N, Donohue, C, Fahey, Ba, Farrell, R, Fitzgerald, C, Kinsella, J, Larkin, Jo, Lennon, P, Maguire, Pj, Mccormick, P, Mehigan, Bj, Mohan, H, Nugent, T, Sullivan, H, Ravi, N, Reynolds, Jv, Rogers, A, Shokuhi, P, Smith, J, Smith, La, James&#8217, s Hospital), Timon C (St., Bashir, Y, Bass, G, Connelly, T, Earley, H, Elliott, Ja, Gillis, A, Kavanagh, D, Neary, P, riordan, J, Reynolds, Is, Rice, D, Ridgway, P, Umair, M, Whelan, M (Tallaght Hospital), Carroll, P, Collins, C, Corless, K, Finnegan, L, Fowler, A, Hogan, A, Kerin, M, Lowery, A, McAnena, P, McKevitt, K, Nizami, K, Ryan, &#201, Samy, A (University Hospital Galway), Coffey, Jc, Cunningham, R, Devine, M, Nally, D, Peirce, C, Tormey, S (University Hospital Limerick), Hardy, N, Malley, S, Italy: Macina S (Asst Mantua), Ryan M (University Hospital Waterford/University College Cork)., Mariani, Nm, Opocher, E, Pisani Ceretti A (Asst Santi Paolo, E Carlo), Ferrari, F, Odicino, F, Sartori, E (Asst Spedali Civili, Ospedale Di Brescia), Cotsoglou C, Granieri S (Asst Vimercate), Bianco, F, Camillo&#8217, Colledan, M, Tornese, S, Zambelli MF (Asst-Papa Giovanni Xxiii- Bergamo), Bissolotti, G, Fusetti, S, Lemma, F (Azienda Ospedaliera Di Padova), Marino, M, Mirabella, A, Vaccarella, G (Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo), Agostini, C, Alemanno, G, Bartolini, I, Bergamini, C, Bruscino, A, Checcucci, C, De Vincenti, R, Di Bella, A, Fambrini, M, Fortuna, L, Maltinti, G, Muiesan, P, Petraglia, F, Prosperi, P, Ringressi, Mn, Risaliti, M, Sorbi, F, Taddei, A, Tucci, R (Azienda Ospedaliera Universitaria Careggi), Bassi, C, Campagnaro, T, Casetti, L, De Pastena, M, Esposito, A, Fontana, M, Guglielmi, A, Landoni, L, Malleo, G, Marchegiani, G, Nobile, S, Paiella, S, Pedrazzani, C, Rattizzato, S, Ruzzenente, A, Salvia, R, Turri, G, Tuveri, M (Azienda Ospedaliera Universitaria Integrata Di Verona), Bellora, P, Aloisio, G, Ferrari, M, Francone, E, Gentilli, S, Nikaj, H (Azienda Ospedaliero Universitaria Maggiore Della Carit&#224, Bianchini, M, Chiarugi, M, Coccolini, F, Di Franco, G, Furbetta, N, Gianardi, D, Guadagni, S, Morelli, L, Palmeri, M, Tartaglia, D (Azienda Ospedaliero Universitaria Pisana), Anania, G, Carcoforo, P, Chiozza, M, De Troia, A, Koleva Radica, M, Portinari, M, Sibilla, Mg, Urbani, A (Azienda Ospedaliero Universitaria Sant&#8217, anna), Fabbri, N, Feo, Cv, Gennari, S, Parini, S, Righini E (Azienda Unit&#224, Sanitaria Locale di Ferrara, - University of Ferrara), Ampollini, L, Bellanti, L, Bergonzani, M, Bertoli, G, Bocchialini, G, Angelo, G, Lanfranco, D, Musini, L, Poli, T, Santoro, Gp, Varazzani, A (Azienda Ospedaliero-Universitaria Di Parma), Aguzzoli, L, Borgonovo, G, Castro Ruiz, C, Coiro, S, Falco, G, Mandato, Vd, Mastrofilippo, V, Montella, Mt, Annessi, V, Zizzo M (Azienda Unit&#224, Sanitaria Locale, - Irccs Di Reggio Emilia), Grossi, U, Novello, S, Romano, M, Rossi, S, Zanus, G (Ca&#8217, Foncello Treviso-DISCOG-Universit Di Padova), Esposito, G, Frongia, F, Pisanu, A, Podda, M (Cagliari University Hospital), Belluco, C, Lauretta, A, Montori, G, Moras, L, Olivieri, M (Centro Di Riferimento Oncologico Di Aviano (Cro) Irccs), Bussu, F, Carta, Ag, Cossu, Ml, Cottu, P, Fancellu, A, Feo, Cf, Ginesu, Gc, Giuliani, G, Madonia, M, Perra, T, Piras, A, Porcu, A, Rizzo, D, Scanu, Am, Tedde, A, Tedde, M (Cliniche San Pietro, Sassari), A. o. u., Delrio, P, Rega D (Colorectal Surgical Oncology Unit, - Istituto Nazionale Tumori Fondazione, Pascale-I. r. c. c. s., ), Badalamenti, G, Campisi, G, Cordova, A, Franza, M, Maniaci, G, Rinaldi, G, Toia, F (Department Of Surgical, University Of Palermo), Oncological And Oral Sciences., Calabr&#242, M, Farnesi, F, Lunghi, Eg, Muratore, A, Pipitone Federico NS (Edoardo Agnelli), B&#224, mbina, F, Andrea, G, Familiari, P, Picotti, V (Fabrizio Spaziani), De Palma, G, Luglio, G, Pagano, G, Tropeano FP (Federico Ii University Hospital), Baldari, L, Beltramini, Ga, Boni, L, Cassinotti, E, Gianni&#8217, Pignataro, L, Torretta S (Fondazione Irccs Ca&#8217, Granda, - Ospedale Maggiore Policlinico), Abatini, C, Baia, M, Biasoni, D, Bogani, G, Cadenelli, P, Capizzi, V, Cioffi, Spb, Citterio, D, Comini, Lv, Cosimelli, M, Fiore, M, Folli, S, Gennaro, M, Giannini, L, Gronchi, A, Guaglio, M, Macchi, A, Martinelli, F, Mazzaferro, V, Mosca, A, Pasquali, S, Piazza, C, Raspagliesi, F, Rolli, L, Salvioni, R, Sarpietro, G, Sarre, C, Sorrentino, L (Fondazione Irccs Istituto Nazionale Dei Tumori, Milano), Agnes, A, Alfieri, S, Belia, F, Biondi, A, Cozza, V, Amore, A, Ugo, D, De Simone, V, Fagotti, A, Gasparini, G, Gordini, L, Litta, F, Lombardi, Cp, Lorenzon, L, Marra, Aa, Marzi, F, Moro, A, Parello, A, Perrone, E, Persiani, R, Ratto, C, Rosa, F, Saponaro, G, Scambia, G, Scrima, O, Sganga, G, Tudisco, R (Fondazione Policlinico Universitario Agostino Gemelli), Belli, A, Granata, V, Izzo, F, Palaia, R, Patrone R (Hpb Surgical Oncology Unit, - Istituto Nazionale Tumori Fondazione, Pascale- I. r. c. c. s., ), Carrano, Fm, Carvello, Mm, De Virgilio, A, Di Candido, F, Ferreli, F, Gaino, F, Mercante, G, Rossi, V, Spinelli, A, Spriano, G (Humanitas Clinical And Research Center Irccs, Rozzano (Mi) &amp, Humanitas, University, Department Of Biomedical Sciences, Pieve Emanuele (Mi)), Donati, Dm, Frisoni, T, Palmerini, E (Irccs Istituto Ortopedico Rizzoli), Aprile, A, Barra, F, Batistotti, P, Ferrero, S, Fregatti, P, Scabini, S, Sparavigna, M (Irccs Ospedale Policlinico San Martino), Asti, E, Bernardi, D, Bonavina, L, Lovece, A (University of Milan, IRCCS Policlinico San Donato), Adamoli, L, Ansarin, M, Cenciarelli, S, Chu, F, De Berardinis, R, Fumagalli Romario, U, Mastrilli, F, Pietrobon, G, Tagliabue M (Istituto Europeo Di Oncologia, - Irccs -Milano), Badellino, E, Ferrero, A, Massobrio, R (Mauriziano Hospital Torino, Italy), De Manzoni Garberini, A (Ospedale Civile Spirito Santo), Federico, P, Maida, P, Marra, E, Marte, G, Petrillo, A, Tammaro, T, Tufo, A (Ospedale Del Mare), Berselli, M, Borroni, G, Cocozza, E, Conti, L, Desio, M, Livraghi, L, Quintodei, V, Rizzi, A, Zullo A (Ospedale Di Circolo, E Fondazione Macchi (Varese)), Baldi, C, Corbellini, C, Sampietro GM (Ospedale Di Rho, - Asst Rhodense), Cellerino P (Ospedale Fatebenefratelli, E Oftalmico), Baldini, E, Capelli, P, Isolani, Sm, Ribolla, M (Ospedale Guglielmo Da Saliceto Piacenza), Bondurri, A, Colombo, F, Ferrario, L, Guerci, C, Maffioli, A (Ospedale Luigi Sacco Milano), Armao, T, Ballabio, M, Bisagni, P, Gagliano, A, Longhi, M, Madonini, M, Pizzini, P (Ospedale Maggiore Di Lodi), Baietti, Am, Biasini, M, Maremonti, P, Neri, F, Prucher, Gm, Ricci, S, Ruggiero, F, Zarabini AG (Ospedale Maggiore/Bellaria Carlo Alberto Pizzardi Ausl Bologna), Barmasse, R, Mochet, S, Usai, A (Ospedale Regionale Umberto Parini), Leonardo - Asl Napoli 3 Sud, Incollingo P (Ospedale S., Castellammare Di Stabia), Mancini, S, Marino Cosentino, L, Sagnotta, A (Ospedale San Filippo Neri), Fruscio, R, Grassi, T, Nespoli, Lc, Tamini, N (Ospedale San Gerardo), Anastasi, A, Bartalucci, B, Bellacci, A, Canonico, G, Capezzuoli, L, Di Martino, C, Ipponi, P, Linari, C, Montelatici, M, Nelli, T, Spagni, G, Tirloni, L, Vitali, A (Ospedale San Giovanni Di Dio), Abate, E, Casati, M, Casiraghi, T, Laface, L, Schiavo M (Ospedale Vittorio Emanuele Iii, - Carate Brianza), Arminio, A, Cotoia, A, Lizzi, V, Vovola, F (Ospedali Riuniti Azienda Ospedaliera Universitaria Foggia), Vergari, R (Ospedali Riuniti Di Ancona), Ugo, S, Depalma, N, 8220, Vito Fazzi&#8221, Spampinato MG (P. o., Bartolucci, P, Brachini, G, Bruzzaniti, P, Chiappini, A, Chiarella, V, Ciccarone, F, Cicerchia, Pm, Cirillo, B, De Toma, G, Di bartolomeo, A, Fiori, E, Fonsi, Gb, Franco, G, Frati, A, Giugliano, M, Iannone, I, La Torre, F, Lapolla, P, Leonardo, C, Marruzzo, G, Meneghini, S, Mingoli, A, Ribuffo, D, Salvati, M, Santoro, A, Sapienza, P, Scafa, Ak, Simonelli, L, Zambon M (Policlinico Umberto, I Sapienza University Of Rome), Capolupo, Gt, Carannante, F, Caricato, M, Mascian&#224, G, Mazzotta, E (Policlinico Universitario Campus Bio Medico Of Rome), Gattolin, A, Migliore, M, Rimonda, R, Sasia, D, Travaglio, E (Regina Montis Regalis Hospital, Mondov&#236, Cervellera, M, Gori, A, Sartarelli, L, orsola-Malpighi Hospital), Tonini V (S., Giacometti, M, Zonta, S (Ospedale San Biagio, Asl, VCO), Chessa, A, Fiorini, A, Norcini, C (San Giovanni Di Dio), Colletti, G, Confalonieri, M, Costanzi, A, Frattaruolo, C, Mari, G, Monteleone, M (San Leopoldo Mandic), Bandiera, A, Bocciolone, L, Bonavina, G, Candiani, M, De Nardi, P, Gagliardi, F, Medone, M, Mortini, P, Negri, G, Ottolina, J, Parise, P, Piloni, M, Sileri, P, Vignali, A (San Raffaele Scientific Institute, Milan), Belvedere, A, Bernante, P, Bertoglio, P, Boussedra, S, Brunocilla, E, Cipriani, R, Cisternino, G, De Crescenzo, E, De Iaco, P, Dondi, G, Frio, F, Jovine, E, Mineo Bianchi, F, Neri, J, Parlanti, D, Perrone, Am, Pezzuto, Ap, Pignatti, M, Pinto, V, Poggioli, G, Ravaioli, M, Rottoli, M, Schiavina, R, Serenari, M, Serra, M, Solli, P, Taffurelli, M, Tanzanu, M, Tesei, M, Violante, T, Zanotti, S (Sant&#8217, orsola Hospital, Alma Mater Studiorum University Of Bologna, Borghi, F, Cianflocca, D, Di Maria Grimaldi, S, Donati, D, Gelarda, E, Geretto, P, Giraudo, G, Giuffrida, Mc, Marano, A, Palagi, S, Pellegrino, L, Peluso, C, Testa V (Santa Croce, E Carle Hospital, Cuneo), Agresta, F, Prando, D, Zese M (Santa Maria Degli Angeli Hospital Ulss5, - Adria), Aquila, F, Gambacciani, C, Lippa, L, Pieri, F, Santonocito OS (Spedali Riuniti Di Livorno), Armatura, G, Bertelli, G, Frena, A, Marinello, P, Notte, F, Patauner, S, Moritz Hospital), Scotton G (St., Fulginiti, Sf, Gallo, G, Sammarco, G, Vescio, G (University &#8216, Magna Graecia&#8217, Of Catanzaro), Balercia, P, Catarzi, L, Consorti G (University Hospital Umberto, I Ancona), Di Marzo, F (Valtiberina), Japan: Daiko H, Fontana T (Vittorio Emanuele)., Ishikawa, M, Ishiyama, K, Iwata, S, Kanematsu, K, Kanemitsu, Y, Kato, T, Kawai, A, Kobayashi, E, Kobayashi Kato, M, Moritani, K, Nakatani, F, Oguma, J, Tanase, Y, Jordan: Al Abdallah M, Uno M (National Cancer Center Hospital)., Ayasra, F, Ayasra, Y, Qasem, A (Al-Basheer Hospital), Abu Za&#8217, nouneh FJ, Fahmawee, T, Hmedat, A, Ibrahim, A, Obeidat, K (King Abdullah University Hospital), Abdel Al, S, Abdel Jalil, R, Abou Chaar MK, Al-Masri, M, Al-Najjar, H, Alawneh, F, Alsaraireh, O, Elayyan, M, Ghanem, R, Libya: Alkadeeki G (Al-Jalaa Hospital), Lataifeh I (King Hussein Cancer Center)., Aldokali, N, Senossi, O, Subhi MT (Alkhadra Hospital), Burgan, D, Kamoka, E, Kilani, Ai, Salamah, A, Salem, M, Shuwayyah, A (National Cancer Institute, Sabratha, - Libya), Abdulwahed, E, Alshareea, E, Aribi, N, Aribi, S, Biala, M, Ghamgh, R, Morgom, M (Tripoli Central Hospital), Aldayri, Z, Ellojli, I, Lithuania: Bradulskis S, Kredan A (Tripoli University Hospital)., Dainius, E, Kubiliute, E, Kutkevi&#269, ius, J, Parseliunas, A, Subocius, A, Madagascar: Rasoaherinomenjanahary F, Venskutonis D (Lithuanian University Of Health Sciences Kaunas Clinical Hospital)., Razafindrahita, Jb, Malaysia: Ong EC (Bintulu), Samison LH (Joseph Ravoahangy Andrianavalona Hospital)., Hamdan, Kh, Ibrahim, Mr, Tan, Ja, Thanapal MR (Hospital Kuala Lumpur), Amin Sahid, N, Hayati, F, Jayasilan, J, Sriram, Rk, Subramaniam, S (Queen Elizabeth Hospital &amp, Universiti Malaysia Sabah, Kota, Kinabalu, Sabah, Malaysia), Che Jusoh, A, Hussain, Ah, Mohamed Sidek AS, Mohd Yunus MF, Soh, Jy, Wong, Mpk, Zakaria, Ad, Zakaria, Z (School Of Medical Sciences &amp, Hospital, Universiti Sains Malaysia), Fadzli, A, Fathi, Nq, Koh, Ps, Liew, Yt, Roslani, Ac, Tang, Cy, Teoh, Ly, Wong, Wj, Mexico: Alvarez MR, Yahaya AS (University Malaya Medical Centre)., Arrangoiz, R, Cordera, F, De la Rosa Abaroa MA, G&#243, mez-Pedraza, A, Hernandez, R, Maffuz-Aziz, A, Posada JA (Abc Medical Center), Becerra Garc&#237, a FC (Hospital San &#193, ngel Inn Chapultepec), Alfaro-Goldaracena, A, Buerba, Ga, Castillejos- Molina RA, Chan, C, Dominguez-Rosado, I, Medina-Franco, H, Mercado, M&#225, Oropeza- Aguilar, M, Pe&#241, a G&#243, mez Portugal, E, Posadas-Trujillo, Oe, Rodriguez-Covarrubias, F, Salgado-Nesme, N, Morocco: Arkha Y, Vilatoba M (Instituto Nacional De Ciencias M&#233, dicas Y Nutrici&#243, n &#8220, Salvador Zubir&#225, n&#8221, Bechri, H, El Ouahabi, A, Oudrhiri MY (Centre Hospitalier Universitaire Ibn Sina Rabat), Derkaoui hassani F, El abbadi N (Cheikh Zaid International University Hospital), Amrani, L, Belkhadir, Zh, Benkabbou, A, Chakib, O, El Ahmadi, B, El Bouazizi, Y, Essangri, H, Ghannam, A, Majbar, Am, Mohsine, R, Netherlands: Hompes R, Souadka A (Institut National D&#8217, oncologie)., Meima-van Praag, E, Pronk, Ajm, Sharabiany, S (Amsterdam Umc, University Of Amsterdam), Grotenhuis, B, Hartveld, L, Reijers, S, Van Houdt, W (Antoni Van Leeuwenhoek Ziekenhuis), Baaij, J, Bolster-van Eenennaam, M, De Graaff, M, Sloothaak, D, Van Duijvendijk, P (Gelre Ziekenhuis), Posma-Bouman, L (Slingeland Ziekenhuis), Derksen, T, Franken, J, Oosterling, S (Spaarne Gasthuis), De Bree, R (University Medical Center Utrecht), Konsten, J, Nigeria: Fidelis L, Van Heinsbergen M (Viecuri Medisch Centrum)., Sholadoye, Tt, Tolani, M (Ahmadu Bello University Teaching Hospital), Olaogun, J (Ekiti State University Teaching Hospital), Egbuchulem, Ik, Lawal, Ta, Ogundoyin, O, Olulana DI (University College Hospital), Abdur-Rahman, L, Adeyeye, A, Aremu, I, Bello, J, Olasehinde, O, Oman: Massoud J, Popoola A (University Of Ilorin Teaching Hospital)., Massoud, R, Pakistan: Jamal A, Sorour TM (Khoula Hospital)., Kerawala AA (Cancer Foundation Hospital), Memon, As, Nafees Ahmed, R, Pfau Civil Hospital), Rai L (Dr Ruth K. m., Ayub, B, Hassan, N, Martins, Rs, Ramesh, P, Sayyed, R (Patel Hospital), Butt, U, Kashif, M, Khan, Wh, Qureshi, A, Umar, M, Waris Farooka, M, Wasim, T (Services Hospital Lahore), Ayubi, A, Rashid, I, Peru: Falcon GM, Waqar SH (The Pakistan Institute Of Medical Sciences)., Philippines: Jocson R, Robles R (Instituto Regional De Enfermedades Neopl&#225, sicas Del Sur)., Teh, C (National Kidney &amp, Poland: Major P (Jagiellonian University Medical College), Transplant Institute)., Bobi&#324, ski, M, Kotarski, J, Rasoul-Peli&#324, ska, K (Medical University Of Lublin, Portugal: Azevedo C, Chair And Department Of Gynaecological Oncology And Gynaecology)., Machado, D, Mendes, F (Centro Hospitalar Cova Da Beira), De Sousa, X (Centro Hospitalar De Set&#250, bal), Fernandes, U, Ferreira, C, Guidi, G, Leal, C, Mar&#231, al, A, Marques, R, Martins, D, Melo, A, Tenreiro, N, Vaz Pereira, R, Vieira B (Centro Hospitalar De Tr&#225, s-Os-Montes, E Alto Douro, E. p. e., ), Almeida, Ji, Correia de S&#225, T, Costa, Mjma, Fernandes, V, Ferraz, I, Gil, Cg, Lima da Silva, C, Lopes, L, Machado, N, Marialva, J, Nunes Coelho, M, Pedro, J, Pereira, C, Reis, R, Ribeiro, A, Santos, R, Saraiva, P, Silva, R, Tavares, F, Teixeira M (Centro Hospitalar Do Tamega, E Sousa), Almeida, Ac, Amaral, Mj, Andrade, R, Athayde Nem&#233, sio, R, Breda, D, Camacho, C, Canhoto, C, Colino, M, Correia, S, Costa, M, De Barros, J, De Oliveira L&#243, pez AL, Duque, M, Garrido, S, Guerreiro, P, Guimar&#227, es, A, L&#225, zaro, A, Lopes, C, Martins, R, Nogueira, O, Oliveira, A, Oliveira, Jm, Rodrigues, M, Ruivo, A, Santos, E, Silva, M, Sim&#245, es, J, Valente da Costa A (Centro Hospitalar, E Universit&#225, rio De Coimbra), Almeida, A, Cavaleiro, S, Devezas, V, Faria, Cs, J&#225, come, F, Magalh&#227, es Maia, M, Nogueiro, J, Pereira, A, Pereira-Neves, A, Pina-Vaz, T, Santos-Sousa, H, Silveira, H, Vaz, S, Vieira P (Centro Hospitalar, E Universit&#225, rio De S&#227, o Jo&#227, Gomes da Costa A, Lobo Antunes I (Centro Hospitalar Lisboa Norte), Pinto J, Tojal A (Centro Hospitalar Tondela-Viseu), Cardoso, N, Cardoso, P, Domingues, Jc, Henriques, P, Manso, Mi, Martins dos Santos, G, Morais, H, Pereira, R, Revez, T, Ribeiro, R, Ribeiro, Vi, Soares, A, Sousa, S, Teixeira J (Centro Hospitalar Universit&#225, rio Do Algarve, - Unidade De Faro), Amorim, E, Baptista, Vh, Cunha, Mf, Dias, B, Fazenda, A, Melo Neves JP, Policarpo, F, Sampaio da N&#243, voa Gomes Miguel II, Veiga D (Centro Hospitalar Universitario Do Algarve, - Unidade De Portim&#227, Andrade, Ak, Bandovas, Jp, Borges, N, Branquinho, A, Chumbinho, B, Correia, J, Fidalgo, H, Figueiredo de Barros, I, Frade, S, Gomes, J, Maciel, J, Pina, S, Rodrigues, A, Silva, N, Silveira Nunes, I, Sousa, R (Centro Hospitalar Universit&#225, rio Lisboa Central), Ascens&#227, o, J, Azevedo, P, Costeira, B, Cunha, C, Garrido, R, Gomes, H, Louren&#231, o, I, Mendinhos, G, Miranda, P, Nobre Pinto, A, Peralta Ferreira, M, Ribeiro, J, Rio Rodrigues, L, Sousa Fernandes, M (Hospital Beatriz Angelo), Azevedo J (Hospital Da Horta, E. p. e. ), Galv&#227, o, D, Soares, Ac, Vieira, A, Vieira, B (Hospital De Santo Espirito Da Ilha Terceira), Patr&#237, cio, B, Santos, Pmdd, Vieira Paiva Lopes AC (Hospital De Torres Vedras, - Centro Hospitalar Do Oeste), Cunha, R, Faustino, A, Freitas, A, Martins, Ab, Mendes, Jr, Parreira, R, Rosa, J, Teves, M (Hospital Do Divino Esp&#237, rito Santo), Abreu da Silva, A, Claro, M, Costa Santos, D, Deus, Ac, Grilo JV (Hospital Do Litoral Alentejano), Borges, F, Corte Real, J, Henriques, S, Lima, Mj, Matos Costa, P (Hospital Garcia De Orta), Brito da Silva, F, Caiado, A, Fonseca, F (Instituto Portugu&#234, s De Oncologia De Lisboa Francisco Gentil), 194, ngelo, M, Baiao, Jm, Martins Jord&#227, Vieira Caro&#231, o, T (Ipo Coimbra), Messias, J, Millan, A, Salgado, I, Santos, P (Ipo Lisboa), Ba&#237, a, C, Canotilho, R, Correia, Am, Ferreira Pinto AP, Peyroteo, M, Puerto Rico: Escobar P, Videira JF (Ipo Porto)., R&#233, union: Kassir R, Maldonado Santiago M (Instituto Gineco Oncologico)., Romania: Bezede C, Sauvat F (Chu Reunion)., Chitul, A, Ciofic, E, Cristian, D, Grama, F (Coltea Clinical Hospital), Pirtea L, Secosan C (Emergency Clinical City Hospital), Bonci, E, Gata, V, Ion Chiricuta Institute Of Oncology), Titu S (Prof. Dr., Ginghina, O, Iordache, N, Russia: Garmanova T, Iosifescu RV (Saint John Emergency Hospital)., Kazachenko, E, Markaryan, D, Rodimov, S, Tsarkov, P, Tulina, I (Clinic Of Coloproctology And Minimally Invasive Surgery, Sechenov Medical State University), Litvina, Y, Provozina, A (Immanuel Kant Baltic Federal University, Regional Clinical Hospital), Agapov, M, Galliamov, E, Kakotkin, V, Kubyshkin, V, 1050, 1072, 1084, 1083, 1086, 1074, &#1040, (Moscow Research And Educational Center, Saudi Arabia: Alshahrani M, Lomonosov Moscow State University)., Alsharif, F, Eskander, M (Aseer Central Hospital), Al Raddadi, R, Majrashi, S, Mashat, A (East Jeddah General Hospital), Akeel, N, Alharthi, M, Aljiffry, M, Basendowah, M, Farsi, A, Ghunaim, M, Khoja, A, Maghrabi, A, Malibary, N, Nassif, M, Nawawi, A, Saleem, A, Samkari, A, Trabulsi, N (King Abdulaziz University Hospital), Al Awwad, S, Alghamdi, M, Alnumani, T, Nasser, M, Said bayazeed, A (King Fahad General Hospital), Alhefdhi, A, Almalik, O, Alomair, A, Alotaibi, N, Alresaini, F, Alsalamah, R, Alsobhi, S, Mahasin, Z, Othman, E, Velagapudi, S (King Faisal Specialist Hospital), Al Habes, H, Alamri, A, Alkarak, S, Alqannas, M, Alyami, M, Alzamanan, M, Cort&#233, s Guiral, D, Elawad, A (King Khalid Hospital), AlAamer, O, Alriyees, L, Alselaim, N (King Saud Bin Abdulaziz University For Health Sciences, King Abdullah International Medical Research Center, Ministry Of National Guard, Health, Affairs, General Surgery Department., ), Abdulkareem, A, Ajlan, A, Akkour, K, Al-Habib, A, Al-Khayal, K, Alatar, A, Alburakan, A, Alhalal, H, Alhassan, B, Alhassan, N, Alobeed, O, Alsaif, A, Alsaif, F, Alshammari, S, Alshaygy, I, Barry, M, Bin Nasser, A, Bin Traiki, T, Bokhari, A, Elwatidy, S, Helmi, H, Madkhali, A, Nouh, T, Rabah, Pd, Serbia: Paunovic I, Zubaidi A (King Saud University)., Slijepcevic, N (Centre For Endocrine Surgery, Clinical Centre Of Serbia), Aleksi&#263, L, Antic, A, Barisic, G, Ceranic, M, Galun, D, Gruba&#269, &#381, Jelenkovic, J, Kecmanovi&#263, Kmezi&#263, Knezevic, D, Krivokapic, Z, Latin&#269, Markovic, V, Mati&#263, Miladinov, M, Pavlov, M, Pejovic, I, Radenkovic, D, Tadic, B, Vasljevi&#263, J, Velickovic, D, Zivanovic, M (Clinic For Digestive Surgery, Perovic M, Srbinovic L (Clinic For Gynecology And Obstetrics Narodni Front), Andrijasevic, S, Bozanovic, T, Cerovic Popovic, R, Dokic, M, Janjic, T, Jeremic, K, Kadija, S, Ladjevic Likic, I, Mirkovic, L, Pantovic, S, Pilic, I, Radojevic, M, Stefanovic, A, Vidakovic, S, Vilendecic, Z (Clinic For Gynecology And Obstetrics, Clinical Center Of Serbia), Antic, S, Dun&#273, erovi&#263, Jelovac, D, Jezdic, Z, Konstantinovic, V, Kotlar, B, Kuzmanovic, C, Lazi&#263, Petrovic, M, Popovic, F, Pucar, A, Romic, M, Sumrak, S, Vujanac, V (Clinic For Maxillofacial Surgery, School Of Dental Medicine, University Of Belgrade), Bascarevic, V, Bogdanovi&#263, I, Gruji&#269, Ilic, R, Mili&#263, evi&#263, Milisavljevi&#263, F, Miljkovi&#263, Paunovic, A, 352, 263, epanovi&#263, V, Stanimirovic, A, Todorovic, M (Clinic For Neurosurgery, Jotic, A, Milovanovic, J, Trivic, A (Clinic For Otorhinolaryngology And Maxillofacial Surgery, Bumbasirevic, U, Dzamic, Z, Kajmakovi&#263, B, Prijovi&#263, N, Zivkovic, M (Clinic Of Urology, Buta, M, Cvetkovic, A, Djurisic, I, Gacic, S, Goran, M, Inic, Z, Jeftic, N, Jevric, M, Jokic, V, Markovic, I, Milanovi&#263, Nikolic, S, Pejnovic, L, Savkovi&#263, Spurnic, I, Stevic, D, Stojiljkovic, D, Vucic, N, Zegarac, M (Institute For Oncology And Radiology Of Serbia), Karamarkovic, A, Kenic, M, Kovacevic, B, Krdzic, I, Singapore: Chan CW, Milutinovi&#263, V (Zvezdara University Medical Center)., Slovakia: G&#225, lis B, Lieske B (National University Hospital)., South Africa: Almgla N, &#352, imko K (University Hospital Bratislava)., Bernon, M, Boutall, A, Cairncross, L, Herman, A, Hilton, T, Jonas, E, Kloppers, C, Malherbe, F, Mugla, W, Nel, D, Rayamajhi, S, Van Wyngaard, T, Spain: Casta&#241, o-Leon AM, Vogel J (Groote Schuur Hospital)., Delgado Fernandez, J, Eiriz Fernandez, C, Espino Segura-Illa, M, Esteban Sinovas, O, Garcia Perez, D, Gomez, P, Jimenez-Roldan, L, Lagares, A, Moreno- Gomez, L, Paredes, I, P&#233, rez N&#250, 241, ez, A, S&#225, nchez Aniceto, G, Santas, M (12 De Octubre University Hospital), Fern&#225, ndez Rodr&#237, guez, P, Paniagua Garc&#237, a Se&#241, orans, M, Sanchez- Santos, R, Vigorita, V (&#193, lvaro Cunqueiro Hospital), Acrich, E, Baena Sanfeliu, E, Barrios, O, Golda, T, Santanach, C, Serrano-Navidad, M, Sorribas Grifell, M, Vives RV (Bellvitge University Hospital), Escol&#224, D, Jim&#233, nez A (Comarcal Alt Pened&#233, Cayetano Paniagua L, G&#243, mez Fern&#225, ndez L (Consorci Sanitari De Terrassa), Artigues, E, Bernal-Sprekelsen, Jc, Catal&#225, Bauset JC (Consorcio Hospital General Universitario), Collera, P, Diaz Del Gobbo, R, Farre Font, R, Flores Clotet, R, mez D&#237, az CJ, Gu&#224, rdia, N, Guariglia, Ca, Osorio, A, Sanchez Jimenez, R, Sanchon, L, Soto Montesinos C (Fundaci&#243, Althaia, - Xarxa Assistencial Universit&#224, ria De Manresa), Albi Martin B, Garc&#237, a Villayz&#225, n JE (Fundaci&#243, n Jimenez Diaz University Hospital), Alonso-Lamberti, L, Assaf, M, Baeza Pintado, N, Carabias, A, a-Quijada, J, Huertas Fernandez MA, Jimenez Miram&#243, n, J, Jimenez, V, Jover, Jm, Landeo Ag&#252, ero SA, Leon, R, Mart&#237, n Salamanca MB, rez Sim&#243, n, V, Ponce, S, Rodriguez, Jl, Salazar, A, Valle Rubio, A (Getafe University Hospital), Aguado, H (Hell&#237, n Hospital), Aldecoa Ansorregui, I, Bravo Infante, R, De Lacy FB, Di Somma, A, D&#237, az-Feijoo, B, Ense&#241, at Nora, J, Fabregas, N, Ferr&#233, s, A, Gil Iba&#241, ez, B, Gonzalez Sanchez JJ, Gracia, I, Hoyos Castro JA, Lacy, Am, Langdon, C, Mombl&#225, n, D, Morales, X, Oleaga, L, Otero, A, Pedrosa, L, Poblete Carrizo, J, Reyes Figueroa LA, Roldan Ramos, P, Rumia-Arboix, J, Tercero-Uribe, Ai, Topczewski, Te, Torales, J, Torne, A, Torn&#233, R, Turrado-Rodriguez, V, Valero, R, Valverde, S (Hospital Clinic Barcelona), Anula, R, Cano-Valderrama, O, Del Campo Mart&#237, n, M, ez-Valladares, L, Dom&#237, nguez, I, Dziakova, J, a Alonso, M, a Romero, E, mez Latorre, L, Muguerza, Jm, Pizarro, Mj, Saez Carlin, P, nchez del Pueblo, C, nchez-Pernaute, A, Sanz Ortega, G, Sanz-Lopez, R, Torres, A (Hospital Cl&#237, nico De Madrid), Garc&#233, s-Albir, M, Lopez, F, n-Ar&#233, valo, J, Moro-Valdezate, D, Pla-Marti, V (Hospital Cl&#237, nico Universitario De Valencia), Beltr&#225, n de Heredia, J, De Andr&#233, s Asenjo, B, mez Sanz, T, Jezieniecki, C, Nu&#241, ez Del Barrio, H, Ortiz de Sol&#243, rzano Aurusa FJ, Romero de Diego, A, Ruiz Soriano, M, Trujillo D&#237, az, J, Vazquez fernandez, A (Hospital Cl&#237, nico Universitario De Valladolid), Lora-Cumplido P, Sosa MV (Hospital De Cabue&#241, es), Gonzalez-Gonzalez E, Minaya Bravo AM (Hospital Del Henares), Alonso de la Fuente, N, Cazador Labat, M, Cecchini, L, Espinosa, Ca, Jimenez Toscano, M, L&#243, pez Campillo, A, Mancebo, G, Martorell, P, Munarriz, M (Hospital Del Mar), Grau-Talens EJ, Martin-Perez B (Hospital Don Benito-Villanueva), Benavides Buleje JA, Carrasco Prats, M, ndez, Pv, ndez-L&#243, pez, A, a Escudero, D, a Porcel VJ, Garcia Soria, V, Gim&#233, nez Franc&#233, s, C, Gonz&#225, lez Valverde FM, Gurrea, E, pez-Morales, P, Marco Garrido, A, nez Alonso JA, Medina, E, Mu&#241, oz Camarena JM, Parra Ba&#241, os PA, a Ros, E, Ramirez Faraco, M, Ruiz-Mar&#237, Sanchez Rodriguez, C, Valero Soriano, M (Hospital General Reina Sof&#237, Estaire G&#243, mez, M, ndez Camu&#241, as, &#193, Garcia Santos EP, Jimenez Higuera, E, nez-Pinedo, C, oz-Atienza, V, Padilla-Valverde, D, Pic&#243, n Rodr&#237, guez, R, Redondo Calvo FJ, nchez-Garc&#237, a, S, Sanchez-Pelaez, D (Hospital General Universitario De Ciudad Real), Colombari, Rc, Del valle, E, ndez, M, Lozano Lominchar, P, n, L, Rey Valcarcel, C, Steiner, Ma, Tudela, M, Zorrilla Ort&#250, zar, J (Hospital General Universitario Gregorio Mara&#241, 243, Alcaide Matas, F, a P&#233, rez JM, Troncoso Pereira, P (Hospital Mateu Orfila), Mora-Guzm&#225, n, I (Hospital Santa B&#225, rbara), Abell&#225, Achalandabaso Boira, M, Jorba, R, Memba Ikuga, R, Olona, C, Sales Mallafr&#233, R (Hospital Universitari De Tarragona Joan Xxiii), Cavall&#233, Busquets, P, Gavalda Pellice MGP, Salinas Pe&#241, a, J (Hospital Universitari Sant Joan), Aragon Achig EJ, Barbier, L, Caja Vivancos, P, Gainza, A, a Gutierrez JJ, Mallabiabarrena Ormaechea, G, Mar&#237, n, H, Martin Playa, P, Melchor Corc&#243, stegui, I, Prieto Calvo, M, Rodriguez Fraga, A, Villalabeitia Ateca, I (Hospital Universitario Cruces), De Andres Olabarria, U, Dur&#225, n Ballesteros, M, ndez Pablos FJ, Ib&#225, ez-Aguirre, Fj, Sanz Larrainzar, A, Ugarte-Sierra, B (Hospital Universitario De Galdakao), De la Hoz Rodr&#237, guez, &#193, Di Martino, M, a Septiem, J, Martin-Perez, E, oz de Nova JL (Hospital Universitario De La Princesa), Calvo Espino P, Guillamot Ruano P (Hospital Universitario De M&#243, stoles), Colao Garc&#237, a, L, az P&#233, rez, D, Esteban Agust&#237, E, Galindo Jara, P, Gutierrez Samaniego, M, Hernandez Bartolome MA, Serrano Gonz&#225, lez, J (Hospital Universitario De Torrej&#243, n De Ardoz), Alonso Poza, A, Di&#233, guez, B, a-Conde, M, Hern&#225, ndez-Garc&#237, a, M, Losada, M (Hospital Universitario Del Sureste), Chiesa-Estomba, Cm, lez Garc&#237, a J&#193, Larruscain, E, Sistiaga-Su&#225, rez JA (Hospital Universitario Donostia), Alvarez, E, Chavarrias, N, Fr&#237, as, L, a Pineda, V, Geg&#250, ndez Sim&#243, n, A, Gort&#225, zar, S, Gracia, M, Guevara, J, ndez Gutierrez, A, Loayza, A, a Dolores DT, C, Melendez, M, Moreno-Palacios, E, Perez, Y, Prieto Nieto MI, Ramos- Mart&#237, n, P, Rubio-Perez, I, Saavedra, J, Sanchez-Mendez, Ji, Siegrist Ridruejo, J, Urbieta, A, Zapardiel, I (Hospital Universitario La Paz), Cantalejo diaz, M, De Miguel Ardevines MDC, Duque-Mall&#233, Gascon Ferrer, I, lez-Nicol&#225, s Tr&#233, bol MT, Gracia-Roche, C, Herrero Lopez, M, Jariod Ferrer UM, Lanzon, A, Martinez German, A, Matute, M, Redondo, C, nchez Fuentes, N, nchez-Rubio, M, Santero-Ramirez, Ms, Saud&#237, Sim&#243, n Sanz MV, Uson-Bouthelier, T (Hospital Universitario Miguel Servet), Blazquez Martin, A, Diez Alonso, M, a Rico, E, Garcia-Loarte Gomez, E, Garcia-Moreno Nisa, F, Gutierrez Calvo, A, Hernandez, P, Lasa, I, Mendoza-Moreno, F, Morales Palacios, N, Ovejero Merino, E, Vera Mansilla, C (Hospital Universitario Principe De Asturias), Acebes Garc&#237, a, F, Bail&#243, Bueno Ca&#241, ones AD, Choolani Bhojwani, E, Marcos-Santos, P, Miguel, T, Pacheco S&#225, nchez, D, rez-Saborido, B, Sanchez Gonzalez, J, Tejero-Pintor FJ (Hospital Universitario R&#237, o Hortega), Alconchel, F, Conesa, A, Gil Mart&#237, nez, J, Guti&#233, rrez Fern&#225, ndez AI, Lopez Abad, A, Nicol&#225, s-L&#243, pez, T, Ramirez Romero, P, Roca Calvo MJ, Rodrigues, K, Ruiz Manzanera JJ, Soriano AI (Hospital Universitario Virgen De La Arrixaca), Cano, A, Capitan-Morales, L, Cintas Catena, J, Gomez-Rosado, J, Oliva Mompean, F, rez S&#225, nchez MA, R&#237, o Lafuente FD, Torres Arcos, C, Valdes-Hernandez, J (Hospital Universitario Virgen Macarena), Cholewa, H, Domingo, S, Frasson, M, Lago, V, Marina Martin, T, nez Chicote, C, Sancho-Muriel J (Hospital Universitario, Y Polit&#233, cnico La Fe), Landaluce-olavarria A, Lecumberri D (Hospital Urduliz), Abad Gurumeta, A, Abad-Motos, A, nez-Hurtado, E, Ripoll&#233, s-Melchor, J, Ruiz Escobar, A (Infanta Leonor University Hospital), Cuadrado- Garc&#237, a, A, Garcia-Sancho Tellez, L, Heras Aznar, J, Mat&#233, P, Ortega V&#225, zquez, I, Picardo, Al, Rojo L&#243, pez JA, Sanchez Cabezudo Noguera, F, Serralta de Colsa, D (Infanta Sof&#237, a University Hospital), Anchuelo Latorre, J, Cagigas Fernandez, C, Cai&#241, a Ruiz, R, Gomez Ruiz, M, Hernanz, F, Jimeno Fraile, J, nez-P&#233, rez, P, Poch, C, Santarrufina Martinez, S, Valbuena Jabares, V (Marqu&#233, s De Valdecilla University Hospital), Moliner-S&#225, nchez, C, Pingarron-Martin, L, Rey-Biel, J, Ruiz Martin, I (Rey Juan Carlos University Hospital), Blas Laina JL, Cros, B, Escartin, J, Garcia Egea, J, Nogu&#233, Talal El-Abur, I, Y&#225, nez, C (Royo Villanova), Cagigal Ortega EP, Cervera, I, az Pe&#241, a, P, Elena, Gdcr, Enjuto, D, ndez Bernab&#233, s Garc&#237, a, R, Gonzalez, J, ndez, I, Herrera-Merino, N, Marqueta De Salas, M, Martinez Pascual, P, Perez Gonzalez, M, Ramos Bonilla, A, Rodr&#237, guez G&#243, mez, L (Severo Ochoa University Hospital), Besc&#243, Blanco-Colino, R, Brana, I, Caimari, B, De Pablo Garc&#237, a-Cuenca, A, Duran-Valles, F, Espin-Basany, E, Giralt L&#243, pez de Sagredo, J, Pamias, J, Pellino, G, Prat, N, Pujol Pina, R, Sri Lanka: Arulanantham A, Saez barba M (Vall D&#8217, hebron University Hospital)., Bandara, Gbk, Jayarajah, U, Ravindrakumar, S, Rodrigo VS (District General Hospital Chilaw), Srishankar S (Teaching Hospital Anuradhapura). Sudan: Ali karar AA (Al-Rajhi). Sweden: Elbe P, Lindqvist EK (Karolinska University Hospital), Taflin, H (Sahlgrenska University Hospital), 196, lg&#229, Heinius, G, Nordberg, M, Pieniowski, E (South General Hospital), Gkekas, I, fgren, N, Ruteg&#229, rd, M, Switzerland: Arigoni M, Sund M (Umea University Hospital)., Bernasconi, M, Christoforidis, D, Di Giuseppe, M, La Regina, D, Mongelli, F (Ente Ospedaliero Cantonale), Chevallay, M, Dwidar, O, Gialamas, E, Sauvain, M (Hopital De Pourtales), Klenke, F, Koll&#224, r, A, Kurze, C (Inselspital, Bern University Hospital, University Of Bern), Adamina, M, B&#228, chler, T, Crugnale, As, Giardini, M, Guglielmetti, L, Peros, G, Turkey: Aghayeva A, Solimene F (Kantonsspital Winterthur)., Hamzaoglu, I, Sahin, I (Acibadem Altunizade Hospital), Akaydin, E, Aliyeva, Z, Aytac, E, Baca, B, D&#252, lgero&#287, lu, O, Ozben, V, Ozmen, Bb, Uras, C (Acibadem Atakent Hospital), Arikan, Ae, Bilgin, Ia, Bozk&#305, rl&#305, Ceyhan, Go, Kara, H, Karahasano&#287, lu, T, Uras, C (Acibadem Maslak Hospital), Celik, H (Adana Baskent University), Meydanli MM (Ankara City Hospital), Akilli, H, Ayhan, A, Kuscu, E (Baskent University), Onan MA (Gazi University Medical Faculty Hospital), Akgor, U, Dincer, Ha, Erol, T, Gultekin, M, Orhan, N, Ozgul, N, Salman, Mc, Soyak, B (Hacettepe University Hospital), Alhamed, A, Erg&#252, n, S, OZcel&#305, k, Mf, Sanli, An, Uluda&#287, Velidedeoglu, M, Zengin AK (Istanbul Universty, - Cerrahpa&#351, a Medical Faculty), Bozkurt, Ma, Kara, Y, Kocata&#351, A (Kanuni Sultan Suleyman Training And Research Hospital), Cimenoglu, B, Demirhan, R, Lutfi Kirdar Training And Research Hospital), Saracoglu K (Kartal Dr., Azamat, I&#775, f, Balik, E, Bu&#287, ra, D, Giray, B, Kulle, Cb, Taskiran, C, Vatansever, D (Ko&#231, University Medical School), G&#246, zal, K, G&#252, ler, Sa, ken, H, Tatar, Oc, Utkan, Nz, Y&#305, ld&#305, r&#305, m, A, Y&#252, ksel, E (Kocaeli University Teaching Hospital), Akin, E, Altintoprak, F, Bayhan, Z, Cakmak, G, 199, apo&#287, lu, R, elebi, F, Demir, H, Dikicier, E, Firat, N, n&#252, ll&#252, Kamburo&#287, lu, Mb, Kocer, B, 231, 252, k, If, Mantoglu, B (Sakarya University Faculty Of Medicine), olak, E, Kucuk, Go, Uyanik MS (Samsun Training And Research Hospital), 304, lhan Varank Training And Research Hospital), G&#246, ksoy B (Sehit Prof. dr., Bozkurt, E, Citgez, B, Mihmanli, M, Tanal, M, Yetkin, G (Sisli Hamidiye Etfal Training And Research Hospital), Akalin, M, Arican, C, Avci, Ek, Aydin, C, Demirli At&#305, c&#305, Emiroglu, M, Kaya, T, Kebab&#231, 305, Kilinc, G, Kirmizi, Y, 287, c&#252, H, Salimo&#287, lu, S, Sert, I&#775, Tugmen, C, Tuncer, K, Uslu, G, Ye&#351, ilyurt, D (University Of Health Sciences Tepecik Training And Research Hospital), Karaman, E, Kolusar&#305, A (Van Yuzuncu Yil University, Medical, Faculty), Uganda: Benson O, Yildiz A (Yildirim Beyazit University Yenimahalle Training And Research Hospital)., United Kingdom: Agilinko J, Lule H (Kampala International University Teaching Hospital)., Ahmeidat, A, Barabasz, M, Bekheit, M, Cheung, Lk, Colloc, T, Cymes, W, Elhusseini, M, Gradinariu, G, Hannah, A, Kamera, Bs, Mignot, G, Shaikh, S, Sharma, P (Aberdeen Royal Infirmary), Abu-Nayla, I, Agrawal, A, Al-Mohammad, A, Ali, S, Ashcroft, J, Azizi, A, Baker, O, Balakrishnan, A, Byrne, M, Colquhoun, A, Cotter, A, Coughlin, P, Davies, Rj, Durrani, A, Elshaer, M, Fordington, S, Forouhi, P, Georgiades, F, Grimes, H, Habeeb, A, Hudson, V, Hutchinson, P, Irune, E, Jah, A, Khan, Dz, Kolias, A, Kyriacou, H, Lamb, B, Liau, S, Luke, L, Mahmoud, R, Mannion, R, Masterson, L, Mitrofan, Cg, Mohan, M, Morris, A, Murphy, S, Neill, R, Price, S, Pushpa-rajah, J, Raby-Smith, W, Ramzi, J, Rooney, S, Santarius, T, Singh, A, Stewart, Gd, Tan, Xs, Townson, A, Tweedle, E, Walker, C, Waseem, S, Yordanov, S (Addenbrooke&#8217, Jones, T, Kattakayam, A, Loh, C, Lunevicius, R, Pringle, S, Schache, A, Shaw, R, Sheel, A (Aintree University Hospital), Rossborough, C (Altnagelvin Area Hospital), Angelou, D, Choynowski, M, McAree, B, McCanny, A, Neely, D (Antrim Area Hospital- Northern Health And Social Care Trust), Tutoveanu, G (Barnsley Hospital Nhs Foundation Trust), Ahad, S, De La Cruz Monroy MFI, Mosley, F, Oktseloglou, V (Bradford Royal Infirmary), Alanbuki, A, Patel, M, Shabana, A (Brighton And Sussex Nhs Trust, Princess Royal Hospital), Perera, E, Raveendran, D, Ravi- Shankar, K, Thiruchelvam, J (Broomfield Hospital), Arrowsmith L, Campbell W (Causeway Hospital), Grove, T, Kontovounisios, C, Warren, O (Chelsea And Westminster Hospital), Rolland, P (Cheltenham General Hospital), Aggarwal, A, Brown, S, Jelley, C, Neal, N (Churchill Hospital), Clifford, R, Eardley, N, Krishnan, E, Manu, N, Martin, E, Roy Mahapatra, S, Serevina, Ol, Smith, C, Vimalachandran, D (Countess Of Chester Hospital), Bordenave, M, Houston, R, Putnam, G, Robson, A, Tustin, H (Cumberland Infirmary), Emslie, K, Labib, Pl, Marchbank, A, Miller, D, Minto, G, Natale, J, Nwinee, H, Panahi, P, Rogers, L (Derriford Hospital), Abubakar, A, Akhter Rahman MM, Kyk, Ko, Brien, H, Sasapu, K, Woodun, H (Diana Princess Of Wales Hospital Grimsby), Inglis R, Ng HJ (Dumfries And Galloway Royal Infirmary), De Gea Rico, A, Ghazali, N, Lambert, J, Markose, G, Math, S, Sarantitis, I, Shrestha, D, Sultana, A, Taggarsi, M, Timbrell, S, Vaz, Op, Vitone, L (East Lancashire Hospitals Nhs Trust), Day, A, Dent, H, Fahim, M, Waheed, S (East Surrey Hospital), Hunt A, Laskar N (East Sussex Healthcare (Conquest Hospital And Eastbourne District General Hospital)), Gupta, A, Steinke, J, Thrumurthy, S (Epsom &amp, St Helier University Hospitals Nhs Trust), Massie, E, McGivern, K, Rutherford, D, Wilson, M (Forth Valley Royal Hospital), Hardie J, Kazzaz S (Frimley Health Nhs Ft - Frimley Park), Handa, S, Kaushal, M, Kler, A, Patel, P, Redfern, J, Tezas, S (Furness General Hospital), Aawsaj, Y, Amonkar, S, Blackwell, L, Blake, D, Carter, J, Emerson, H, Fisher, A, Katory, M, Korompelis, P, McCormick, W, Mustafa, A, Pearce, L, Ratnavelu, N, Reehal, R (Gateshead Health Nhs Foundation Trust), Kretzmer, L, Lalou, L, Manku, B, Parwaiz, I, Stafford, J (George Eliot Hospital), Abdelkarim, M, Asqalan, A, Gala, T, Ibrahim, S, Maw, A, Mithany, R, Morgan, R, Sundaram Venkatesan, G (Glan Clwyd Hospital), Ang, K, Caruana, Ej, Chowdhry, Mf, Mohammad, A, Nakas, A, Rathinam, S (Glenfield Hospital), Boal, M, Brown, O, Dwerryhouse, S, Higgs, S, Vallance, A (Gloucestershire Royal Hospital), Boyd, E, Irvine, V, Kirk, A (Golden Jubilee National Hospital), Bakolas, G, Boulton, A, Chandock, A, Khan, T, Kumar, M (Good Hope Hospital), Agoston, P, Bill&#232, Challacombe, B, Fraser, S, Harrison-Phipps, K, King, J, Mehra, G, Mills, L, Najdy, M, Nath, R, Okiror, L, Pilling, J, Rizzo, V, Routledge, T, Sayasneh, A, Stroman, L, Wali, A (Guy&#8217, Fehervari, M, Fotopoulou, C, Habib, N, Hamrang-Yousefi, S, Jawad, Z, Jiao, L, Pai, M, Ploski, J, Rajagopal, P, Saso, S, Sodergren, M, Spalding, D (Hammersmith Hospital), Laws, S (Hampshire Hospitals Nhs Trust), Hardie C, McNaught C (Harrogate District Hospital), Alam, R, Budacan, A, Cahill, J, Kalkat, M, Karandikar, S, Kenyon, L, Naumann, D, Patel, A (Heartlands Hospital), Ayorinde, J, Chase, T, Cuming, T, Ghanbari, A, Humphreys, L, Tayeh, S (Homerton University Hospital), Aboelkassem Ibrahim, A, Bichoo, R, Cao, H, Chai, Akw, Choudhury, J, Evans, C, Fitzjohn, H, Ikram, H, Langstroth, M, Loubani, M, McMillan, A, Nazir, S, Qadri, Ssa, Robinson, A, Ross, E, Sehgal, T, Wilkins, A (Hull University Teaching Hospitals Nhs Trust), Dixon, J, Dunning, J, Freystaetter, K, Jha, M, Lester, S, Madhavan, A, Thulasiraman, Sv, Viswanath, Y (James Cook University Hospital), Curl-Roper, T, Delimpalta, C, Liao, Ccl, Velchuru, V, Westwood, E (James Paget Univeristy Nhs Foundation Trust Hospital), Belcher, E, Bond-Smith, G, Chidambaram, S, Di Chiara, F, Fasanmade, K, Fraser, L, Fu, H, Ganau, M, Gore, S, Graystone, J, Jeyaretna, D, Khatkar, H, Lami, M, Maher, M, Mastoridis, S, Mihai, R, Piper, R, Prabhu, S, Risk, Obf, Selbong, U, Shah, K, Smillie, R, Soleymani majd, H, Sravanam, S, Stavroulias, D, Tebala, Gd, Vatish, M, Verberne, C, Wallwork, K, Winter, S (John Radcliffe Hospital), Bhatti, Mi, Boyd-Carson, H, Elsey, E, Gemmill, E, Herrod, P, Jibreel, M, Lenzi, E, Saafan, T, Sapre, D, Sian, T, Watson, N (King&#8217, s Mill Hospital), Athanasiou, A, Bourke, G, Bradshaw, L, Brunelli, A, Burke, J, Coe, P, Costigan, F, Elkadi, H, Ho, M, Johnstone, J, Kanatas, A, Kantola, V, Kaufmann, A, Laios, A, Lam, S, MacInnes, E, Munot, S, Nahm, C, Otify, M, Pompili, C, Smith, I, Theophilou, G, Toogood, G, Wade, R, Ward, D, West, C (Leeds Teaching Hospitals Trust), Annamalai, S, Ashmore, C, Boddy, A, Hossain, T, Kourdouli, A (Leicester Royal Infirmary), Gvaramadze, A, Jibril, A, Prusty, L, Thekkinkattil, D (Lincoln County Hospital), Harky A, Shackcloth M (Liverpool Heart And Chest Hospital), Askari, A, Cirocchi, N, Kudchadkar, S, Patel, K, Sagar, J, Shaw, S, Talwar, R (Luton And Dunstable University Hospital), Abdalla, M, Edmondson, R, Ismail, O, Jones, D, Newton, K, Stylianides, N (Manchester Royal Infirmary), Aderombi, A, Andaleeb, U, Bajomo, O, Beatson, K, Garrett, W, Mehmood, M, V (Medway Hospital), Ng, Al-Habsi, R, Divya, Gs, Keeler, B (Milton Keynes University Hospital), Al- Sarireh, B, Egan, R, Harries, R, Henry, A, Kittur, M, Li, Z, Parkins, K, Soliman, F, Spencer, N, Thompson, D (Morriston Hospital Swansea), Burgess, C, Gemmell, C, Grieco, C, Hollyman, M, Hunt, L, Morrison, J, Ojha, S, Ryan, N (Musgrove Park Hospital), Abbadessa, F, Barnard, S, Dawe, N, Hammond, J, Mahmoud Ali, F, McPherson, I, Mellor, C, Moir, J, Pandanaboyana, S, Powell, J, Rai, B, Roy, C, Sachdeva, A, Saleh, C, Tingle, S, Williams T (Newcastle Upon Tyne Hospitals Nhs Foundation Trust., ), Manickavasagam, J, McDonald, C, McGrath, N, McSorley, N, Ragupathy, K, Ramsay, L, Solth, A (Ninewells Hospital), Kakisi, O, Seebah, K, Shaikh, I, Sreedharan, L, Youssef, M (Norfolk And Norwich University Hospital), Shah, J (North Manchester General Hospital), Ameerally, P (Northampton General Hospital), McLarty, N, Mills, S, Shenfine, A (Northumbria Nhs Hospital Trust), Sahnan, K (Northwick Park Hospital), Abu, J, Addae-Boateng, E, Bratt, D, Brock, L, Burnside, N, Cadwell-Sneath, S, Gajjar, K, Gan, C, Grundy, C, Hallam, K, Hassell, K, Hawari, M, Joshi, A, Khout, H, Konstantinidi, K, Lee, Rxn, Nunns, D, Schiemer, R, Walton, T, Weaver, H, Whisker, L, Williamson, K (Nottingham City Hospital), McVeigh, J, Myatt, R, Williams MA (Nuffield Orthopaedic Centre), Kaur, R, Leung, E, Sundar, S (Pan- Birmingham Gynaecological Cancer Centre), Michel, M, Patil, S, Ravindran, S, Sarveswaran, J, Scott, L (Pinderfields Hospital), Edmond M, King E (Poole Hospital), Almond, M, Bhangu, A, Breik, O, Cato, Ld, Desai, A, Ford, S, Griffiths, E, Idle, M, Kamal, M, Kisiel, A, Kulkarni, R, Mak, Jkc, Martin, T, Nankivell, P, Parente, A, Parmar, S, Pathanki, Am, Phelan, L, Praveen, P, Saeed, S, Sharma, N, Singh, J, Tirotta, F, Vijayan, D (Queen Elizabeth Hospital Birmingham), Geddes, A, McCaul, J, McMahon, J (Queen Elizabeth University Hospital), Khan, Ah, Khan, F, Mansuri, A, Mukherjee, S, Sarigul, M, Singh, S, Tan, Kl, Woodham, A (Queen&#8217, s Hospital Romford), Adiamah, A, Brewer, H, Chowdhury, A, Evans, J, Humes, D, Jackman, J, Koh, A, Lewis-Lloyd, C, Oyende, O, Reilly, J, Worku, D (Queens Medical Centre), Cool, P, Cribb, G, Shepherd, K (Robert Jones And Agnes Hunt Orthopaedic Hospital), Bisset C, Moug S (Royal Alexandra Hospital), Elson, N, Faulkner, G, Saleh, P, Underwood, C (Royal Bolton Hospital), Brixton, G, Findlay, L, Klatte, T, Majkowska, A, Manson, J, Potter, R (Royal Bournemouth Hospital), Bhalla, A, Chia, Z, Daliya, P, Goyal, A, Grimley, E, Hamad, A, Kumar, A, Malcolm, Fl, Theophilidou, E (Royal Derby Hospital), Bowden, J, Campain, N, Daniels, I, Fowler, G, John, J, Massey, L, McDermott, F, McGrath, J, McLennan, A, Ng, M, Pascoe, J, Rajaretnam, N (Royal Devon And Exeter Hospital), Bulathsinhala, S, Davidson, B, Fusai, G, Hidalgo Salinas, C, Machairas, N, Pissanou, T, Pollok, Jm, Raptis, Da, Soggiu, F, Tzerbinis, H, Xyda SE (Royal Free Hospital), Beamish, A, Davies, E, Foulkes, R, Magowan, D, Nassa, H, Ooi, R, Price, C, Smith, L, Solari, F, Tang, A, Williams, G (Royal Gwent Hospital), Al-Tamimi, Y, Bacon, A, Beasley, N, Chew, D, Crank, M, Ilenkovan, N, Macdonald, M, Narice, B, Rominiyi, O, Thompson, A, Varley, I (Royal Hallamshire Hospital), Drake, T, Harrison, E, Linder, G, Mayes, J, McGregor, R, Skipworth, R, Zamvar, V (Royal Infirmary Of Edinburgh), Hawkin, P, Raymond, T, Ryska, O (Royal Lancaster Infirmary), Baron, R, Dunne, D, Gahunia, S, Halloran, C, Howes, N, McKinney, R, McNicol, F, Russ, J, Szatmary, P, Tan, Jr, Thomas, A, Whelan, P (Royal Liverpool University Hospital), Anzak, A, Banerjee, A, Fuwa, O, Hughes, F, Jayasinghe, Jd, Knowles, C, Kocher, H, Leal Silva, I, Ledesma, Fs, Minicozzi, A, Navaratne, L, Rahman, R, Ramamoorthy, R, Sohrabi, C, Thaha, M, Thakur, B, Venn, M, Yip, V (Royal London Hospital), Baumber R, Parry J (Royal National Orthopaedic Hospital), Evans, S, Jeys, L, Morris, G, Parry, M, Stevenson, J (Royal Orthopaedic Hospital), Ahmadi, N, Aresu, G, Barrett-Brown, Zm, Coonar, As, Durio Yates, H, Gearon, D, Hogan, J, King, M, Peryt, A, Pradeep, Is, Smith, C (Royal Papworth Hospital), Adishesh, M, Atherton, R, Baxter, K, Brocklehurst, M, Chaudhury, M, Krishnamohan, N, McAleer, J, Owens, G, Parkin, E, Patkar, P, Phang, I (Royal Preston Hospital), Aladeojebi, A, Ali, M, Barmayehvar, B, Gaunt, A, Gowda, M, Halliday, E, Kitchen, M, Mansour, F, Thomas, M, Zakai, D (Royal Stoke University Hospital), Abbassi-Ghadi, N, Assalaarachchi, H, Currie, A, Flavin, M, Frampton, A, Hague, M, Hammer, C, Hopper, J, Horsnell, J, Humphries, S, Kamocka, A, Madhuri, Tk, Preston, S, Singh, P, Stebbing, J, Tailor, A, Walker, D (Royal Surrey County Hospital), Aljanadi, F, Jones, M, Mhandu, P, Donnell, C, Turkington, R (Royal Victoria Hospital, Belfast), Al-Ishaq, Z, Bhasin, S, Bodla, As, Burahee, A, Crichton, A, Fossett, R, Pigadas, N, Rahman, E, Snee, D, Vidya, R, Yassin, N (Royal Wolverhampton Nhs Trust), Fountain, D, Hasan, Mt, Karabatsou, K, Laurente, R, Pathmanaban, O (Salford Royal Hospital), Al-mukhtar, A, Edwards, J, Giblin, A, Kelty, C, Lee, M, Lye, G, Newman, T, Sharkey, A, Steele, C, Sureshkumar Shah, N, Whitehall, E (Sheffield Teaching Hospital Nhs Foundation Trust), Athwal, R, Baker, A, Jones, L, Konstantinou, C, Ramcharan, S, Vatish, J, Wilkin, R (South Warwickshire Nhs Foundation Trust), Ethunandan, M, Sekhon, Gk, Shields, H, Singh, R, Wensley, F (Southampton General Hospital), Lawday S, Lyons A (Southmead Hospital), Abbott, T, Anwar, S, Ghufoor, K, Sohrabi, C (St Bartholomew&#8217, s Hospital (Non-Cardiac Unit)), Chung, E, Hagger, R, Hainsworth, A, Karim, A, Owen, H, Ramwell, A, Williams, K (St George&#8217, Baker, C, Davies, A, Gossage, J, Kelly, M, Knight, W (St Thomas&#8217, Hospital), Hall, J (Stepping Hill Hospital), Harris, G, James, G, Kang, C, Lin, Dj, Rajgor, Ad, Royle, T, Scurrah, R, Steel, B, Watson LJ (Sunderland Royal Hospital), Choi, D, Hutchison, R, Jain, A, Luoma, V, Marcus, H, May, R, Menon, A, Pramodana, B, Webber, L (The National Hospital For Neurology And Neurosurgery), Aneke, Ia, Asaad, P, Brown, B, Collis, J, Duff, S, Khan, A, Moura, F, Wadham, B, Warburton, H (The University Hospital Of South Manchester), Elmoslemany, T, Jenkinson, M, Millward, C, Zakaria, R (The Walton Centre Nhs Foundation Trust), Mccluney, S, Parmar, C, Shah, S (The Whittington Hospital), Allison, J, Babar, Ms, Collard, B, Goodrum, S, Lau, K, Patel, A, Scott, R, Thomas, E, Whitmore, H (Torbay And South Devon Nhs Trust), Balasubramaniam, D, Jayasankar, B, Kapoor, S, Ramachandran, A (Tunbridge Wells Hospital), Elhamshary, A, Imam, Smb, Kapriniotis, K, Kasivisvanathan, V, Lindsay, J, Rakhshani-Moghadam, S (University College London Hospital At Westmoreland Street), Beech, N, Chand, M, Green, L, Kalavrezos, N, Kiconco, H, McEwen, R, Schilling, C, Sinha, D (University College London Hospital), Pereca J, Singh J (University Hospital Ayr), Chopra, S, Egbeare, D, Thomas, R (University Hospital Llandough), Combellack, T, Jones, Sef, Kornaszewska, M, Mohammed, M, Sharma, A, Tahhan, G, Valtzoglou, V, Williams, J (University Hospital Of Wales), Eskander, P, Gash, K, Gourbault, L, Hanna, M, Maccabe, T, Newton, C, Olivier, J, Rozwadowski, S, Teh, E, West, D (University Hospitals Bristol NHS Foundation Trust), Al-omishy, H, Baig, M, Bates, H, Di Taranto, G, Dickson, K, Dunne, N, Gill, C, Howe, D, Jeevan, D, Khajuria, A, Martin-Ucar, A, McEvoy, K, Naredla, P, Ng, V, Robertson, S, Sait, M, Sarma, Dr, Shanbhag, S, Shortland, T, Simmonds, S, Skillman, J, Tewari, N, Walton, G (University Hospitals Coventry And Warwickshire Nhs Trusts), Akhtar, Ma, Brunt, A, McIntyre, J, Milne, K, Rashid, Mm, Sgr&#242, Stewart, Ke, Turnbull, A (Victoria Hospital Kirkcaldy), Aguilar Gonzalez M, Talukder S (West Suffolk Hospital), Boyle, C, Fernando, D, Gallagher, K, Laird, A, Tham, D (Western General Hospital), Bath, M, Patki, P, Tanabalan, C (Whipps Cross University Hospital), Arif, T, Magee, C, Nambirajan, T, Powell, S, Vinayagam, R (Wirral University Teaching Hospital), Flindall, I, Hanson, A, Mahendran, V (Worcestershire Royal Hospital), Green, S, Lim, M, MacDonald, L, Miu, V, Onos, L, Sheridan, K, Young, R (York Teaching Hospitals Nhs Trust), Alam, F, Griffiths, O, Houlden, C, Jones, R, Kolli, Vs, Lala, Ak, Leeson, S, Peevor, R, United States of America: Chen L, Seymour Z (Ysbyty Gwynedd)., Henderson, E, Loehrer, A (Dartmouth-Hitchcock Medical Center), Brown, K, Fleming, D, Heron, C, Hill, C, Kay, H, Leede, E, McElhinney, K, Olson, K, Osterberg, Ec, Riley, C, Srikanth, P, Thornhill, M (Dell Seton Medical Center At The University Of Texas), Blazer, D, DiLalla, G, Hwang, Es, Lee, W, Lidsky, M, Plichta, J, Rosenberger, L, Scheri, R, Turnage, K, Visgauss, J, Zani, S (Duke University Medical Center), Farma, J (Fox Chase Cancer Center), Clark J, Kwon D (Henry Ford Hospital), Etchill, E, Gabre-Kidan, A, Jenny, He, Kent, A, Ladd, M, Long, C, Malapati, H, Margalit, A, Rapaport, S, Rose, J, Stevens, K, Tsai, L, Vervoort, D, Yesantharao, P (Johns Hopkins Hospital), Dehal, A (Kaiser Permanente Panorama City Medical Center), Klaristenfeld, D (Kaiser Permanente San Diego Medical Center), Huynh, K (Kaiser Permanente West Los Angeles), Brown L, Ganly I (Memorial Sloan Kettering Cancer Center), Mullinax, J (Moffitt Cancer Center), Gusani, N, Hazelton, J, Maines, J, Oh, Js, Ssentongo, A, Ssentongo, P (Pennsylvania State University), Azam, M, Choudhry, A, Marx, W (Suny Upstate University Hospital), Fleming, J, Fuson, A, Gigliotti, J, Ovaitt, A, Ying, Y (University Of Alabama Birmingham), Abel, Mk, Boeck, Ma, Chern, H, Corvera, C, El- sayed, I, Glencer, A, Ha, P, Hamilton, Bcs, Heaton, C, Hirose, K, Jablons, Dm, Kirkwood, K, Kornblith, Lz, Kratz, Jr, Lee, R, Miller, Pn, Nakakura, E, Nunez-Garcia, B, Ozgediz, D, Sarin, A, Sheu, B, Varma, M, Wai, K, Xu MJ (University Of California, San Francisco (UCSF)), Beswick, D, Goddard, J, Manor, J, Song, J (University Of Colorado Hospital/Memorial Hospital/Medical Center Of The Rockies (All Within Uchealth System)), Fullmer, T, Gaskill, C, Gross, N, Kiong, K, Roland, Cl, Zafar SN (University Of Texas Md Anderson Cancer Center), Abdallah, M, Abouassi, A, Almasri, M, Kulkarni, G, Marwan, H, Mehdi, M (University Of Texas Medical Branch), Aoun, S, Ban, Vs, Batjer, Hh, Caruso, J (University Of Texas Southwestern), Abbott, D, Acher, A, Aiken, T, Barrett, J, Foley, E, Schwartz, P, Zafar SN (University Of Wisconsin), Hawkins, A, Uruguay: Laufer J, Maiga A (Vanderbilt University Medical Center)., Scasso, S (Hospital Pereira Rossell, Montevideo, )., Glasbey, J. C., Nepogodiev, D., Simoes, J. F. F., Omar, O., Li, E., Venn, M. L., Chaar, M. K. A., Capizzi, V., Chaudhry, D., Desai, A., Edwards, J. G., Evans, J. P., Fiore, M., Videria, J. F., Ford, S. J., Ganly, I., Griffiths, E. A., Gujjuri, R. R., Kolias, A. G., Kaafarani, H. M. A., Minaya-Bravo, A., Mckay, S. C., Mohan, H. M., Roberts, K. J., Miguel-Mendez, C. S., Pockney, P. G., Shaw, R., Smart, N. J., Stewart, G. D., Sundar, S., Vidya, R., Bhangu, A. A., Allemand, C., Boccalatte, L., Figari, M., Lamm, M., Larranaga, J., Marchitelli, C., Noll, F., Odetto, D., Perrotta, M., Saadi, J., Zamora, L., Alurralde, C., Caram, E. L., Eskinazi, D., Mendoza, J. P., Usandivaras, M., Badra, R., Esteban, A., Garcia, J. S., Garcia, P. M., Gerchunoff, J. I., Lucchini, S. M., Nigra, M. A., Vargas, L., Hovhannisyan, T., Stepanyan, A., Gould, T., Gourlay, R., Griffiths, B., Gananadha, S., Mclaren, M., Cecire, J., Joshi, N., Salindera, S., Sutherland, A., Ahn, J. 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A., Gillis, A., Kavanagh, D., Neary, P., O'Riordan, J., Reynolds, I. S., Rice, D., Ridgway, P., Umair, M., Whelan, M., Carroll, P., Collins, C., Corless, K., Finnegan, L., Fowler, A., Hogan, A., Kerin, M., Lowery, A., Mcanena, P., Mckevitt, K., Nizami, K., Ryan, E., Samy, A., Coffey, J. C., Cunningham, R., Devine, M., Nally, D., Peirce, C., Tormey, S., Hardy, N., O'Malley, S., Ryan, M., Macina, S., Mariani, N. M., Opocher, E., Pisani Ceretti, A., Ferrari, F., Odicino, F., Sartori, E., Cotsoglou, C., Granieri, S., Bianco, F., Camillo, A., Colledan, M., Tornese, S., Zambelli, M. F., Bissolotti, G., Fusetti, S., Lemma, F., Marino, M. V., Mirabella, A., Vaccarella, G., Agostini, C., Alemanno, G., Bartolini, I., Bergamini, C., Bruscino, A., Checcucci, C., De Vincenti, R., Di Bella, A., Fambrini, M., Fortuna, L., Maltinti, G., Muiesan, P., Petraglia, F., Prosperi, P., Ringressi, M. 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V., Cosimelli, M., Folli, S., Gennaro, M., Giannini, L., Gronchi, A., Guaglio, M., Macchi, A., Martinelli, F., Mazzaferro, V., Mosca, A., Pasquali, S., Piazza, C., Raspagliesi, F., Rolli, L., Salvioni, R., Sarpietro, G., Sarre, C., Sorrentino, L., Agnes, A., Alfieri, S., Belia, F., Biondi, A., Cozza, V., D'Amore, A., D'Ugo, D., De Simone, V., Fagotti, A., Gasparini, G., Gordini, L., Litta, F., Lombardi, C. P., Lorenzon, L., Marra, A. A., Marzi, F., Moro, A., Parello, A., Perrone, E., Persiani, R., Ratto, C., Rosa, F., Saponaro, G., Scambia, G., Scrima, O., Sganga, G., Tudisco, R., Belli, A., Granata, V., Izzo, F., Palaia, R., Patrone, R., Carrano, F. M., Carvello, M. M., De Virgilio, A., Di Candido, F., Ferreli, F., Gaino, F., Mercante, G., Rossi, V., Spinelli, A., Spriano, G., Donati, D. M., Frisoni, T., Palmerini, E., Aprile, A., Barra, F., Batistotti, P., Ferrero, S., Fregatti, P., Scabini, S., Sparavigna, M., Asti, E., Bernardi, D., Bonavina, L., Lovece, A., Adamoli, L., Ansarin, M., Cenciarelli, S., Chu, F., De Berardinis, R., Fumagalli Romario, U., Mastrilli, F., Pietrobon, G., Tagliabue, M., Badellino, E., Ferrero, A., Massobrio, R., De Manzoni Garberini, A., Federico, P., Maida, P., Marra, E., Marte, G., Petrillo, A., Tammaro, T., Tufo, A., Berselli, M., Borroni, G., Cocozza, E., Conti, L., Desio, M., Livraghi, L., Quintodei, V., Rizzi, A., Zullo, A., Baldi, C., Corbellini, C., Sampietro, G. M., Cellerino, P., Baldini, E., Capelli, P., Isolani, S. M., Ribolla, M., Bondurri, A., Colombo, F., Ferrario, L., Guerci, C., Maffioli, A., Armao, T., Ballabio, M., Bisagni, P., Gagliano, A., Longhi, M., Madonini, M., Pizzini, P., Baietti, A. M., Biasini, M., Maremonti, P., Neri, F., Prucher, G. M., Ricci, S., Ruggiero, F., Zarabini, A. G., Barmasse, R., Mochet, S., Usai, A., Incollingo, P., Mancini, S., Marino Cosentino, L., Sagnotta, A., Fruscio, R., Grassi, T., Nespoli, L. C., Tamini, N., Anastasi, A., Bartalucci, B., Bellacci, A., Canonico, G., Capezzuoli, L., Di Martino, C., Ipponi, P., Linari, C., Montelatici, M., Nelli, T., Spagni, G., Tirloni, L., Vitali, A., Abate, E., Casati, M., Casiraghi, T., Laface, L., Schiavo, M., Arminio, A., Cotoia, A., Lizzi, V., Vovola, F., Vergari, R., D'Ugo, S., Depalma, N., Spampinato, M. G., Bartolucci, P., Brachini, G., Bruzzaniti, P., Chiappini, A., Chiarella, V., Ciccarone, F., Cicerchia, P. M., Cirillo, B., De Toma, G., Di bartolomeo, A., Fiori, E., Fonsi, G. B., Franco, G., Frati, A., Giugliano, M., Iannone, I., La Torre, F., Lapolla, P., Leonardo, C., Marruzzo, G., Meneghini, S., Mingoli, A., Ribuffo, D., Salvati, M., Santoro, A., Sapienza, P., Scafa, A. K., Simonelli, L., Zambon, M., Capolupo, G. T., Carannante, F., Caricato, M., Masciana, G., Mazzotta, E., Gattolin, A., Migliore, M., Rimonda, R., Sasia, D., Travaglio, E., Cervellera, M., Gori, A., Sartarelli, L., Tonini, V., Giacometti, M., Zonta, S., Chessa, A., Fiorini, A., Norcini, C., Colletti, G., Confalonieri, M., Costanzi, A., Frattaruolo, C., Mari, G., Monteleone, M., Bandiera, A., Bocciolone, L., Bonavina, G., Candiani, M., Candotti, G., De Nardi, P., Gagliardi, F., Medone, M., Mortini, P., Negri, G., Parise, P., Piloni, M., Sileri, P., Vignali, A., Belvedere, A., Bernante, P., Bertoglio, P., Boussedra, S., Brunocilla, E., Cipriani, R., Cisternino, G., De Crescenzo, E., De Iaco, P., Dondi, G., Frio, F., Jovine, E., Mineo Bianchi, F., Neri, J., Parlanti, D., Perrone, A. M., Pezzuto, A. 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N., Nunns, D., Schiemer, R., Walton, T., Weaver, H., Whisker, L., Williamson, K., Mcveigh, J., Myatt, R., Williams, M. A., Kaur, R., Leung, E., Michel, M., Patil, S., Ravindran, S., Sarveswaran, J., Scott, L., Edmond, M., King, E., Almond, M., Breik, O., Cato, L. D., Idle, M., Kamal, M., Kisiel, A., Kulkarni, R., Mak, J. K. C., Martin, T., Nankivell, P., Parente, A., Parmar, S., Pathanki, A. M., Phelan, L., Praveen, P., Saeed, S., Sharma, N., Singh, J., Tirotta, F., Vijayan, D., Geddes, A., Mccaul, J., Mcmahon, J., Khan, A. H., Khan, F., Mansuri, A., Mukherjee, S., Sarigul, M., Singh, S., Tan, K. 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T., Karabatsou, K., Laurente, R., Pathmanaban, O., Al-Mukhtar, A., Giblin, A., Kelty, C., Lee, M., Lye, G., Newman, T., Sharkey, A., Steele, C., Sureshkumar Shah, N., Whitehall, E., Athwal, R., Baker, A., Jones, L., Konstantinou, C., Ramcharan, S., Vatish, J., Wilkin, R., Ethunandan, M., Sekhon, G. K., Shields, H., Singh, R., Wensley, F., Lawday, S., Lyons, A., Abbott, T., Anwar, S., Ghufoor, K., Chung, E., Hagger, R., Hainsworth, A., Karim, A., Owen, H., Ramwell, A., Williams, K., Baker, C., Davies, A., Gossage, J., Kelly, M., Knight, W., Hall, J., Harris, G., James, G., Kang, C., Lin, D. J., Rajgor, A. D., Royle, T., Scurrah, R., Steel, B., Watson, L. J., Choi, D., Hutchison, R., Jain, A., Luoma, V., Marcus, H., May, R., Menon, A., Pramodana, B., Webber, L., Aneke, I. A., Asaad, P., Brown, B., Collis, J., Duff, S., Moura, F., Wadham, B., Warburton, H., Elmoslemany, T., Jenkinson, M., Millward, C., Zakaria, R., Mccluney, S., Parmar, C., Shah, S., Allison, J., Babar, M. 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D, Geddes, A, Mccaul, J, Mcmahon, J, H Khan, A, Khan, F, Mansuri, A, Mukherjee, S, Sarigul, M, Singh, S, L Tan, K, Woodham, A, Adiamah, A, Brewer, H, Chowdhury, A, Evans, J, Humes, D, Jackman, J, Koh, A, Lewis-Lloyd, C, Oyende, O, Reilly, J, Worku, D, Cool, P, Cribb, G, Shepherd, K, Bisset, C, Moug, S, Elson, N, Faulkner, G, Saleh, P, Underwood, C, Brixton, G, Findlay, L, Klatte, T, Majkowska, A, Manson, J, Potter, R, Bhalla, A, Chia, Z, Daliya, P, Goyal, A, Grimley, E, Hamad, A, Kumar, A, L Malcolm, F, Theophilidou, E, Bowden, J, Campain, N, Daniels, I, Fowler, G, John, J, Massey, L, Mcdermott, F, Mcgrath, J, Mclennan, A, Ng, M, Pascoe, J, Rajaretnam, N, Bulathsinhala, S, Davidson, B, Fusai, G, Hidalgo Salinas, C, Machairas, N, Pissanou, T, M Pollok, J, A Raptis, D, Soggiu, F, Tzerbinis, H, E Xyda, S, Beamish, A, Davies, E, Foulkes, R, Magowan, D, Nassa, H, Ooi, R, Price, C, Smith, L, Solari, F, Tang, A, Williams, G, Al-Tamimi, Y, Bacon, A, Beasley, N, Chew, D, Crank, M, Ilenkovan, N, Macdonald, M, Narice, B, Rominiyi, O, Thompson, A, Varley, I, Drake, T, Harrison, E, Linder, G, Mayes, J, Mcgregor, R, Skipworth, R, Zamvar, V, Hawkin, P, Raymond, T, Ryska, O, Baron, R, Dunne, D, Gahunia, S, Halloran, C, Howes, N, Mckinney, R, Mcnicol, F, Russ, J, Szatmary, P, R Tan, J, Thomas, A, Whelan, P, Anzak, A, Banerjee, A, Fuwa, O, Hughes, F, D Jayasinghe, J, Knowles, C, Kocher, H, Leal Silva, I, S Ledesma, F, Minicozzi, A, Navaratne, L, Rahman, R, Ramamoorthy, R, Sohrabi, C, Thaha, M, Thakur, B, Venn, M, Yip, V, Baumber, R, Parry, J, Evans, S, Jeys, L, Morris, G, Parry, M, Ahmadi, N, Aresu, G, M Barrett-Brown, Z, S Coonar, A, Durio Yates, H, Gearon, D, Hogan, J, King, M, Peryt, A, S Pradeep, I, Adishesh, M, Atherton, R, Baxter, K, Brocklehurst, M, Chaudhury, M, Krishnamohan, N, Mcaleer, J, Owens, G, Parkin, E, Patkar, P, Phang, I, Aladeojebi, A, Ali, M, Barmayehvar, B, Gaunt, A, Gowda, M, Halliday, E, Kitchen, M, Mansour, F, Thomas, M, Zakai, D, Abbassi-Ghadi, N, Assalaarachchi, H, Currie, A, Flavin, M, Frampton, A, Hague, M, Hammer, C, Hopper, J, Horsnell, J, Humphries, S, Kamocka, A, K Madhuri, T, Preston, S, Singh, P, Stebbing, J, Tailor, A, Walker, D, Aljanadi, F, Jones, M, Mhandu, P, O'Donnell, C, Turkington, R, Al-Ishaq, Z, Bhasin, S, S Bodla, A, Burahee, A, Crichton, A, Fossett, R, Pigadas, N, Pickford, S, Rahman, E, Snee, D, Vidya, R, Yassin, N, Fountain, D, T Hasan, M, Karabatsou, K, Laurente, R, Pathmanaban, O, Al-Mukhtar, A, Edwards, J, Giblin, A, Kelty, C, Lee, M, Lye, G, Newman, T, Sharkey, A, Steele, C, Sureshkumar Shah, N, Whitehall, E, Athwal, R, Baker, A, Jones, L, Konstantinou, C, Ramcharan, S, Vatish, J, Wilkin, R, Ethunandan, M, K Sekhon, G, Shields, H, Singh, R, Wensley, F, Lawday, S, Lyons, A, Abbott, T, Anwar, S, Ghufoor, K, Chung, E, Hagger, R, Hainsworth, A, Karim, A, Owen, H, Ramwell, A, Williams, K, Baker, C, Davies, A, Gossage, J, Kelly, M, Knight, W, Hall, J, Harris, G, James, G, Kang, C, J Lin, D, D Rajgor, A, Royle, T, Scurrah, R, Steel, B, J Watson, L, Choi, D, Hutchison, R, Jain, A, Luoma, V, Marcus, H, May, R, Menon, A, Pramodana, B, Webber, L, A Aneke, I, Asaad, P, Brown, B, Collis, J, Duff, S, Khan, A, Moura, F, Wadham, B, Warburton, H, Elmoslemany, T, Jenkinson, M, Millward, C, Zakaria, R, Mccluney, S, Parmar, C, Shah, S, Allison, J, S Babar, M, Collard, B, Goodrum, S, Lau, K, Scott, R, Thomas, E, Whitmore, H, Balasubramaniam, D, Jayasankar, B, Kapoor, S, Ramachandran, A, Elhamshary, A, Imam, Smb, Kapriniotis, K, Kasivisvanathan, V, Lindsay, J, Rakhshani-Moghadam, S, Beech, N, Chand, M, Green, L, Kalavrezos, N, Kiconco, H, Mcewen, R, Schilling, C, Sinha, D, Pereca, J, Chopra, S, Egbeare, D, Thomas, R, Combellack, T, Jones, Sef, Kornaszewska, M, Mohammed, M, Sharma, A, Tahhan, G, Valtzoglou, V, Williams, J, Eskander, P, Gash, K, Gourbault, L, Hanna, M, Maccabe, T, Newton, C, Olivier, J, Rozwadowski, S, Teh, E, West, D, Al-Omishy, H, Baig, M, Bates, H, Di Taranto, G, Dickson, K, Dunne, N, Gill, C, Howe, D, Jeevan, D, Khajuria, A, Martin-Ucar AMcEvoy, K, Naredla, P, Robertson, S, Sait, M, R Sarma, D, Shanbhag, S, Shortland, T, Simmonds, S, Skillman, J, Tewari, N, Walton, G, A Akhtar, M, Brunt, A, Mcintyre, J, Milne, K, M Rashid, M, Sgro, A, E Stewart, K, Turnbull, A, Aguilar Gonzalez, M, Talukder, S, Boyle, C, Fernando, D, Gallagher, K, Laird, A, Tham, D, Bath, M, Patki, P, Tanabalan, C, Arif, T, Magee, C, Nambirajan, T, Powell, S, Vinayagam, R, Flindall, I, Hanson, A, Mahendran, V, Green, S, Lim, M, Macdonald, L, Miu, V, Onos, L, Sheridan, K, Young, R, Alam, F, Griffiths, O, Houlden, C, Jones, R, S Kolli, V, K Lala, A, Leeson, S, Peevor, R, Seymour, Z, Chen, L, Henderson, E, Loehrer, A, Brown, K, Fleming, D, Heron, C, Hill, C, Kay, H, Leede, E, Mcelhinney, K, Olson, K, C Osterberg, E, Riley, C, Srikanth, P, Thornhill, M, Blazer, D, Dilalla, G, S Hwang, E, Lee, W, Lidsky, M, Plichta, J, Rosenberger, L, Scheri, R, Turnage, K, Visgauss, J, Zani, S, Farma, J, Clark, J, Kwon, D, Etchill, E, E Gabre-Kidan AJenny, H, Kent, A, Ladd, M, Long, C, Malapati, H, Margalit, A, Rapaport, S, Rose, J, Stevens, K, Tsai, L, Vervoort, D, Yesantharao, P, Dehal, A, Klaristenfeld, D, Huynh, K, Brown, L, Ganly, I, Mullinax, J, Gusani, N, Hazelton, J, Maines, J, S Oh, J, Ssentongo, A, Ssentongo, P, Azam, M, Choudhry, A, Marx, W, Fleming, J, Fuson, A, Gigliotti, J, Ovaitt, A, Ying, Y, K Abel, M, Andaya, V, Bigay, K, A Boeck, M, Chern, H, Corvera, C, El-Sayed, I, Glencer, A, Ha, P, Hamilton, Bc, Heaton, C, Hirose, K, M Jablons, D, Kirkwood, K, Z Kornblith, L, R Kratz, J, Lee, R, N Miller, P, Nakakura, E, Nunez-Garcia, B, O'Donnell, R, Ozgediz, D, Park, P, Robinson, B, Sarin, A, Sheu, B, Varma, M, Wai, K, Wustrack, R, J Xu, M, Beswick, D, Goddard, J, Manor, J, Song, J, Fullmer, T, Gaskill, C, Gross, N, Kiong, K, L Roland, C, N Zafar, S, Abdallah, M, Abouassi, A, Almasri, M, Kulkarni, G, Marwan, H, Mehdi, M, Aoun, S, S Ban, V, H Batjer, H, Caruso, J, Abbott, D, Acher, A, Aiken, T, Barrett, J, Foley, E, Schwartz, P, Hawkins, A, Maiga, A, Laufer, J, Scasso, S, Surgery, Graduate School, Glasbey, J, Nepogodiev, D, Simoes, J, Omar, O, Li, E, Abou Chaar, M, Chaudhry, D, Videria, J, Gujjuri, R, Kaafarani, H, Minaya-Bravo, A, Mckay, S, Roberts, K, Miguel-Mendez, C, Smart, N, Stewart, G, Institut de Recherche sur les Maladies Virales et Hépatiques (IVH), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie (ICube), École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Université de Strasbourg (UNISTRA)-Institut National des Sciences Appliquées - Strasbourg (INSA Strasbourg), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de Recherche en Informatique et en Automatique (Inria)-Les Hôpitaux Universitaires de Strasbourg (HUS)-Centre National de la Recherche Scientifique (CNRS)-Matériaux et Nanosciences Grand-Est (MNGE), Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Réseau nanophotonique et optique, Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), COVIDSurg Collaborative, Kolias, Angelos [0000-0003-3992-0587], Stewart, Grant [0000-0003-3188-9140], Apollo - University of Cambridge Repository, Glasbey JC, Nepogodiev D, Simoes JFF, Omar O, Li E, Venn ML, Pgdme, Abou Chaar MK, Capizzi V, Chaudhry D, Desai A, Edwards JG, Evans JP, Fiore M, Videria JF, Ford SJ, Ganly I, Griffiths EA, Gujjuri RR, Kolias AG, Kaafarani HMA, Minaya-Bravo A, McKay SC, Mohan HM, Roberts KJ, San Miguel-Méndez C, Pockney P, Shaw R, Smart NJ, Stewart GD, Sundar Mrcog S, Vidya R, Bhangu AA, COVIDSurg Collaborative, Palmerini Emanuela, Frisoni Tommaso, Donati Davide, A Belvedere, P Bernante, P Bertoglio, S Boussedra, E Brunocilla, R Cipriani, G Cisternino, E De Crescenzo, P De Iaco, G Dondi, F Frio, E Jovine, F Mineo Bianchi, J Neri, D Parlanti, A M Perrone, A P Pezzuto, M Pignatti, V Pinto, G Poggioli, M Ravaioli, M Rottoli, R Schiavina, M Serenari, M Serra, P Solli, M Taffurelli, M Tanzanu, M Tesei, T Violante, S Zanotti, V Tonini, M Cervellera, A Gori, L Sartarelli, Glasbey, James C, Simoes, Joana F F, Venn, Mary L, Pgdme, null, Abou Chaar, Mohammad K, Edwards, Jonathan G, Evans, Jonathan P, Videria, Jose Flavio, Ford, Samuel J, Griffiths, Ewen A, Gujjuri, Rohan R, Kolias, Angelos G, Kaafarani, Haytham M A, McKay, Siobhan C, Mohan, Helen M, Roberts, Keith J, Smart, Neil J, Stewart, Grant D, Sundar Mrcog, Sudha, and Bhangu, Aneel A, Toia, F
Subjects: Male, Cancer Research, Outcome Assessment, International Cooperation, Settore MED/18 - CHIRURGIA GENERALE, Settore MED/19 - Chirurgia Plastica, 030230 surgery, Aged, Aged, 80 and over, COVID-19, Cohort Studies, Critical Care, Elective Surgical Procedures, Epidemics, Female, Humans, Logistic Models, Middle Aged, Neoplasms, Outcome Assessment, Health Care, Postoperative Complications, SARS-CoV-2, 0302 clinical medicine, Operating theater, cohort studies, Health care, middle aged, 80 and over, Medicine, Lung, Cancer, COVID-19/epidemiology, OUTCOMES, Manchester Cancer Research Centre, Pulmonary Complication, ORIGINAL REPORTS, aged, Oncology, 030220 oncology & carcinogenesis, Pneumonia & Influenza, Patient Safety, Elective Surgical Procedure, Life Sciences & Biomedicine, 6.4 Surgery, Cohort study, Human, medicine.medical_specialty, elective surgical procedures/methods, Logistic Model, Health Care, Clinical Sciences, Oncology and Carcinogenesis, Epidemic, [SDV.CAN]Life Sciences [q-bio]/Cancer, cancer surgery, SARS-CoV-2 pandemic, epidemics, COVIDSurg Collaborative, NO, outcome assessment, health care/methods, 03 medical and health sciences, male, Settore MED/28 - Malattie Odontostomatologiche, Clinical Research, 1112 Oncology and Carcinogenesis, Oncology & Carcinogenesis, Elective surgery, Elective Cancer Surgery in SARS-CoV-2, Elective Cancer Surgery in COVID-19, covid 19, sars-cov-2, Science & Technology, business.industry, Prevention, ResearchInstitutes_Networks_Beacons/mcrc, Evaluation of treatments and therapeutic interventions, 1103 Clinical Sciences, Pneumonia, Odds ratio, medicine.disease, Good Health and Well Being, neoplasms/surgery, critical care/methods, Emergency medicine, postoperative complications/prevention & control, Neoplasm, Postoperative Complication, Cohort Studie, business, aged, 80 and over, SARS-CoV-2/physiology, logistic models
Abstract: PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks. Copyright © 2020 American Society of Clinical Oncology. All rights reserved. Bowel and Cancer Research; Sarcoma UK; Yorkshire Cancer Research; European Society of Coloproctology; National Institute for Health Research: 16.136.79; Bowel Disease Research Foundation; Urology Foundation Supported by a National Institute for Health Research (NIHR) Global Health Research Unit grant (NIHR 16.136.79) using UK aid from the UK government to support global health research, Association of Coloproctology of Great Britain and Ireland, Bowel & Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, The Urology Foundation, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research. The funders had no role in the study design; data collection, analysis, and interpretation; or writing of this report. The views expressed are those of the authors and not necessarily those of the National Health Service, NIHR, or UK Department of Health and Social Care.
Published: 2021

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