Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4-1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0-2 weeks, 3-4 weeks and 5-6 weeks of the diagnosis (odds ratio (95%CI) 4.1 (3.3-4.8), 3.9 (2.6-5.1) and 3.6 (2.0-5.2), respectively). Surgery performed ≥ 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5 (0.9-2.1)). After a ≥ 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2-8.7) vs. 2.4% (95%CI 1.4-3.4) vs. 1.3% (95%CI 0.6-2.0), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay.

SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS-CoV-2 diagnosis was defined as peri-operative (7 days before to 30 days after surgery); recent (1-6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre-operative anti-coagulation for baseline comorbidities was not available. Postoperative venous thromboembolism rate was 0.5% (666/123,591) in patients without SARS-CoV-2; 2.2% (50/2317) in patients with peri-operative SARS-CoV-2; 1.6% (15/953) in patients with recent SARS-CoV-2; and 1.0% (11/1148) in patients with previous SARS-CoV-2. After adjustment for confounding factors, patients with peri-operative (adjusted odds ratio 1.5 (95%CI 1.1-2.0)) and recent SARS-CoV-2 (1.9 (95%CI 1.2-3.3)) remained at higher risk of venous thromboembolism, with a borderline finding in previous SARS-CoV-2 (1.7 (95%CI 0.9-3.0)). Overall, venous thromboembolism was independently associated with 30-day mortality ). In patients with SARS-CoV-2, mortality without venous thromboembolism was 7.4% (319/4342) and with venous thromboembolism was 40.8% (31/76). Patients undergoing surgery with peri-operative or recent SARS-CoV-2 appear to be at increased risk of postoperative venous thromboembolism compared with patients with no history of SARS-CoV-2 infection. Optimal venous thromboembolism prophylaxis and treatment are unknown in this cohort of patients, and these data should be interpreted accordingly.

Los estudiantes de salud presentan altos niveles de estrés ante las exigencias académicas, lo que impacta negativamente en su salud y su desempeño académico. Debido a que el estrés afecta el funcionamiento fisiológico de diferentes procesos metabólicos, hormonales e inmunológicos, se han implementado estrategias para hacerle frente, de allí que el objetivo de esta revisión de la literatura consistió en identificar la relación que existe entre la disminución del estrés acádemico y la práctica yoga en estudiantes de las áreas de la salud. Para ello, se realizó una búsqueda sistemátizada de la literatura, mediante la declaración PRISMA, en la base bibliográfica Medline a través del uso de los descriptores en salud “stress” y “yoga”. Después de la identificación, selección y elección, fueron incluidos 18 artículos en la discusión. Se concluyó que la práctica de yoga disminuye el estrés percibido en la medida que aumenta el bienestar físico y mental.

La presente revisión describe los mecanismos fisiopatológicos relacionados con la infección por el Coronavirus de 2019, (COVID-19 ó SARS-CoV-2). Este virus descubierto en  Wuhan-China, presentó una transmisión zoonótica y posteriormente se transmitió entre humanos a través de aerosoles y superficies contaminadas con un índice alto de contagio desatando una Pandemia. A través de búsqueda sistemática en MEDLINE Y EMBASE, se seleccionaron los estudios que apuntan al objetivo general. Se discute sobre el genoma, estructura, receptor celular, respuesta inmune y diseminación hacia otros tejidos. En conclusión, el virus analizado, presenta factores que inciden en la severidad de la manifestación clínica y en la predisposición de adultos mayores y/o con comorbilidades, a presentar fenómenos inflamatorios generalizados. La expresión del receptor celular es un factor importante en la progresión. Aunque existe evidencia de la presencia viral en SNC, se requieren estudios que profundicen la acción del virus sobre este y otros tejidos.