After the declaration of the coronavirus disease 2019 (COVID-19) pandemic, gynecological surgery joins the readjustment process that this great global health crisis implies. In the light of current literature, the five steps towards its resilience are described as below; (1) Dynamic prioritization of surgical indications and reintroduction of elective surgeries: Diverse surgical prioritization lists are published including the most common gynecological pathologies. (2) Minimally invasive surgery through laparoscopy and robotic assistance: Some authors suggest a theoretical but unproven risk of viral transmission during these approaches because of the aerosol generation. These theories are opposed to the well-proven advantages of these approaches compared to open surgery. (3) Optimization of surgical procedures, according to the recommendations of different societies aimed at reducing the dispersion of aerosols and surgical smoke. (4) Clinical, epidemiological and microbiological screening of all patients awaiting prompt surgery: This screening should be adapted to the local alert state. (5) Protection through the reduction of number of persons present in the operating room, and the use of adapted personal protective equipment according to physical proximity to the patient.

Background: and Purpose Visual hallucinations (VH) and subjective cognitive complaints (SCC) are associated with cognitive impairment (CI) in Parkinson’s disease. Our aims were to determine the association between VH and SCC and the risk of CI development in a cohort of patients with Parkinson’s disease and normal cognition (PD-NC). Methods: Patients with PD-NC (total score of >80 on the Parkinson’s Disease Cognitive Rating Scale [PD-CRS]) recruited from the Spanish COPPADIS cohort from January 2016 to November 2017 were followed up after 2 years. Subjects with a score of ≥1 on domain 5 and item 13 of the Non-Motor Symptoms Scale at baseline (V0) were considered as “with SCC” and “with VH,” respectively. CI at the 2-year follow-up (plus or minus 1 month) (V2) was defined as a PD-CRS total score of <81. Results: At V0 (n=376, 58.2% males, age 61.14±8.73 years [mean±SD]), the frequencies of VH and SCC were 13.6% and 62.2%, respectively. VH were more frequent in patients with SCC than in those without: 18.8% (44/234) vs 4.9% (7/142), p<0.0001. At V2, 15.2% (57/376) of the patients had developed CI. VH presenting at V0 was associated with a higher risk of CI at V2 (odds ratio [OR]=2.68, 95% confidence interval=1.05–6.83, p=0.039) after controlling for the effects of age, disease duration, education, medication, motor and nonmotor status, mood, and PD-CRS total score at V0. Although SCC were not associated with CI at V2, presenting both VH and SCC at V0 increased the probability of having CI at V2 (OR=3.71, 95% confidence interval=1.36–10.17, p=0.011). Conclusions VH were associated with the development of SCC and CI at the 2-year follow-up in patients with PD-NC.