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.

Aim. To study prevalence of arterial hypertension (AH), mean values of systolic and diastolic blood pressure (SBP, DBP), awareness of patients about their disease, medication consumption (MC) and efficacy of treatment in several regions of Russia.Material and methods. Representative selections were made in 9 regions of Russia: men (n=5563), women (n=9737) of 25–64 y.o., studied in 2012–2013 with the response 80%. Systematic stratified multilevel random selection was formed with localilty criteria (Kisch method). The Questionnaire on the presence of AH included: awareness of the patient about his disease, drug intake. BP measurement was performed on the right arm by automatic tonometer Omron in sitting position after 5 minutes resting. The mean value of two measurements was used. BP defined as SBP ≥140 mmHg, DBP ≥90 mmHg, or if the patient had taken antihypertensive therapy. Efficacy of treatment — the part of patients (in %) who reached target BP. Control group — part of patients (in %) with BP <140/90 mmHg. Statistic data calculation was done with computer-based statistic software — SAS with standardising by age stratification of Europe.Results. Mean SBP and DBP were 130,7±0,1 mmHg and 81,6±0,1 mmHg respectively. Prevalence of AH — 44%, higher in men (p<0,001). Prevalence of AH was higher in rural area citizens in men — 51,8% vs 47,5% (р<0,02) and in women — 42,9% vs 40,2% (р<0,05). Awareness was 67,5% in men, 78,9% in women. Medications were taken by 60,9% of women and 39,5% of men. Effectively treated were 53,5% of women and 41,4% of men. With the age the part of effectively treated decreases (p<0,0005). BP is under control only in 1/3 of women and 14,4% of men.Conclusion. The role of AH as one of the main modifiable risk factors of cardiovascular diseases is proved, however it is depressing that the percent of controlled AH is low. BP control is the main task of outpatient surveillance at every local outpatient department, where now less than a half of those affected are being observed.

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.

Participants of the study ESSE-RF-2 and co-authors: Moscow: Konstantinov V. V., Pokrovskaya M.S., Efimova I.A., Sivakova O.V.; Krasnodar: Alekseenko S.N., Gubarev S.V.; Оmsk: Livzan M.A., Grishechkina I.A., Rozhkova M.Yu.; Republic of Karelia: Vezikova N.N., Skopec I. S.; Ryazan: Filippov E.V., Dobrynina N.V., Nikulina N.N., Pereverzeva K.G., Moseychuk K.A.Aim. Evaluate the prevalence, awareness, treatment, and control of hypertension among people aged 25-64 examined in 4 regions of the Russian Federation. Material and methods. Study materials were the representative selections of non-organized male (n=3000) and female (n=3714) inhabitants of aged 25-64 from 4 regions of the Russian Federation (Krasnodar region, Omsk region, Ryazan region, the Republic of Karelia), response rate>80%. Systematic stratified multilevel random election was formed with locality criteria (Kisch method). All the participants were interviewed using the standard questionnaire. The universal epidemiological methods and evaluation criteria were used. The study was approved by the local ethics Committee of National research center for preventive medicine. Participants signed informed consent. Hypertension was defined as an average systolic blood pressure (SBP)≥140 mmHg and/or average diastolic blood pressure (DBP)≥90 mmHg and/or antihypertensive therapy (AHT). The efficacy of treatment was the achievement of the target BP. Control group – patients with BP<140/90 mmHg. Results. Mean SBP and DBP were 128.7±0,3 mmHg and 82.8±0.1 mmHg, respectively, higher BP was detected among male (p<0,001). The prevalence of hypertension was 44.2% that was higher among males than females (49.1% vs 39.9%, р˂0.0005), the highest hypertension frequency was in the Ryazan region. The awareness of hypertension was higher among females than in males 76.8% vs 69.4%. There were more persons with hypertension grade 1 among those, who were not aware of the hypertension. Medications were taken by 65.5% of females and 41.8% of males.Angiotensin-converting enzyme inhibitors were received by 49.9% of patients, angiotensin II receptor antagonists by 30.9%, beta blockers – 29.5%, diuretics – 22.7%, calcium antagonists – 15.7%, centrally acting drugs – 3.3%, others – 0.2%. The lack of AHT intake was negatively associated with age, ischemic heart disease, urban life and hypo-HDL especially among males. Heart rate >80 per min in females increased by 1.7 times the probability of absence of AHT. The prevalence of effectively treated was 49.7% of the participants with hypertension. The associations between ineffective treatment and abdominal obesity, ischemic heart disease (males), age, rural type of settlement, obesity (females) were found. Only 24.9% of patients had control of the hypertension.Conclusion. The prevalence of hypertension in Russian Federation remains high. An important task of the medical community is to identify the disease at an earlier stage of its development, before the appearance of complications. This approach can reduce the period from the onset of high blood pressure to a visit to the doctor.