Scientific research on COVID-19 conducted in Hong Kong in 2020

Abstract

Much research has been conducted into the coronavirus disease 2019 (COVID-19) pandemic internationally and regionally. [1][2][3][4] Before the pandemic became widespread, researchers in Hong Kong have alerted health authorities to initiate emergency measures. 5,6 The accumulated scientific evidence on COVID-19, including clinical characteristics, transmission, risk factors, diagnostic testing and screening, immune responses, treatment and pharmaceutical prophylaxis, and vaccines has greatly helped inform the infection prevention, early recognition, rapid identification, and disease control of COVID-19. Research attention paid to the routine clinical management of chronic conditions are of equal importance in the wider context of the pandemic, given the dynamic links between COVID-19 and underlying health conditions. 7 In this issue of the Hong Kong Medical Journal, Yee et al 8 reviewed institutional data from all urology centres in the government-run healthcare sector in Hong Kong during the COVID-19 pandemic, to assess the changes in urology practice and resident training. Compared with a control period, the authors report drastic reductions of 28.5% to 49.6% in the numbers of operating sessions, clinic attendances, cystoscopy sessions, prostate biopsies, and shockwave lithotripsy sessions across all the centres reviewed. The number of surgeries performed by residents was also reduced dramatically during the pandemic. Key aspects of urology practice have undergone substantial changes, which resulted as a response to challenges including shortages in frontline healthcare resources such as personal protective equipment, or rigid management of patient flow in hospitals. Similar challenges were identified in primary care during the early phase of the COVID-19 outbreak, as shown in a cross-sectional study conducted among family doctors affiliated with the Hong Kong College of Family Physicians. 9 In other specialist services such as obstetrics and gynaecology practices, restrictive measures intended to limit the spread of COVID-19 resulted in an increased psychological burden on pregnant women who experienced cancellation of prenatal exercises, antenatal talks, hospital tours, and postnatal classes. 10 Local

Physician motivation and satisfaction matter in healthcare

“…For example, research studies focused on coronavirus disease 2019 (COVID-19) are increasingly led by frontline physicians who seek to gain insights regarding disease transmission, risk factors, screening, clinical diagnosis, immune responses, treatment and pharmaceutical prophylaxis, and vaccines. 5 The various high-value functions performed by physicians inevitably require continuous dedication, commitment, and passion. Therefore, work motivation and career satisfaction among physicians have received increasing attention over the years, considering their close relationships with healthcare quality.…”

Reforming education and pedagogy in medicine and health with digital innovations to enhance learning practices and outcomes

“…There is a need to manage physicians' increasing clinical responsibilities that arise from rapid progress in health systems, in addition to the growing demand for medical and translational research conducted in clinical settings. 12 Longer working hours can lead to significant work-life imbalance and greater risks of dissatisfaction and depression among physicians. A territory-wide survey revealed a high prevalence of burnout among training and practising physicians in Hong Kong.…”

Bringing sepsis care back to the emergency department: New prognostic tools and extended role of emergency physicians

“…In a systemic review and meta‐analysis of 13 clinical studies that involved 940 patients, Wang et al found that the venous‐to‐arterial carbon dioxide pressure changes and the arteriovenous oxygen content difference ratio (Pcv‐aCO2/Ca‐vO2), a marker for global anaerobic metabolism, is an important predictor for mortality in patients with sepsis or septic shock. A higher ratio of Pcv‐aCO2/Ca‐vO2 was associated with a higher 28‐day mortality (risk ratio = 1.89, 95% confidence interval = 1.48–2.41) and a higher Sequential Organ Failure Assessment (SOFA) score (standardised mean difference = 1.58, 95% confidence interval = 0.88–2.28) 1 . Wang et al recommended that the use of this ratio combined with lactic acid clearance and central venous blood oxygen saturation to guide the effects of early resuscitation treatment in sepsis patients.…”