ECMO for COVID-19 patients in Europe and Israel

Since March 15th, 2020, 177 centres from Europe and Israel have joined the study, routinely reporting on the ECMO support they provide to COVID-19 patients. The mean annual number of cases treated with ECMO in the participating centres before the pandemic (2019) was 55. The number of COVID-19 patients has increased rapidly each week reaching 1531 treated patients as of September 14th. The greatest number of cases has been reported from France (n = 385), UK (n = 193), Germany (n = 176), Spain (n = 166), and Italy (n = 136) .The mean age of treated patients was 52.6 years (range 16–80), 79% were male. The ECMO configuration used was VV in 91% of cases, VA in 5% and other in 4%. The mean PaO2 before ECMO implantation was 65 mmHg. The mean duration of ECMO support thus far has been 18 days and the mean ICU length of stay of these patients was 33 days. As of the 14th September, overall 841 patients have been weaned from ECMO support, 601 died during ECMO support, 71 died after withdrawal of ECMO, 79 are still receiving ECMO support and for 10 patients status n.a. . Our preliminary data suggest that patients placed on ECMO with severe refractory respiratory or cardiac failure secondary to COVID-19 have a reasonable (55%) chance of survival. Further extensive data analysis is expected to provide invaluable information on the demographics, severity of illness, indications and different ECMO management strategies in these patients

Progressive Functional and Neuroretinal Affectation in Patients With Multiple Sclerosis Treated With Fingolimod

To evaluate the effect of fingolimod in visual function and neuroretinal structures in patients with multiple sclerosis (MS) for a period of 1 year

Mean, standard deviation (SD), and comparison of retinal nerve fiber layer (RNFL) and macular thickness values obtained with the Cirrus High Definition optical coherence tomography (OCT) device between the group without atheroma plaques and the group with at least one atheroma plaque.

<p>Mean, standard deviation (SD), and comparison of retinal nerve fiber layer (RNFL) and macular thickness values obtained with the Cirrus High Definition optical coherence tomography (OCT) device between the group without atheroma plaques and the group with at least one atheroma plaque.</p

Mean, standard deviation (SD), and comparison of retinal nerve fiber layer (RNFL) and macular thickness values obtained with the Cirrus High Definition optical coherence tomography (OCT) device in the group with and without cardiovascular risk according to the Framingham criteria.

<p>Mean, standard deviation (SD), and comparison of retinal nerve fiber layer (RNFL) and macular thickness values obtained with the Cirrus High Definition optical coherence tomography (OCT) device in the group with and without cardiovascular risk according to the Framingham criteria.</p

Mean, standard deviation (SD), and comparison of cardiovascular parameters and of retinal nerve fiber layer (RNFL) and macular thickness values obtained with the Cirrus High Definition optical coherence tomography (OCT) device measured in subjects without classic major cardiovascular risk factors and subjects with at least one classic major cardiovascular risk factor.

<p>Significant differences are marked in bold. Abbreviations: LDL (low-density lipoprotein), HDL (high-density lipoprotein).</p

Mean, standard deviation (SD), and comparison of retinal nerve fiber layer (RNFL) and macular thickness values obtained with the Cirrus High Definition optical coherence tomography (OCT) device in the right eye, between the group with and without atheroma plaques in the right carotid.

<p>Mean, standard deviation (SD), and comparison of retinal nerve fiber layer (RNFL) and macular thickness values obtained with the Cirrus High Definition optical coherence tomography (OCT) device in the right eye, between the group with and without atheroma plaques in the right carotid.</p

Bar graphs of optical coherence tomography measurements in microns.

<p>Representation in bar graphs of retinal nerve fiber layer (RNFL).</p

Mean, standard deviation (SD), and comparison of retinal nerve fiber layer (RNFL) and macular thickness values obtained with the Cirrus High Definition optical coherence tomography (OCT) device in the left eye, between the group with and without atheroma plaques in the left carotid.

<p>Mean, standard deviation (SD), and comparison of retinal nerve fiber layer (RNFL) and macular thickness values obtained with the Cirrus High Definition optical coherence tomography (OCT) device in the left eye, between the group with and without atheroma plaques in the left carotid.</p

Influence of cardiovascular condition on retinal and retinal nerve fiber layer measurements

To assess changes in the retinal nerve fiber layer (RNFL) and macula in subjects with cardiovascular risk factors or subclinical ischemia.Prospective and observational study.A total of 152 healthy men underwent cardiovascular examination, including quantification of subclinical atheroma plaques by artery ultrasound scans, blood analysis, and a complete ophthalmic evaluation, including spectral-domain optical coherence tomography. The variables registered in cardiovascular examination were quantification of classic major risk factors, subclinical atheroma plaques by artery ultrasound scans, and analytical records. The ophthalmic evaluation registered RNFL and macular thickness.Mean subject age was 51.27±3.71 years. The 40 subjects without classic cardiovascular risk factors did not show differences in RNFL and macular thicknesses compared with the 112 subjects with at least one risk factor (except in sector 9 that showed higher thicknesses in subjects with ≥1 risk factor). Comparison between the group of subjects with and without atheroma plaques revealed no differences in RNFL and macular thicknesses. The sub-analysis of subjects with subclinical atheroma plaques in the common carotid artery revealed a significant reduction in central macular thickness in the left eye compared with the right eye (p = 0.016), RNFL in the superior quadrant (p = 0.007), and the 11 o'clock sector (p = 0.020). Comparison between smokers and nonsmokers revealed that smokers had significant thinning of the central macular thickness (p = 0.034), the nasal RNFL quadrant (p = 0.006), and the 3 and 5 o'clock sectors (p = 0.016 and 0.009).Classic cardiovascular risk factors do not cause RNFL or macular thickness reduction, but tobacco smoking habit reduces nasal RNFL thickness. Subclinical atherosclerosis in the common carotid artery associates a reduction in central macular and nasal RNFL quadrant thicknesses in the left eye compared with the right eye