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

Constraints on the Higgs boson width from off-shell production and decay to Z-boson pairs

Constraints are presented on the total width of the recently discovered Higgs boson, GH, using its relative on-shell and off-shell production and decay rates to a pair of Z bosons, where one Z boson decays to an electron or muon pair, and the other to an electron, muon, or neutrino pair. The analysis is based on the data collected by the CMS experiment at the LHC in 2011 and 2012, corresponding to integrated luminosities of 5.1fb-1 at a center-of-mass energy vs=7 TeV and 19.7fb-1at vs=8 TeV. A simultaneous maximum likelihood fit to the measured kinematic distributions near the resonance peak and above the Z-boson pair production threshold leads to an upper limit on the Higgs boson width of GH<22 MeV at a 95% confidence level, which is 5.4 times the expected value in the standard model at the measured mass of mH=125.6 GeV

Do Chinese SOEs and Private Companies Differ in Their Foreign Location Strategies?

We empirically analyze the host-country determinants of Chinese outbound foreign direct investments (ODI) in the period from 2003 to 2008, using disaggregated data by country and sector and distinguishing between State-owned enterprises (SOEs) and privately owned firms. Our results show that the pattern of Chinese ODI differs according to corporate ownership. Private firms are attracted by large markets and host-country strategic assets and are averse to economic and political risks when choosing investment locations abroad. Differently, state-owned enterprises follow the strategic needs of their home country and invest more in natural resource sectors, being largely indifferent to the political and economic conditions in the host countries

Measurement of forward-backward asymmetry A FB and of the weak mixing angle in processes of dilepton production in proton-proton collisions at 1as = 7 TeV in the CMS experiment at the LHC

The results obtained by measuring the forward \u2013 backward asymmetry ( A FB ) of Drell \u2013 Yan lepton pairs in proton \u2013 proton collisions at 1as =7 TeV at the LHC are presented. This asymmetry is measured as a function of the dilepton mass and rapidity in the dielectron and dimuon channels. The values of A FB were found for invariant masses of dileptons in the range of 40 M ll 600 GeV. The results for the e ff ective weak mixing angle that were deduced from data on dimuon production in Drell \u2013 Yan processes are also presented. The respective data sample was collected by using the Compact Muon Solenoid (CMS) detector over the period spanning the years 2010 and 2011. The measured asymmetry and the e ff ective weak mixing are consistent with the respective Standard Model predictions

Searches for signals from microscopic black holes in processes of proton collisions at 1as = 7 TeV in the CMS experiment at the LHC

If the fundamental scale of mul tidimensional gravity is about one or several TeV units, microscopic black holes or objects referred to as string balls may be produced at the LHC. The most recent results obtained by the CMS Collaboration at the LHC from searches for such signals at the c.m. proton- interaction energy of 7 TeV and for an integrated luminosity of 4.7 fb 12 1 . Lower limits on the masses of objects of strongly acting gravity were set in the parameter region accessible to tests at the present time. Prospects for further research in this field are discusse

Search for supersymmetry in pp collisions at sqrt(s) = 8 TeV in events with a single lepton, large jet multiplicity, and multiple b jets

Submitted to Phys. Lett. B ; see paper for full list of authorsResults are reported from a search for supersymmetry in pp collisions at a center-of-mass energy of 8 TeV, based on events with a single isolated lepton (e or mu) and multiple jets, at least two of which are identified as b jets. The data sample corresponds to an integrated luminosity of 19.3 inverse femtobarns recorded by the CMS experiment at the LHC in 2012. The search is motivated by supersymmetric models that involve strong-production processes and cascade decays of new particles. The resulting final states contain multiple jets as well as missing transverse momentum from weakly interacting particles. The event yields, observed across several kinematic regions, are consistent with the expectations from standard model processes predicted from control samples in the data. The results are interpreted in the context of simplified supersymmetric scenarios with pair production of gluinos, where each gluino decays to a top quark-antiquark pair and the lightest neutralino. For the case of decays via virtual top squarks, gluinos with a mass smaller than 1.26 TeV are excluded for low neutralino masses

Erratum to: Guidelines for the use and interpretation of assays for monitoring autophagy (3rd edition) (Autophagy, 12, 1, 1-222, 10.1080/15548627.2015.1100356

No abstract available

Outcomes from elective colorectal cancer surgery during the SARS‐CoV‐2 pandemic

Aim This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic. Method This was an international cohort study of patients undergoing elective resection of colon or rectal cancer without preoperative suspicion of SARS-CoV-2. Centres entered data from their first recorded case of COVID-19 until 19 April 2020. The primary outcome was 30-day mortality. Secondary outcomes included anastomotic leak, postoperative SARS-CoV-2 and a comparison with prepandemic European Society of Coloproctology cohort data. Results From 2073 patients in 40 countries, 1.3% (27/2073) had a defunctioning stoma and 3.0% (63/2073) had an end stoma instead of an anastomosis only. Thirty-day mortality was 1.8% (38/2073), the incidence of postoperative SARS-CoV-2 was 3.8% (78/2073) and the anastomotic leak rate was 4.9% (86/1738). Mortality was lowest in patients without a leak or SARS-CoV-2 (14/1601, 0.9%) and highest in patients with both a leak and SARS-CoV-2 (5/13, 38.5%). Mortality was independently associated with anastomotic leak (adjusted odds ratio 6.01, 95% confidence interval 2.58–14.06), postoperative SARS-CoV-2 (16.90, 7.86–36.38), male sex (2.46, 1.01–5.93), age >70 years (2.87, 1.32–6.20) and advanced cancer stage (3.43, 1.16–10.21). Compared with prepandemic data, there were fewer anastomotic leaks (4.9% versus 7.7%) and an overall shorter length of stay (6 versus 7 days) but higher mortality (1.7% versus 1.1%). Conclusion Surgeons need to further mitigate against both SARS-CoV-2 and anastomotic leak when offering surgery during current and future COVID-19 waves based on patient, operative and organizational risks