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• Antiplatelet users were older and had significantly more comorbidities. • Adjusted analyses showed no differences in COVID-19 severity with antiplatelet use. • Users of antiplatelets both at home and during admission also had similar outcomes. To evaluate the association between pre-hospitalization antiplatelet medication use and COVID-19 disease severity. Retrospective cohort study. Inpatient units at The Mount Sinai Hospital. Adults age ≥18 admitted between March 1, 2020 and April 9, 2020 with confirmed COVID-19 infection with at least 28 days follow-up. We captured baseline demographic, pre-hospitalization antiplatelet medication use, and clinical encounter data for all patients who met inclusion criteria. The primary endpoint was peak score on a 6-point modified ordinal scale (MOS), which is based on World Health Organization blueprint R&S groups, used to grade severity of illness through clinical outcomes of interest. Scores indicate the following: 1 – COVID-19 infection not requiring hospitalization, 2 – requiring hospitalization but not supplemental oxygen, 3 – hospitalization requiring supplemental oxygen, 4 – hospitalization requiring high-flow nasal cannula (HFNC) or non-invasive positive pressure ventilation (NIPPV), 5 – hospitalization requiring intubation or extracorporeal membrane oxygenation (ECMO), 6 – death. Multivariable adjusted partial proportional odds model (PPOM) was performed to examine the association between pre-hospitalization antiplatelet medication use and likelihood of each MOS score. Of 762 people admitted with COVID-19, 239 (31.4%) used antiplatelet medications pre-hospitalization while 523 (68.6%) did not. Antiplatelet users were older and had more co-morbidities at baseline. Before adjusting for covariates, patients who used antiplatelet medications pre-hospitalization were more likely than non-users to have peak MOS score 6 (death, OR 1.75, 95% CI 1.21–2.52), peak MOS score ≥5 (intubation/ECMO or death, OR 1.4, 95% CI 1.00–1.98) and peak MOS score ≥4 (HFNC, NIPPV, intubation/ECMO or death, OR 1.40, 95% CI 1.01–1.94). On multivariable adjusted PPOM analysis controlling for 13 covariates, there were no longer any significant differences in peak MOS scores between users and non-users. After adjusting for covariates, pre-hospital antiplatelet use was not associated with COVID-19 severity in hospitalized patients. [ABSTRACT FROM AUTHOR]

Anal canal duplication (ACD) is a rare congenital anorectal malformation (ARM) with limited cases and surgical techniques described in the literature to date. A full-term 8-month-old female with a history of constipation was referred to our pediatric surgery clinic for two patent anal orifices draining feculent material. Imaging established that these two openings converged into a common rectum separated by intervening tissue. Intraoperative sphincter mapping further confirmed that the sphincter complex completely encircled the posterior opening and partially surrounded the anterior opening, with viable contractile tissue within the dividing septum. An anoplasty procedure was performed, in which the intervening muscular tissue between the dual anal openings was divided and subcutaneously tunneled to construct a single, functioning neo-anus surrounded by sphincter muscle. There were no postoperative complications, and she continues to have a single, well-functioning anus. Anal canal duplication can be treated successfully with an anoplasty if sufficient sphincter muscle is present. Here, we present a perineal approach for joining two communicating anal openings with excellent results. [ABSTRACT FROM AUTHOR]