Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Measurement of CP violation and constraints on the CKM angle gamma in B-+/- -> DK +/- with D -> K-s(0)pi(+)pi(-) decays

A model-dependent amplitude analysis of B-+/- -> DK +/- with D -> K-s(0)pi(+)pi(-) decays is performed using proton proton collision data, corresponding to an integrated luminosity of 1 fb(-1), recorded by LHCb at a centre-of-mass energy of 7 TeV in 2011. Values of the CP violation observables x +/- and y +/-, which are sensitive to the CKM angle gamma, are measured to be x- = +0.027 +/- 0.0441(-0.008)(+0.010) +/- 0.001, y- = +0.013 +/- 0.0481(-0.007)(+0.009) +/- 0.003, x+ = -0.084 +/- 0.045 +/- 0.009 +/- 0.005, y+ = -0.032 +/- 0.048(-0.009)(+0.010) +/- 0.008, where the first uncertainty is statistical, the second systematic and the third arises from the uncertainty of the D -> K-S(0)pi(+)pi(-) amplitude model. The value of gamma is determined to be (84(-42)(+49))degrees including all sources of uncertainty. Neutral D meson mixing is found to have negligible effect. (C) 2014 The Authors. Published by Elsevier B.V

Measurement of the (B)over-bar(0)-B-0 and (B)over-bars(0)-B-s(0) production asymmetries in pp collisions at root s=7 TeV

The (B) over bar (0)-B-0 and (B) over bar (0)(s)-B-s(0) production asymmetries, A(P)(B-0) and A(P)(B-s(0)), are measured by means of a time-dependent analysis of B-0 -> J/Psi K-*0, B-0 -> D-pi(+) and B-s(0) -> D-s(-)pi(+) decays, using a data sample corresponding to an integrated luminosity of 1.0 fb(-1), collected by LHCb in pp collisions at a centre-of-mass energy of 7 TeV. The measurements are performed as a function of transverse momentum and pseudorapidity of the B-0 and B-s(0) mesons within the LHCb acceptance. The production asymmetries, integrated over p(T) and eta in the range 4 < p(T) < 30 GeV/c and 2.5 < eta < 4.5, are determined to be A(P)(B-0) = (-0.35 +/- 0.76 +/- 0.28)% and A(P)(B-s(0)) = (1.09 +/- 2.61 +/- 0.66)%, where the first uncertainties are statistical and the second systematic. (C) 2014 The Authors. Published by Elsevier B.V

Effective lifetime measurements in the B-s(0) -> K+K-, B-0 -> K+pi(-) and B-s(0) -> pi K-+(-) decays

Measurements of the effective lifetimes in the B-s(0) -> K+K-, B-0 -> K+pi(-) and B-s(0) -> pi K-+(-) decays are presented using 1.0 fb(-1)of pp collision data collected at a centre-of-mass energy of 7 TeV by the LHCb experiment. The analysis uses a data-driven approach to correct for the decay time acceptance. The measured effective lifetimes are tau(Bs0 -> K+K-) = 1.407 +/- 0.016 (stat) +/- 0.007 (syst) ps, tau(Bs0 -> K+pi-) = 1.524 +/- 0.011 (stat) +/- 0.004 (syst) ps, tau(Bs0 ->pi+K-) = 1.60 +/- 0.06 (stat) +/- 0.01 (syst) ps. This is the most precise determination to date of the effective lifetime in the B-s(0) -> K+K- decay and provides constraints on contributions from physics beyond the Standard Model to the B-s(0) mixing phase and the width difference Delta Gamma(s). (C) 2014 The Authors. Published by Elsevier B.V

Measurement of the Xi(-)(b) and Omega(-)(b) baryon lifetimes

Using a data sample of pp collisions corresponding to an integrated luminosity of 3 fb(-1), the Xi(-)(b) and Omega(-)(b) baryons are reconstructed in the Xi(-)(b) -> J/psi Xi(-) and Omega(-)(b) -> J/psi Omega(-) decay modes and their lifetimes measured to be tau(Xi(-)(b)) = 1.55(-0.09)(+0.10) (stat) +/- 0.03 (syst) ps, tau(Omega(-)(b)) = 1.54(-0.21)(+0.26) (stat) +/- 0.05 (syst) ps. These are the most precise determinations to date. Both measurements are in good agreement with previous experimental results and with theoretical predictions. (C) 2014 The Authors. Published by Elsevier B.V

B flavour tagging using charm decays at the LHCb experiment

An algorithm is described for tagging the flavour content at production of neutral B mesons in the LHCb experiment. The algorithm exploits the correlation of the flavour of a B meson with the charge of a reconstructed secondary charm hadron from the decay of the other b hadron produced in the proton-proton collision. Charm hadron candidates are identified in a number of fully or partially reconstructed Cabibbo-favoured decay modes. The algorithm is calibrated on the self-tagged decay modes B+ -> J/psi K+ and B-0 -> J/psi K*(0) using 3.0fb(-1) of data collected by the LHCb experiment at pp centre-of-mass energies of 7TeV and 8TeV. Its tagging power on these samples of B -> J/psi X decays is (0.30 +/- 0.01 +/- 0.01) %

Measurement of the track reconstruction efficiency at LHCb

The determination of track reconstruction efficiencies at LHCb using J/psi -> mu(+)mu(-) decays is presented. Efficiencies above 95% are found for the data taking periods in 2010, 2011, and 2012. The ratio of the track reconstruction efficiency of muons in data and simulation is compatible with unity and measured with an uncertainty of 0.8% for data taking in 2010, and at a precision of 0.4% for data taking in 2011 and 2012. For hadrons an additional 1.4% uncertainty due to material interactions is assumed. This result is crucial for accurate cross section and branching fraction measurements in LHCb

Measurement of the CP-violating phase phi(s) in (B)over-bar(s)(0) -> J / psi pi(+)pi(-) decays

The mixing-induced CP-violating phase phi(s) in B-s(0) and (B) over bar (0)(s) decays is measured using the J / psi pi(+)pi(-) final state in data, taken from 3 fb(-1) of integrated luminosity, collected with the LHCb detector in 7 and 8 TeV centre-of-mass pp collisions at the LHC. A time-dependent flavour-tagged amplitude analysis, allowing for direct CP violation, yields a value for the phase phi(s) = 70 +/- 68 +/- 8 mrad. This result is consistent with the Standard Model expectation and previous measurements. (C) 2014 The Authors. Published by Elsevier B.V

Evidence for the decay X(3872) -> psi(2S)gamma

Evidence for the decay mode X(3872) -> psi(2S)gamma in B+ -> X(3872)K+ decays is found with a significance of 4.4 standard deviations. The analysis is based on a data sample of proton proton collisions, corresponding to an integrated luminosity of 3 fb(-1), collected with the LHCb detector, at centre-of-mass energies of 7 and 8 TeV. The ratio of the branching fraction of the X(3872) -> psi(2S)gamma decay to that of the X(3872) -> J/psi gamma decay is measured to be B(X(3872) -> psi(2S)gamma)/B(X(3872) -> J/psi gamma) = 2.46 +/- 0.64 +/- 0.29, where the first uncertainty is statistical and the second is systematic. The measured value does not support a pure D (D) over bar* molecular interpretation of the X(3872) state. (C) 2014 CERN for the benefit of the LHCb Collaboration. Published by Elsevier B.V