COVID-19 and the second wave during autumn: preventive strategies in cardiac and thoracic surgery divisions
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Eur Surg https://doi.org/10.1007/s10353-020-00682-9
COVID-19 and the second wave during autumn: preventive strategies in cardiac and thoracic surgery divisions Francesco Donatelli
· Antonio Miceli · Silvia Cirri · Enrico Coscioni · Claudio Napoli
Received: 9 November 2020 / Accepted: 12 November 2020 © Springer-Verlag GmbH Austria, part of Springer Nature 2020
Dear Editor, During the current second peak of the COVID-19 (coronavirus disease 2019) pandemic seen worldwide, increasing critical care unit bed capacity, associated with an increase in both ECMO (extracorporeal membrane oxygenation) and mechanical ventilation devices, is crucial for maintaining an adequate setting for cardiothoracic surgery in referral centers [1]. Theoretically, this urgency will persist until herd immunity is acquired either by natural infection or through vaccination, which has a low probability of being available on a global scale by the 2020 fall and winter seasons. Results of three early-phase COVID-19 vaccine trials were reported, one from the mRNA-1273 Study Group, the second from the Jenner Institute at Oxford University with support from AstraZeneca, and the third from CanSino Biologics in Wuhan, China [2–4]. These ongoing clinical trials have reported promising data by inducing an antiSARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) humoral response.
F. Donatelli, MD · A. Miceli, MD, PhD · S. Cirri, MD Chair of Cardiac Surgery, Department of Cardiothoracic Center, Istituto Clinico Sant’Ambrogio, University of Milan, Milan, Italy E. Coscioni, MD Department of Cardiac Surgery, Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy Prof. C. Napoli, MD, PhD () Clinical Department of Internal Medicine and Specialistics, Azienda Ospedaliera Universitaria, and University Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy [email protected]
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However, additional mitigation methods are needed. Additionally, cocirculation of COVID-19 and the seasonal influenza virus has been established [5]; thus, we are observing the condition that influenza per se exerts pressure on health care systems through increasing hospital admissions to critical units, accounting for increasing mortality worldwide. Recently, it was established that viral respiratory infections may act through synergic epigenetic mechanisms in the development of severe forms of respiratory infections [6]. Moreover, gram-positive pathogens, Staphylococcus aureus, group A Streptococcus, and Streptococcus pneumoniae have been shown to co-isolate with COVID-19 [7]. Therefore, it was proposed that pneumococcal vaccination could prevent superimposed S. pneumoniae infection in patients with COVID-19. As the infection rate for COVID-19 has been surprisingly high worldwide since mid-September 2020, it is mandatory to follow tight infection control measures including applying bundles in ventilator-associated pneumonia and central line-associated bloodstream infections [
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