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Introduction: Health care workers (HCWs) are a high-risk group for SARS-CoV-2 infection, therefore there is an urgent need for rapid, simple, and sensitive tests to diagnose COVID-19 infection among health care settings. Aim(s): The aim of our study was to assess the contribution of the SARS-CoV-2 antigen rapid diagnostic tests (AgRDTs) with RT-PCR which is the gold standard for the diagnosis of COVID-19. Method(s): A retrospective descriptive study of HCWs at Charles Nicolle Hospital who consulted the Occupational Medicine health Department during the period from January 3, 2022, to January 31, 2022, for symptoms suggestive of COVID-19 infection. The Panbio antigen rapid diagnostic tests were used in all suspected cases. In case of negative Ag-RDTs, we completed with RT-PCR. Result(s): Our population consisted mainly of nurses (n=146), blue-collar workers (n=100), trainees (n=105) and senior technicians (n=84). We performed 638 Ag-RDTs and 177 RT-PCR during the study period. Ag-RDTs were positive in 461 cases (72.25%). 146 HCPs tested negative by both methods. Discordant results were obtained in 31 cases (17.51%). RT-PCR was positive in 31 cases. Conclusion(s): In our series, the Ag -RDT seems a reliable way for the diagnosis of covid 19 in symptomatic HCWs.
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Introduction: The COVID-19 pandemic has caused an overload within health care structures in Tunisia, impacting negatively on the management of other pathologies. In this study, we estimated the impact of the COVID-19 pandemic on delay in diagnosis and management of lung cancer in a Department of Pulmonology in Tunisia. Method(s): A retrospective study including patients with lung cancer managed between January 2019 and December 2021 in the Pulmonology IV Department of Abderrahmane Mami Hospital. The patients were divided into two groups: Group 1(G1):(n= 59) included patients diagnosed before Covid-19 pandemic (January/December 2019). Group 2 (G2): (n =71) diagnosed during the Covid-19 pandemic (march 2020/December 2021). Result(s): One hundred and thirty male patients were included with an average age of 60.8 years. The mean delay between the onset of symptoms and the first consultation was 43.27 days in G1 versus 39.92 in G2 . The mean delay between first consultation and the histological diagnosis was significantly longer in G2 (34.3 days vs 31.85 days in G1;p = 0.037). The most common histological type in both groups was adenocarcinoma. Sixty point six percent of patients of G2 were diagnosed at metastatic stage (vs 47.5 % in G1 ). The mean delay between histological diagnosis and initiation of specific treatment was significantly longer in G2 (60.34 days vs 41.67 days in G1 ;p = 0.014). Conclusion(s): The study demonstrates the significant impact of COVID-19 on diagnostic and therapeutic delays for lung cancer patients in our department. A specific care pathway needs to be created in order to ensure treatment within the optimal deadlines.
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Introduction: Many patients suffer from persistent and prolonged effects after acute COVID-19. The aim of our study is to describe the prevalence of Long COVID in survivors after discharge and to determine the relation between the severity of acute COVID-19 infection and Long COVID. Method(s): Retrospective study of hospitalized patients with COVID-19 in pneumology department II of Abderahman Mami hospital. We compared 2 groups: a moderate COVID-19 group (G1) and a severe COVID-19 group (G2). We compared persistent symptoms, Chest CT and pulmonary function tests assessments at 3 months after discharge in the two groups. Result(s): A total of 150 patients were initially admitted. Median age was 64 years. Patients in G2 were older and had more comorbidities than those in the moderate group. The main comorbidities were hypertension (38.6%) and diabetes (33.3%). Common symptoms of acute COVID 19 revealed were: breathlessness (86%), cough (68%) and fatigue (63%). Ninety patients were followed up for a mean of 3 months. The Prevalence of Long COVID was 54.4% (n=49). G2 had a higher Prevalence compared to G1: 35.7%G1 (n=15) vs 70.8%G2 (n=34), p=0.001. The most frequent persistent symptoms revealed were: breathlessness (27.2% G1 vs 67.5% 2, p=0.001) fatigue (21.2% G1 s 42.5%, p=0.05) and cough (12.1% G1 vs 18.4% G2, p=0.205). Pulmonary diffusion impairment was the most common pulmonary dysfunction (45% G1 vs 69.2% G2 p=0.19). Abnormal CT findings are predominately found in patients of G2. Lung fibrotic-like changes were observed in 25% of the patients in G2 vs 14.2% in G1 within 3 months. Conclusion(s): A spectrum of sequelae has been reported among COVID-19 survivors. Patients with high-risk of postacute COVID-19 should be identified.
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Introduction: At the end of 2020, several vaccines against covid-19 have been validated by the World Health Organization in order to stop this pandemic. However, a growing number of people, including health care workers (HCWs), express reluctance to be vaccinated against covid-19. Aim(s): To determine the causes of reluctance towards the covid-19 vaccine expressed by health care personnel. Method(s): This was a descriptive and cross-sectional study that interested the HCWs of the Charles Nicolle Hospital of Tunisia reluctant to the anti-covid-19 vaccination during the period from October 25, 2021, to January 31, 2021. The causes of renunciation were studied through a pre-established questionnaire. Result(s): Our population consisted of 112 HCWs. The average age was 41.1 +/-10.2 years old. Females were predominant (66.1%). The average professional seniority was 12.4 +/- 11.3 years. Our population consisted mainly of blue-collar workers (29.1% of cases) followed by senior technicians (26.4% of cases) and nurses (24.5% of cases). The HCWs belonged to the medical services in 45% of the cases. Previous infection with SARS -Cov2 virus was noted in 55.4% of the HCWs. The reasons for renunciation were: the potential adverse effects that the vaccine could cause in the long term (59.8%), the speed of clinical trials is a source of concern (30.4%), and at the use of new vaccine technologies, particularly mRNA vaccines remains a factor of distrust (26.8%). Conclusion(s): It is imperative to strengthen the confidence of the HCWs towards the different vaccines against covid19 while insisting on the benefit-risk balance which always remains in favor of vaccination.
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COVID-19 vaccination is one of the most effective ways to prevent the spread of SARS-CoV2. However,these vaccines are not devoid of adverse effects requiring post-vaccination follow-up. Aim(s): Determine the frequency of adverse events(AEs)of an anti-COVID-19 messenger RNA vaccine (mRNA) collected among health care workers(HCW) at Charles Nicolle Hospital in Tunis. Method(s): Descriptive cross-sectional study carried out in September 2021, involving the HCW of the Charles Nicolle hospital in Tunis who had received the first dose of an mRNA anti-COVID 19 vaccine during a mobile vaccination campaign in the workplace. The data collection was carried out using a pre-established questionnaire containing the adverse vaccine reactions defined by the Tunisian Ministry of Health technical sheets. Result(s): The study population was composed of 139 HCW. Post-vaccine AEs were reported in 78% of cases. A predominance of women was noticed(78%). The age group most affected was between 40 and 45 years old. The most common AEs were injection site pain in 65% of cases, fever in 30% of cases, headache in 15% of cases and myalgia in 14% of cases. In addition, four cases of dizziness, two cases of generalized pruritus and one case of lymphadenopathy and acute peripheral facial paralysis were reported. The time to onset of AEs ranged from the same day to three days. The average duration of these AEs ranged from one to seven days. Five percent of our population took time off work which variated from one to three days. Conclusion(s): The occurrence of AEs following vaccination with an mRNA vaccine should not destabilize the promotion of vaccination in the workplace. However, close post-vaccination surveillance is necessary to ensure good occupational activity in the care setting.
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Declaration de liens d'interets: Les auteurs declarent ne pas avoir de liens d'interets. Copyright © 2022
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Introduction L’épidémie à Covid-19 a mis sous tension les systèmes de soins du pays. L’objectif de cette étude était d’évaluer le vécu des patients suivis pour cancer bronchopulmonaire (CBP) face à la COVID-19 et son impact sur leur prise en charge. Méthodes Il s’agissait d’une étude transversale. Un questionnaire a été donné aux patients suivis pour CBP consultant en hôpital du jour entre janvier 2021 et juin 2021. Le questionnaire comprenait : les caractéristiques socio-démographiques des patients, leur vécu face à la COVID-19 et son impact sur leur prise en charge. Résultats Cette étude a inclus 55 patients de sexe masculin, l’âge moyen était de 61 ans. La pandémie de la COVID-19 a eu un impact négatif significatif sur la prise en charge. 46 % des patients (23) étaient obligés de changer le lieu de suivi initial. Trente-six pour cent étaient obligé de changer son médecin traitant. Depuis la pandémie, 76 % des patients ont raté leurs rendez-vous : 69 % ont peur de la contagion en venant à l’hôpital, 12,7 % sensation d’insécurité et perte de confiance envers l’équipe médicale. Soixante deux pour cent des patients ont signalé l’incessibilité au personnel médical tandis que 56 % ont signalé la négligence de l’équipe para-médicale.89 % ont raté les séances de chimiothérapies suite à la non-disponibilité des traitements anticancéreux ;14 % ont eu un arrêt complet de la chimiothérapie. En plus, la crainte de la mort était avouée par 72 % d’entre eux, un trait dépressif a été noté dans 12 %. Conclusion Notre étude a permis de mettre en évidence le ressenti des patients des conséquences délétères de la pandémie de la COVID-19 sur la continuité des soins.