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Temporal trends of COVID-19 related in-hospital mortality and demographics in Switzerland – a retrospective single centre cohort study

Original article
Diebold M, Martinez AE, Adam KM, Bassetti S, Osthoff M, Kassi E, Steiger J, Pargger H, Siegemund M, Battegay M, Khanna N, Schaub S, Wesch C, Dickenmann M, Weisser M
Swiss Med Wkly. 2021;151:w20572

In this single-centre retrospective cohort study at the University Hospital Basel, in-hospital mortality was 9.5%, 10.2% and 5.4% in the first, second and third waves, respectively. Age, immunocompromising condition, male sex and chronic kidney disease were factors associated with in-hospital mortality. Importantly, patients without any comorbidity had a very low in-hospital mortality regardless of age.

Risk factors for severe outcomes for COVID-19 patients hospitalised in Switzerland during the first pandemic wave, February to August 2020: prospective observational cohort study

Original article
Maximiano Sousa F, Roelens M, Fricker B, Thiabaud A, Iten A, Cusini A, Flury D, Buettcher M, Zukol F, Balmelli C, Zimmermann P, Troillet N, Vuichard-Gysin D, Schreiber PW, Bernhard-Stirnemann S, Tschudin-Sutter S, Nussbaumer-Ochsner Y, Sommerstein R, Gaudenz R, Marschall J, Senn L, Gardiol C, Keiser O, Schüpbach G, Wymann M, Vidondo B, CH-Sur Study Group
Swiss Med Wkly. 2021;151:w20547

Increasing age is the most important risk factor for in-hospital mortality of hospitalised COVID-19 patients in Switzerland, along with male gender and followed by the presence of comorbidities such as renal diseases, chronic respiratory or cardiovascular disease, oncological malignancies and dementia. Male gender, hypertension and age between 55 and 79 years are, however, risk factors for ICU admission. Mortality and ICU admission need to be considered as separate outcomes when investigating risk factors for pandemic control measures and for hospital resources planning.

Use of telehealth and outcomes before a visit to the emergency department: a cross-sectional study on walk-in patients in Switzerland

Original article
Mettler AC, Piazza L, Michel J, Müller M, Exadaktylos AK, Hautz WE, Sauter TC
Swiss Med Wkly. 2021;151:w20543

An increasing number of patients are using telehealth before contacting the healthcare system. If we are to optimise future telehealth strategies and adequately respond to patient needs, we need to know more about the frequency and characteristics of telehealth use. The  objectives of this study were (i) to investigate whether patients use telehealth before consulting the emergency department (ED), (ii) to compare patients with and without use of telehealth, and (iii) to investigate adherence, confidence and satisfaction.

The role of the Swiss list of occupational diseases in the protection of workers’ health

Original article
Graczyk H, François M, Krief P, Guseva Canu I
Swiss Med Wkly. 2021;151:w20538

Occupational disease lists (ODLs) are essential legal mechanisms for recognising pathologies related to exposure to occupational hazards. In 2017, Switzerland revised its ODL and solicited stakeholders to review the ODL proposal. This revision represented an important and rare event, and was an opportunity to assess the legal status and role of Swiss ODL. The authors examined the structure and content of this revised Swiss list, by comparing it to other official recommendations and ODLs, including those of the International Labour Organization (ILO) and the European Commission (EC).  

Evolution of gynaecologists’ practices regarding the implementation of Swiss legislation on maternity protection at work between 2008 and 2017

Original article
Abderhalden-Zellweger A, Mediouni Z, Probst I, Politis Mercier MP, Danuser B, Wild P, Chiarini B, Hale ML, Krief P
Swiss Med Wkly. 2021;151:w20537

In accordance with the International Labour Organization’s Maternity Protection Convention (No. 183) and European Union Directive 92/857CEE (1992), Switzerland’s Labour Law and its Maternity Protection Ordinance (OProMa) aim to protect the health of pregnant employees and their future children while enabling them to pursue their working activities. Gynaecologists-obstetricians have a key role in this legislation, particularly through the prescription of preventive leave for patients who would otherwise face dangerous or arduous tasks in the absence of an adequate risk analysis or suitable protective measures. However, international and national literature suggests that gynaecologists-obstetricians may encounter difficulties in fulfilling their role. 

Evaluation of existing and desired measures to monitor, prevent and control healthcare-associated infections in Swiss hospitals

Original article
Metsini A, Widmer A, Zingg W, Gardiol C, Vuichard-Gysin D, Eder M, Maag J, Schlegel M, Marschall J, Harbarth S, Sommerstein R, the Swissnoso network
Swiss Med Wkly. 2021;151:w20516

Having an electronic medical record system in place and adequate personnel resources dedicated for surveillance activities are crucial prerequisites for developing and implementing an effective healthcare-associated infections (HAI) surveillance system. The lack of an EMR system and the diversity and capacities of EMR solutions will be the main challenges for successful implementation of national HAI surveillance modules.

“Linkage to care” among people living with HIV – definition in the era of “universal test and treat” in a sub-Sahara African setting

Review article: Biomedical intelligence
Magnolini R, Senkoro E, Vanobberghen F, Weisser M
Swiss Med Wkly. 2021;151:w20535

Prompt linkage to human immunodeficiency virus (HIV) care after diagnosis is of utmost importance for individual health and reduction of HIV transmission. Different definitions for “linkage to care” have challenged comparisons as a public health marker. Its meaning in the era of “universal test and treat” has transformed in all settings, but is most relevant in sub-Sahara Africa, where the burden of new HIV infection is still highest.

Importance of critical care staffing and standard intensive care therapy in the COVID-19 era: a descriptive study of the first epidemic wave at a Swiss tertiary intensive care unit

Original article
Jeitziner MM, Jenni-Moser B, Yok-Ai Q, Thurnheer Zürcher MC, Furrer H, Jakob S
Swiss Med Wkly. 2021;151:w20529

Mortality rates of COVID-19 patients hospitalised in intensive care units (ICUs) are generally high. Availability of ICU resources might influence clinical outcomes. Here the authors report a very low mortality rate of patients treated in a tertiary university ICU in Switzerland. They hypothesise that the sufficient availability of well-trained ICU staff, drugs and special equipment, together with the best standard of ICU supportive care, has been one of the main reasons for the high survival rate observed.

Self-testing for SARS-CoV-2: importance of lay communication

Viewpoint
Coste AT, Egli A, Greub G
Swiss Med Wkly. 2021;151:w20526

The population should be clearly informed on the limitations of rapid antigen testing of self-collected swabs, and therefore the necessity to continue all barrier procedures whatever the rapid antigen test result is and confirm a positive rapid antigen test result with PCR testing.

Insurance coverage policies for reconstructive lymphatic microsurgery procedures in Switzerland

Original article
Uyulmaz S, Fejes A, Grünherz L, Giovanoli P, Lindenblatt N
Swiss Med Wkly. 2021;151:w20456

Insurance companies in Switzerland do not have a uniform policy regarding cost coverage for lymphatic surgery procedures. Moreover, the decision process appeared to be rather uniform within the respective insurance company and independent of the individual case. Standardised evaluation criteria including patient reported outcome measures should be developed to underscore the beneficial effects of lymphatic surgery and facilitate insurance coverage.

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