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Carrying on with liver transplantation during the COVID-19 emergency: Report from piedmont region.

ABSTRACT: BACKGROUND:The COVID-19 pandemic is an emergency worldwide. In Italy, liver transplant activity was carried on, but despite all efforts, a 25% reduction of procured organs has already been observed during the first 4 weeks of the outbreak. AIMS:To analyze if our strategy and organization of LT pathway during the first two months of the COVID-19 emergency succeeded in keeping a high level of LT activity, comparing the number of LT in the first two months with the same period of time in 2019. METHODS:We compared the liver transplants performed in our Center between February 24th and April 17th, 2020 with liver transplants performed in the same period in 2019. RESULTS:In 2020, 21 patients underwent liver transplantation from deceased donors, exactly as the year before, without statistically significant difference. All patients survived in both groups, and the rate of early graft dysfunction was 24% in 2020 and 33% in 2019. In 2020 Median MELD was higher (17 vs 13). We were able to perform 3 multiorgan transplants and one acute liver failure. Nobody died on waiting list. The performance of our Center, despite the maxi-emergency situation, was steady and this was the result of a tremendous team working within the hospital and in our region. CONCLUSIONS:Team working allowed our Center to maintain its activity level, taking care of patients before and after liver transplantation. Sharing our experience, we hope to be helpful to other Centers that are facing the pandemic and, if another pandemic comes, to be more prepared to deal with it.

SUBMITTER: Saracco M

PROVIDER: S-EPMC7413117 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Carrying on with liver transplantation during the COVID-19 emergency: Report from piedmont region.

Saracco Margherita M Martini Silvia S Tandoi Francesco F Dell'Olio Dominic D Ottobrelli Antonio A Scarmozzino Antonio A Amoroso Antonio A Fonio Paolo P Balagna Roberto R Romagnoli Renato R

Clinics and research in hepatology and gastroenterology 20200807 3

<h4>Background</h4>The COVID-19 pandemic is an emergency worldwide. In Italy, liver transplant activity was carried on, but despite all efforts, a 25% reduction of procured organs has already been observed during the first 4 weeks of the outbreak.<h4>Aims</h4>To analyze if our strategy and organization of LT pathway during the first two months of the COVID-19 emergency succeeded in keeping a high level of LT activity, comparing the number of LT in the first two months with the same period of tim ...[more]

PMID: 32859555

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Project description:BackgroundSevere acute respiratory syndrome coronavirus 2 (SARS-COV-2), the causative agent of the coronavirus disease 19 (COVID-19), is a highly transmittable virus. Since the first person-to-person transmission of SARS-CoV-2 was reported in Italy on February 21st, 2020, the number of people infected with SARS-COV-2 increased rapidly, mainly in northern Italian regions, including Piedmont. A strict lockdown was imposed on March 21st until May 4th when a gradual relaxation of the restrictions started. In this context, computational models and computer simulations are one of the available research tools that epidemiologists can exploit to understand the spread of the diseases and to evaluate social measures to counteract, mitigate or delay the spread of the epidemic.MethodsThis study presents an extended version of the Susceptible-Exposed-Infected-Removed-Susceptible (SEIRS) model accounting for population age structure. The infectious population is divided into three sub-groups: (i) undetected infected individuals, (ii) quarantined infected individuals and (iii) hospitalized infected individuals. Moreover, the strength of the government restriction measures and the related population response to these are explicitly represented in the model.ResultsThe proposed model allows us to investigate different scenarios of the COVID-19 spread in Piedmont and the implementation of different infection-control measures and testing approaches. The results show that the implemented control measures have proven effective in containing the epidemic, mitigating the potential dangerous impact of a large proportion of undetected cases. We also forecast the optimal combination of individual-level measures and community surveillance to contain the new wave of COVID-19 spread after the re-opening work and social activities.ConclusionsOur model is an effective tool useful to investigate different scenarios and to inform policy makers about the potential impact of different control strategies. This will be crucial in the upcoming months, when very critical decisions about easing control measures will need to be taken.

Project description:Student engagement in online learning enhance students performance and the outcomes of the learning process in online learning environment. The existed literature revealed various factors influencing student engagement in online leaning, however these studies were before the COVID-19 crisis. The purpose of the current paper is to explore the factors that influence student engagement in online learning during the COVID-19 crisis in middle school settings in developing countries where is a lack of studies about the factors influencing student's engagement in emergency remote learning during the crisis. A qualitative approach was used for data collection and analysis. Semi-structured interviews with 34 participants (14 students, 13 teachers, and 7 parents) were conducted for 20-30 min. Furthermore, online class observations were used for data collection; 13 online classes were observed. Each class was 40 min. A thematic analysis was used to categorize the findings into themes and subthemes. The findings of the study revealed that various factors influence student engagement in online learning during the crisis including infrastructure factors, cultural factors, digital inequality, and the threat to digital privacy. Cultural factors were the important factor that influences females because of parents' culture and their bias against females using online learning compared to male students. Teachers' presence and quality of content were the major factors that influence student engagement, where parental concerns, norms, and traditions emerged as the major factors in the crisis, influencing engagement. Most of the participants reported that teaching and learning online during the crisis has broadened the digital inequality and threatened their digital privacy which influenced negatively student engagement. The limitations of this research included the limited number of participants covering a large geographic area, and the research design using diverse and often limited educational software and delivery methods. Future studies could utilize a mixed-method approach and include more participants.Supplementary informationThe online version contains supplementary material available at 10.1007/s10639-021-10566-4.

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Carrying on with liver transplantation during the COVID-19 emergency: Report from piedmont region.

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Carrying on with liver transplantation during the COVID-19 emergency: Report from piedmont region.

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