Background Ileus is common after elective colorectal surgery, and is associated with increased adverse events and prolonged hospital stay. The aim was to assess the role of non‐steroidal anti‐inflammatory drugs (NSAIDs) for reducing ileus after surgery. Methods A prospective multicentre cohort study was delivered by an international, student‐ and trainee‐led collaborative group. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The primary outcome was time to gastrointestinal recovery, measured using a composite measure of bowel function and tolerance to oral intake. The impact of NSAIDs was explored using Cox regression analyses, including the results of a centre‐specific survey of compliance to enhanced recovery principles. Secondary safety outcomes included anastomotic leak rate and acute kidney injury. Results A total of 4164 patients were included, with a median age of 68 (i.q.r. 57–75) years (54·9 per cent men). Some 1153 (27·7 per cent) received NSAIDs on postoperative days 1–3, of whom 1061 (92·0 per cent) received non‐selective cyclo‐oxygenase inhibitors. After adjustment for baseline differences, the mean time to gastrointestinal recovery did not differ significantly between patients who received NSAIDs and those who did not (4·6 versus 4·8 days; hazard ratio 1·04, 95 per cent c.i. 0·96 to 1·12; P = 0·360). There were no significant differences in anastomotic leak rate (5·4 versus 4·6 per cent; P = 0·349) or acute kidney injury (14·3 versus 13·8 per cent; P = 0·666) between the groups. Significantly fewer patients receiving NSAIDs required strong opioid analgesia (35·3 versus 56·7 per cent; P < 0·001). Conclusion NSAIDs did not reduce the time for gastrointestinal recovery after colorectal surgery, but they were safe and associated with reduced postoperative opioid requirement.

A s of January 2022 in Canada, about 2 300 000 cases of COVID-19 have been confirmed since the beginning of the pandemic, with more than 30 500 deaths. 1 During the first wave of this pandemic (first half of 2020), the province of Quebec, whose population was nearly 8.5 million as of January 2021, 2 had the highest number of COVID-19 cases compared with other provinces. Montréal was the epicentre, accounting for more than one-third of all cases in the province. 3 In the first wave of the pandemic, about 10% of patients who developed COVID-19 in Wuhan, China, required admission to hospital and 5% required admission to the intensive care unit (ICU). 4,5 Older patients and those with existing comorbidities are at higher risk of adverse outcomes. 5 Amid this pandemic, hospitals have tried to continue their usual activities and provide urgent care. Unfortunately, hospital admission represents a potential environment for viral transmission to vulnerable patients. 6 As of February 2021, there were mixed data about outcomes for patients with hospital-acquired (HA) SARS-CoV-2 infection compared with non-hospital-acquired (NHA) infection, as well as inhospital transmission dynamics of SARS-CoV-2. Some studies showed a case fatality rate as high as 36% for patients with HA-COVID-19, 7 while others reported a mortality rate lower than that of patients with NHA-COVID-19. 8 Therefore, we aimed to assess whether mortality and complications were increased in HA cases of SARS-CoV-2 infection when compared with NHA cases at Hôpital Maisonneuve-Rosemont. We also explored the role of patients sharing multi-bed rooms in hospital with respect to in-hospital transmission of SARS-CoV-2.