A Challenging Colectomy for Acute Severe Ulcerative Colitis Complicated by COVID-19

We present the case of a patient with acute severe ulcerative colitis and concomitant COVID-19-related pneumonia who required a colectomy after a prolonged and complicated hospitalization during the initial stages of the SARS-CoV-2 pandemic, before the establishment of official procedures.

Complicated hospitalization due to influenza: Results from the Global Hospital Influenza Network for the 2017–2018 season

Background: Since 2011, the Global Influenza Hospital Surveillance Network (GIHSN) has used active surveillance to prospectively collect epidemiological and virological data on patients hospitalized with influenza virus infection. Here, we describe influenza virus strain circulation in the GIHSN participant countries during 2017–2018 season and examine factors associated with complicated hospitalization among patients admitted with laboratory-confirmed influenza illness.Methods: The study enrolled patients hospitalized in a GIHSN hospital in the previous 48 h with acute respiratory symptoms and who had symptoms consistent with influenza within the 7 days before admission. Enrolled patients were tested by reverse transcription-polymerase chain reaction to confirm influenza virus infection. “Complicated hospitalization” was defined as a need for mechanical ventilation, admission to an intensive care unit, or in-hospital death. In each of four age strata (<15, 15–<50, 50–<65, and ≥65 years), factors associated with complicated hospitalization in influenza-positive patients were identified by mixed effects logistic regression and those associated with length of hospital stay using a linear mixed-effects regression model.Results: The study included 12,803 hospitalized patients at 14 coordinating sites in 13 countries, of which 4,306 (34%) tested positive for influenza. Influenza viruses B/Yamagata, A/H3N2, and A/H1N1pdm09 strains dominated and cocirculated, although the dominant strains varied between sites. Complicated hospitalization occurred in 10.6% of influenza-positive patients. Factors associated with complicated hospitalization in influenza-positive patients included chronic obstructive pulmonary disease (15–<50 years and ≥65 years), diabetes (15–<50 years), male sex (50–<65 years), hospitalization during the last 12 months (50–<65 years), and current smoking (≥65 years). Chronic obstructive pulmonary disease (50–<65 years), other chronic conditions (15–<50 years), influenza A (50–<65 years), and hospitalization during the last 12 months (<15 years) were associated with a longer hospital stay. The proportion of patients with complicated influenza did not differ between influenza A and B.Conclusions: Complicated hospitalizations occurred in over 10% of patients hospitalized with influenza virus infection. Factors commonly associated with complicated or longer hospitalization differed by age group but commonly included chronic obstructive pulmonary disease, diabetes, and hospitalization during the last 12 months.

Complicated hospitalization due to influenza: Results from the Global Hospital Influenza Network for the 2017–2018 season

Background: Since 2011, the Global Influenza Hospital Surveillance Network (GIHSN) has used active surveillance to prospectively collect epidemiological and virological data on patients hospitalized with influenza virus infection. Here, we describe influenza virus strain circulation in the GIHSN participant countries during 2017–2018 season and examine factors associated with complicated hospitalization among patients admitted with laboratory-confirmed influenza illness.Methods: The study enrolled patients hospitalized in a GIHSN hospital in the previous 48 h with acute respiratory symptoms and who had symptoms consistent with influenza within the 7 days before admission. Enrolled patients were tested by reverse transcription-polymerase chain reaction to confirm influenza virus infection. “Complicated hospitalization” was defined as a need for mechanical ventilation, admission to an intensive care unit, or in-hospital death. In each of four age strata (<15, 15–<50, 50–<65, and ≥65 years), factors associated with complicated hospitalization in influenza-positive patients were identified by mixed effects logistic regression and those associated with length of hospital stay using a linear mixed-effects regression model.Results: The study included 12,803 hospitalized patients at 14 coordinating sites in 13 countries, of which 4,306 (34%) tested positive for influenza. Influenza viruses B/Yamagata, A/H3N2, and A/H1N1pdm09 strains dominated and cocirculated, although the dominant strains varied between sites. Complicated hospitalization occurred in 10.6% of influenza-positive patients. Factors associated with complicated hospitalization in influenza-positive patients included chronic obstructive pulmonary disease (15–<50 years and ≥65 years), diabetes (15–<50 years), male sex (50–<65 years), hospitalization during the last 12 months (50–<65 years), and current smoking (≥65 years). Chronic obstructive pulmonary disease (50–<65 years), other chronic conditions (15–<50 years), influenza A (50–<65 years), and hospitalization during the last 12 months (<15 years) were associated with a longer hospital stay. The proportion of patients with complicated influenza did not differ between influenza A and B.Conclusions: Complicated hospitalizations occurred in over 10% of patients hospitalized with influenza virus infection. Factors commonly associated with complicated or longer hospitalization differed by age group but commonly included chronic obstructive pulmonary disease, diabetes, and hospitalization during the last 12 months.

Complicated hospitalization due to influenza: Results from the Global Hospital Influenza Network for the 2017–2018 season

Background: Since 2011, the Global Influenza Hospital Surveillance Network (GIHSN) has used active surveillance to prospectively collect epidemiological and virological data on patients hospitalized with influenza virus infection. Here, we describe influenza virus strain circulation in the GIHSN participant countries during 2017–2018 season and examine factors associated with complicated hospitalization among patients admitted with laboratory-confirmed influenza illness.Methods: Patients at hospitals participating in the GIHSN admitted <48 h with symptoms consistent with influenza infection and ≤7 days of symptom onset were eligible. Enrolled patients were tested by reverse transcription-polymerase chain reaction to confirm influenza virus infection. “Complicated hospitalization” was defined as a need for mechanical ventilation, admission to an intensive care unit, or in-hospital death. In each of three age strata (<15, 15 to <65, and ≥65 years), factors associated with complicated hospitalization in influenza-positive patients were identified by mixed effects logistic regression and those associated with length of hospital stay using a linear mixed-effects regression model.Results: The study included 12,803 hospitalized patients at 14 coordinating sites in 13 countries, of which 4,306 (34%) tested positive for influenza. Influenza viruses B/Yamagata, A/H3N2, and A/H1N1pdm09 strains dominated and cocirculated, although the dominant strains varied between sites. Complicated hospitalization occurred in 10.6% of influenza-positive patients. Factors independently associated with complicated hospitalization in influenza-positive patients included chronic obstructive pulmonary disease (15 to <65 years and ≥65 years), diabetes (15 to <65 years), male sex (15 to <65 years), hospitalization during the last 12 months (15 to <65 years), and current smoking (≥65 years). Chronic obstructive pulmonary disease (15 to <65 years), diabetes (15 to <65 years), and hospitalization during the last 12 months (<15 years) were independently associated with a longer hospital stay. The proportion of patients with complicated influenza and the length of hospital stay did not differ between influenza A and B.Conclusions: Complicated hospitalizations occurred in over 10% of patients hospitalized with influenza virus infection. Factors commonly associated with complicated or longer hospitalization differed by age group but commonly included COPD, diabetes, and hospitalization during the last 12 months.

Dazed, Confused, and Asystolic: Possible Signs of Anti–N-Methyl-D-Aspartate Receptor Encephalitis

Anti–N-methyl-D-aspartate (NMDA) receptor encephalitis is a rare panencephalitis that can present with severe cardiac dysrhythmias. We present a case of a 19-year-old woman with no significant medical history who presented with progressive changes in mental status and profound ictal asystole that necessitated the placement of an external temporary pacemaker. She was diagnosed with and treated for anti-NMDA receptor encephalitis, and she recovered after a prolonged and complicated hospitalization. We review the pathophysiology and management of anti-NMDA receptor encephalitis, as well as its cardiac manifestations.