ABSTRACT
ABSTRACT: This study aimed to evaluate the incidence of co-infection with different types of pathogens in patients with hypoxemic pneumonia due to coronavirus disease 2019 (COVID-19) in Reunion Island.This observational study using a prospectively collected database of hypoxemic pneumonia due to COVID-19 cases was conducted at Félix Guyon University Hospital in Reunion Island, France.Between 18 March 2020 and 15 April 2020, 156 patients were admitted to our hospital for COVID-19. A total of 36 patients had hypoxemic pneumonia (23.1%) due to COVID-19. Thirty of these cases (83.3%) were imported by travelers returning mainly from metropolitan France and Spain. Patients were screened for co-infection with other pathogens at admission: 31 (86.1%) by multiplex polymerase chain reaction (PCR) and 16 (44.4%) by cytobacteriological examination of sputum culture. Five patients (13.9%) were found to have co-infection: 1 with influenza virus A H1N1 (pdm09) associated with Branhamella catarrhalis, 1 with Streptococcus pneumoniae associated with Haemophilus influenzae, 1 with Human Coronavirus 229E, 1 with Rhinovirus, and 1 with methicillin-susceptible Staphylococcus aureus. Patients with co-infection had higher D-dimer levels than those without co-infection (1.36 [1.34-2.36] µg/mL vs 0.63 [0.51-1.12] µg/mL, Pâ=â.05).The incidence of co-infection in our cohort was higher than expected (13.9%). Three co-infections (with influenza virus A(H1N1) pdm09, Streptococcus pneumoniae, and Staphylococcus aureus) required specific treatment. Patients with hypoxemic pneumonia due to COVID-19 should be screened for co-infection using respiratory cultures or multiplex PCR. Whilst our study has a number of limitations, the results from our study suggest that in the absence of screening, patients should be commenced on treatment for co-infection in the presence of an elevated D-dimer.
Subject(s)
COVID-19/epidemiology , Coinfection/epidemiology , Pneumonia/epidemiology , Pneumonia/microbiology , Adult , Female , France/epidemiology , Humans , Hypoxia , Male , Middle Aged , Retrospective Studies , SARS-CoV-2ABSTRACT
The child welfare sector was not spared by the first containment related to COVID-19. Everywhere, a unique organisation had to be set up to combat the spread of the epidemic. In Isère, a doctor explains how one stage followed another, in an unprecedented and uncertain context.
Subject(s)
COVID-19 , Child , Humans , Pandemics , SARS-CoV-2Subject(s)
Coronavirus Infections/complications , Pneumonia, Viral/complications , Pulmonary Embolism/virology , Travel , Betacoronavirus , COVID-19 , Coronavirus Infections/physiopathology , France , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/physiopathology , SARS-CoV-2 , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: This study aimed to evaluate the prognosis of COVID-19 patients in Reunion Island, with a particular focus on the management of patients with hypoxemic pneumonia. METHODS: This retrospective observational study was conducted from 11 March to 17 April 2020 at the only hospital authorized to manage patients with COVID-19 in Reunion Island. RESULTS: Over the study period, 164 out of 398 patients (41.2%) infected with COVID-19 were admitted to Félix Guyon University Hospital. Of these, 36 (22%) developed hypoxemic pneumonia. Patients with hypoxemic pneumonia were aged 66 [56-77] years, 69% were male and 33% had hypertension. Ten patients (27.8%) were hospitalized in intensive care unit (ICU). Hydroxychloroquine/azithromycin treatment was associated with a lower ICU admission rate (P=0.008). None of the 6 patients treated with corticosteroids were hospitalized in ICU (P=0.16). There were no deaths at follow up (minimum 80 days). CONCLUSIONS: Despite the risk profile of COVID-19 patients with severe hypoxemic pneumonia, the mortality rate of the disease in Reunion Island was 0%. This may be due to the care bundle used in our hospital (early hospitalisation, treatment with hydroxychloroquine/azithromycin and/or corticosteroids, non-invasive respiratory support, etc).
Subject(s)
Adrenal Cortex Hormones/administration & dosage , Azithromycin/administration & dosage , COVID-19 Drug Treatment , Hydroxychloroquine/administration & dosage , Aged , COVID-19/virology , Drug Therapy, Combination , Female , Hospitalization , Humans , Intensive Care Units , Kaplan-Meier Estimate , Male , Middle Aged , Retrospective Studies , Reunion , SARS-CoV-2/isolation & purificationSubject(s)
Coinfection/pathology , Coronavirus Infections/pathology , Pneumonia, Viral/pathology , Adolescent , COVID-19 , Coinfection/diagnosis , Coronavirus Infections/diagnosis , Dengue/diagnosis , Dengue/pathology , Exanthema/pathology , Humans , Male , Pandemics , Pneumonia, Viral/diagnosis , ReunionABSTRACT
The aim of this study was to evaluate the occurrence of pulmonary embolism in returning travelers with hypoxemic pneumonia due to COVID-19. All returning travelers to Reunion Island with hypoxemic pneumonia due to COVID-19 underwent computed tomography pulmonary angiography (CTPA) and were included in the cohort. Thirty-five patients were returning travelers with hypoxemic pneumonia due to COVID-19 and had recently returned from one of the countries most affected by the COVID-19 outbreak (mainly from France and Comoros archipelago). Five patients (14.3%) were found to have pulmonary embolism and two (5.9%) were incidentally found to have deep vein thrombosis on CTPA. Patients with pulmonary embolism or deep vein thrombosis had higher D-dimer levels than those without pulmonary embolism or deep vein thrombosis (P = 0.04). Returning travelers with hypoxemic pneumonia due to COVID-19 should be systematically screened for pulmonary embolism.