Becker's Clinical Quality & Infection Control

15 PATIENT SAFETY & OUTCOMES ICU deaths have fallen among COVID-19 patients, but progress is stalling By Mackenzie Bean C OVID-19 mortality rates among patients in intensive care have fallen since peaking last spring, but this improvement is pla- teauing, according to a study published Feb. 1 in Anaesthesia. For the study, researchers conducted a meta-analysis of 52 studies tracking the outcomes of 43,128 patients worldwide. The studies were published through October 2020 — before the emergence of several coronavirus variants that may have fueled an increase in ICU demand, the researchers said. The overall mortality rate at the end of September was 35.5 percent, down from 41.6 percent in May. Researchers pointed to advance- ments in oxygen therapy, fluid and anticoagulation management as the reason for this decrease in deaths. However, researchers found this decrease in ICU mortality has pla- teaued since May. In most parts of the world, this rate falls between 30 percent and 40 percent. The research does not account for global differences in ICU care and patients' underlying health conditions, which is a study limitation. Researchers said more standardized reporting would allow for better comparisons of outcomes between locations and time periods. n NYU Langone performs world's 1st successful face, double hand transplant By Erica Carbajal N YU Langone Health performed the world's first successful face and double hand transplant on a 22-year-old pa- tient in August, the health system announced in a Feb. 3 news release. Joe DiMeo sustained severe burns that covered more than 80 percent of his body after a car accident in 2018. Because of the numerous blood transfusions and skin grafts he received after the accident, Mr. DiMeo's immune system was extremely sensitive, leaving him with only a 6 percent chance of finding a donor. "Finding Joe the perfect donor was like find- ing a needle in a haystack," said Eduardo Ro- driguez, MD, DDS, director of NYU Langone's face transplant program, who led Mr. DiMeo's surgery. A single donor for both the face and hands was identified just 10 months after Mr. DiMeo was put on the transplant list. The 23-hour surgery commanded a team of more than 140 healthcare professionals. Dr. Eduardo attributed the procedure's success to the team's extensive preparation and the use of 3D-printed patient-specific cutting guides, which ensured precise bone alignment and helped identify the best position for implant- able plates and screws. "We practiced the surgery nearly a dozen times over the course of a year, and in the operating rooms we had teams ensuring everyone followed the steps exactly so we didn't skip a beat or get out of sequence," Dr. Rodriguez said. "Ultimately, it went better than I ever expected." There are two other known face and hand combination transplant attempts that were unsuccessful, according to the news release. In one case, the patient died due to an in- fection-related complication, while the other patient's hands were removed after their body rejected them. "This is a once-in-a-lifetime gift, and I hope the family can take some comfort knowing that part of the donor lives on with me," Mr. DiMeo said. n Cedars-Sinai opens COVID-19 recovery program By Erica Carbajal L os Angeles-based Cedars-Sinai Medical Group launched a COVID-19 Re- covery Program to treat patients cleared of the virus who still have lingering symptoms weeks or months later, according to a Jan. 26 news release. To be eligible for treatment in the program, patients must be referred by a physician, have had a confirmed COVID-19 infection and be experiencing persistent symptoms. As part of the program, patients receive an in-person evaluation from an infec- tious diseases or pulmonary medicine expert who can refer them to a network of specialists including cardiologists, pulmonologists, neurologists and psychi- atrists. e program also provides patients with access to clinical trials being conducted by Cedars-Sinai investigators. "Given the sheer number of people worldwide who have had COVID-19 — more than 90 million — if even 1 percent experience symptoms beyond three months, that is a huge number of patients who need help," said Catherine Lee, MD, the program's co-director and an infectious disease specialist at the health system. e program works alongside the Smidt Heart Institute's Post-COVID-19 Car- diology Program, which enrolls patients diagnosed with a heart issue associated with post-COVID-19 recovery, and the Cedars-Sinai Department of Medicine's Post-ICU Clinic, which treats intensive care unit patients who developed respi- ratory and neurological problems aer discharge. n

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