Objective::To report the clinical maternal and fetal outcomes of pregnant women with coronavirus disease 2019 (COVID-19), along with any associated pregnancy complications, in Hong Kong, China, and to assess the impact of COVID-19 vaccination on these outcomes.Methods::This prospective registry-based observational study included pregnant women who were recruited through convenient sampling and had a laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection with a cycle threshold (Ct) value result available on admission to eight local hospitals in Hong Kong, China. Data on clinical symptoms, laboratory results, medical treatments, delivery timing and mode, and pregnancy complications were extracted from the Hospital Authority’s electronic medical record system. Maternal, fetal, and pregnancy outcomes were compared between unvaccinated pregnant women with COVID-19 and those who had received at least one dose of COVID-19 vaccine before diagnosis. Nonparametric continuous variables and categorical variables were analyzed using the Mann-Whitney U test and the Pearson’s chi-squared test respectively. A P value less than 0.05 was considered statistically significant. Results::A total of 164 pregnant women were included, of whom 78 (47.56%) were nulliparous. COVID-19 was diagnosed before 28 weeks’ gestation in 30 (18.29%), while 134 (81.71 %) were diagnosed at or after 28 weeks’ gestation. Sixty-two (37.80%) women received at least one dose of COVID-19 vaccine. There were no significant differences between vaccinated and unvaccinated groups in the time interval between COVID-19 diagnosis and delivery, the Ct value, and the gestational age at infection onset or delivery ( P > 0.05). The majority of women were symptomatic at diagnosis regardless of vaccination status (55 (88.71%) in vaccinated group vs. 78 (76.47%) in unvaccinated group ( P = 0.052). Symptoms did not significantly differ between groups except for cough (62.90% vs. 47.06%, P = 0.049). The overall rate of severe COVID-19 in pregnant women was low. In total, 5 (3.05%) patients experienced severe COVID-19, with vaccinated patients more likely to receive low molecular weight heparin (LMWH) as part of their treatment (62.90% vs. 42.16%, P = 0.010). Ninety-two (56.10%) women had a spontaneous vaginal delivery, 7 (4.27%) had an instrumental delivery, and 44 (26.83%) and 21 (12.80%) underwent emergency and elective cesarean sections respectively. For fetal outcomes, 14 (8.48%) babies were born preterm and four (2.65% of nonpreterm babies, n = 151) had low birthweight. The median birthweight percentile was 52.18 th. There were no statistically significant differences in pregnancy complications or fetal outcomes between vaccinated and unvaccinated groups. Conclusion::The overall rate of severe COVID-19 in pregnant women was low. COVID-19 vaccination did not significantly impact maternal outcomes, except for the use of LMWH. Additionally, the study found no significant differences in fetal outcomes and pregnancy complications between vaccinated and unvaccinated individuals.

Purpose: The incidence of deep vein thrombosis (DVT) following total hip arthroplasty (THA) without chemoprophylaxis could be as high as 50% in Caucasians. However, according to several subsequent studies, the incidence of venous thromboembolic events (VTE) in Asians was much lower. The routine use of chemoprophylaxis, which could potentially cause increased bleeding, infection, and wound complications, has been questioned in low-incidence populations. The objective of this study is to determine the incidence of VTE after primary THA without chemoprophylaxis in an Asian population using a fast-track rehabilitation protocol and to verify the safety profile for use of ‘mechanical prophylaxis alone’ in patients with standard risk of VTE. Materials and Methods: This is a retrospective cohort study of 542 Hong Kong Chinese patients who underwent primary THA without chemoprophylaxis. All patients received intermittent pneumatic compression and graduated compression stockings as mechanical prophylaxis. Multimodal pain management was applied in order to facilitate early mobilisation. Routine duplex ultrasonography was performed between the fourth and seventh postoperative day for detection of proximal DVT. Results: All patients were Chinese (mean age, 63.0±11.9 years). Six patients developed proximal DVT (incidence rate, 1.1%). None of the patients had symptomatic or fatal pulmonary embolism. Conclusion The incidence of VTE after primary THA without chemical prophylaxis can be low in Asian populations when following a fast-track rehabilitation protocol. Mechanical prophylaxis alone can be regarded as a reasonably safe practice in terms of a balanced benefit-to-risk ratio for Asian patients with standard risk of VTE.

Objective::To report the clinical maternal and fetal outcomes of pregnant women with coronavirus disease 2019 (COVID-19), along with any associated pregnancy complications, in Hong Kong, China, and to assess the impact of COVID-19 vaccination on these outcomes.Methods::This prospective registry-based observational study included pregnant women who were recruited through convenient sampling and had a laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection with a cycle threshold (Ct) value result available on admission to eight local hospitals in Hong Kong, China. Data on clinical symptoms, laboratory results, medical treatments, delivery timing and mode, and pregnancy complications were extracted from the Hospital Authority’s electronic medical record system. Maternal, fetal, and pregnancy outcomes were compared between unvaccinated pregnant women with COVID-19 and those who had received at least one dose of COVID-19 vaccine before diagnosis. Nonparametric continuous variables and categorical variables were analyzed using the Mann-Whitney U test and the Pearson’s chi-squared test respectively. A P value less than 0.05 was considered statistically significant. Results::A total of 164 pregnant women were included, of whom 78 (47.56%) were nulliparous. COVID-19 was diagnosed before 28 weeks’ gestation in 30 (18.29%), while 134 (81.71 %) were diagnosed at or after 28 weeks’ gestation. Sixty-two (37.80%) women received at least one dose of COVID-19 vaccine. There were no significant differences between vaccinated and unvaccinated groups in the time interval between COVID-19 diagnosis and delivery, the Ct value, and the gestational age at infection onset or delivery ( P > 0.05). The majority of women were symptomatic at diagnosis regardless of vaccination status (55 (88.71%) in vaccinated group vs. 78 (76.47%) in unvaccinated group ( P = 0.052). Symptoms did not significantly differ between groups except for cough (62.90% vs. 47.06%, P = 0.049). The overall rate of severe COVID-19 in pregnant women was low. In total, 5 (3.05%) patients experienced severe COVID-19, with vaccinated patients more likely to receive low molecular weight heparin (LMWH) as part of their treatment (62.90% vs. 42.16%, P = 0.010). Ninety-two (56.10%) women had a spontaneous vaginal delivery, 7 (4.27%) had an instrumental delivery, and 44 (26.83%) and 21 (12.80%) underwent emergency and elective cesarean sections respectively. For fetal outcomes, 14 (8.48%) babies were born preterm and four (2.65% of nonpreterm babies, n = 151) had low birthweight. The median birthweight percentile was 52.18 th. There were no statistically significant differences in pregnancy complications or fetal outcomes between vaccinated and unvaccinated groups. Conclusion::The overall rate of severe COVID-19 in pregnant women was low. COVID-19 vaccination did not significantly impact maternal outcomes, except for the use of LMWH. Additionally, the study found no significant differences in fetal outcomes and pregnancy complications between vaccinated and unvaccinated individuals.

INTRODUCTION: An echocardiographic calcium score (ECS) predicts cardiovascular disease (CVD) in the general population. Its utility in peritoneal dialysis (PD) patients is unknown. METHODS: This cross-sectional study assessed 125 patients on PD. The ECS (range 0-8) was compared between subjects with CVD and those without. RESULTS: Among the subjects, 54 had CVD and 71 did not. Subjects with CVD were older (69 years vs. 56 years, P < 0.001) and had a higher prevalence of diabetes mellitus (DM) (81.5% vs. 45.1%, P < 0.001). They had lower diastolic blood pressure (72 mmHg vs. 81 mmHg, P < 0.001), lower phosphate (1.6 mmol/L vs. 1.9 mmol/L, P = 0.002), albumin (30 g/L vs. 32 g/L, P = 0.001), parathyroid hormone (34.4 pmol/L vs. 55.8 pmol/L, P = 0.002), total cholesterol (4.5 vs. 4.9, P = 0.047), LDL cholesterol (2.4 mmol/L vs. 2.8 mmol/L, P = 0.019) and HDL cholesterol (0.8 mmol/L vs. 1.1 mmol/L, P = 0.002). The ECS was found to be higher in subjects with CVD than in those without (2 vs. 1, P = 0.001). On multivariate analysis, only DM and age were independently associated with CVD. CONCLUSION The ECS was significantly higher in PD patients with CVD than in those without, reflecting a higher vascular calcification burden in the former. It is a potentially useful tool to quantify vascular calcification in PD patients.
Humans ; Cardiovascular Diseases/diagnostic imaging* ; Cross-Sectional Studies ; Calcium ; Peritoneal Dialysis/adverse effects* ; Vascular Calcification/epidemiology* ; Echocardiography