INVESTIGATION OF THE CLINICAL SIGNIFICANCE OF ESCITALOPRAM-INDUCED ELECTROCARDIOGRAPHIC CHANGES IN MEN: A PILOT OBSERVATIONAL STUDY

Objective: We sought to investigate the clinical significance of secondary electrocardiographic (ECG) changes in men after using escitalopram. Methods: This pilot observational cohort study recruited male patients taking escitalopram for at least 6 mo in Mental Hospital of Qassim. All patients underwent a 12-lead ECG examination. We also measured the heart rate (HR), QTc, and QRS interval. Data on all related medical conditions and medications were recorded. Results: Fifty-three men were recruited, with a mean age of 37.39±8.39 y: 34.4% and 31.1% of these patients were taking escitalopram for depression and anxiety, respectively. The mean dose of escitalopram was 14.35 mg. Observations showed that 20.9% of the patients taking escitalopram had a fast HR (>100 beats/min [bpm]), indicative of sinus tachycardia, whereas 11.4% of patients had a slow HR (<60 bpm). The mean QT and QTc in patients taking escitalopram were 366.62±28.69 and 398.92±16.15 ms, respectively. Conclusion: Low doses of escitalopram resulted in minimal clinically significant changes. Thus, patients should be monitored when doses are escalated further

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population