Rationale, aims and objectives: The purpose of this study is to describe the symptoms and clusters characteristics of COVID-19 patients in Taiwan. Method: The Central Epidemic Command Center (CECC) from Taiwan CDC daily press release publications were extracted for patient demographic information (age, gender, case type and cluster) and the symptoms exhibited by the patients before diagnosis were collected. Results: A total of 1030 COVID-19 cases were reported in Taiwan up until the end of March 2021, of which 1009 patients had symptoms available. Of available patient data, 633 patients (62.74%) were symptomatic and 376 patients (37.26%) were asymptomatic, as classified in our study based on the published list of potential symptoms of COVID-19 by WHO. The most prevalent symptoms of our patients were coughing (29.33%), fever (26.56%) and nasal symptoms (20.22%). Our regression analysis found when the first detected patient of the cluster had a subjective sensation of feeling feverish, the number of infected cases in the cluster increased by 4.59 cases. Similarly, patients who experienced a slightly elevated body temperature or fever were associated with an increase of 2.37 and 0.35 cases in each cluster, respectively. Furthermore, increasing one new COVID-19 test per thousand population reduces 7.22 cases per cluster. Conclusions: The majority of reported cases in Taiwan were symptomatic. Symptoms which had the greatest number of patients overall were cough, fever, and nasal symptoms. It is our hope to help physicians to better diagnose current Taiwan COVID-19 patients, while aiding the government in stopping the spread of new cases.

China has just lifted its zero-Covid policy and made it more relaxed, which suggests the end of zero-Covid globally. Vietnam is one of a few countries that implemented zero-Covid at the very beginning, yet we decided to abandon it much sooner. Consequently, a spike in cases followed just after this opening. Healthcare workers (HCW)—the frontliners—are the most harmed and vulnerable, both physically and psychologically. HCW have been playing a vital role in a successful response against multiple Covid-19 pandemics, and patient safety will obviously be in jeopardy when the well-being of HCW is neglected. Nevertheless, literature has reported the anticipated repercussions of Covid-19 on HCW, especially on their mental health and well-being, mostly due to the shortage of resources and equipment, intense work hours, and lack of support for mental health. In this paper, we report on the burden of Vietnamese HCW during the fourth wave of the pandemic, raise awareness among both the community and the authorities, and also deliver feasible solutions adapted from Vietnam. These insights can also be learned by other countries and modified based on local circumstances to help better deal with future outbreaks.

OBJECTIVE The aim of this study was to access the influence of active warming after epidural anesthesia (EDA) and before general anesthesia in prevention of perioperative hypothermia. METHOD This randomized controlled trial was conducted in the department of anesthesiology in university medical center of Ho Chi Minh city, Vietnam from December 2019 until April 2020. This trial included 60 adult patients who were scheduled for major abdominal surgery with a duration of at least 120 minutes and under combined general anesthesia and EDA. Patients were excluded if age was below 18 years, American Society Anesthesiologists’ physical status classification of IV or higher, or refusal of EDA. Written informed consent was obtained for all patients. Patients were divided randomly into two groups. The first group received 10 minutes of active air-forced warming after EDA before the induction of general anesthesia. The second group was covered with a blanket 10 minutes after EDA and before general anesthesia. Core temperatures were recorded throughout the study. The primary outcome measures were the incidence of perioperative hypothermia and the degree of hypothermia. The secondary outcome measures were rate and time for body temperature to return to normal and incidence of postoperative body shivering. RESULTS Without active warming (n = 21), 70% of patients became hypothermic (<36°C) postoperatively. Active air-forced warming for 10 minutes after EDA and before induction of general anesthesia decreased the incidence of postoperative hypothermia to 26.7% (n = 8). CONCLUSION Active air-forced warming for 10 minutes after EDA and before induction of general anesthesia is efficient in reducing the incidence of perioperative hypothermia.

Background: Atrial fibrillation is the most common complication after cardiac surgery and is associated with an increased risk of postoperative adverse events. The objective of this study was to develop a risk index to predict atrial fibrillation after cardiac surgery. Methods: We performed a prospective cohort study. A total of 405 patients who had undergone adult cardiac surgery from 2015 September to 2016 August at Heart Institute of HCMC and Cho Ray Hospital. Results: In the overall, 98 patients developed POAF (24.2%). The risk score included three significant risk factors (age, left atrial diameter > 41mm, Coronary Artery Bypass Graft with concomitant mitral valve replacement or repair). The point values for were 1 for the age  60, 1 for CABG with concomitant mitral valve replacement or repair and 1 for left atrial diameter > 41mm, and the total risk score ranges from 0 to 3 (AUC = 0.69, 95% CI: 0.63 – 0.75), the best cutoff point was 1 The incidences of POAF associated with scores were: patient with a score of 0, predicted probabilities of POAF was 8.6%; a score of 1: 30.1%; a score of 2: 40.8%; a score of 3: 58.3%. Bootstrapping with 5,000 samples confirmed the final model provided consistent predictions. Conclusions: We developed a simple risk score based on clinical variables and these variables can be collected easily before surgery. This risk score may help accurately stratifies the risk of POAF to identify patients at high risk of POAF before cardiac surgery.

Rationale, aims and objectives Patient-physician communication is the mainstay of successful medical practice. To assess knowledge, attitude, and practice of surgeons and Intensive Care Unit (ICU) physicians about key elements of informed decision-making communication. Methods A multicenter, cross-sectional survey among surgeons, ICU physicians, patients and patient’s relatives in Bangladesh, Egypt, Iraq, and Vietnam was conducted using convenience sampling. Two self-completed questionnaires were dedicated to the survey members. Results While doctors acquire a good level of knowledge and have a positive attitude toward informed decision-making communication, the applying practice level is low although the correlations between knowledge, attitude and practice are strong. The fulfillment of patients’ expectation was lower among those who did not meet their doctors before and after treatment/surgery, had to pay for their treatments or had high education level. Conclusions The gap between knowledge and practice in doctor-patient communication is highlighted. The patient’s experience toward communication with doctor varies among different groups of age, chance to meet with doctor, and payment required.