Covid-19: How do operators contribute in the fight against the pandemic?

Operators of sanitation systems have actively contributed, together with their scientific partners, to the works aiming at better understanding and fighting against the extension of the Covid-19 pandemic. The studies conducted in the emergency since the end of 2019 rapidly enabled to quantify SARS-CoV-2 RNA in these systems, assess the performance of the treatments in reducing the virus, study its viability in the environment, and test the feasibility of an epidemiological surveillance through the quantification of viral RNA in wastewater. Despite the high concentrations of viral RNA observed during the epidemic peaks, reaching several millions of genome copies per litre, the results available to date indicate the absence of detection of infectious form of this virus in wastewater, and the quantification of viral RNA demonstrates a very significant performance of reduction by the processes applied for water and sludge treatment. Consequently, these studies highlight today the essential role of sanitation systems as barriers to the transmission of SARS-CoV-2 in the environment, and the potential offered by wastewater for the surveillance of infectious disease spreading in the populations connected to these systems. Work is still necessary however, especially to confirm the absence of infectious SARS-CoV-2 in sewer systems, standardize the analytical methods in order to make laboratory results more comparable with each other, and better characterize the relation between the concentration of viral RNA in wastewater and epidemiological indicators, in order to estimate the infection rate in a population from quantification in wastewater. © 2021 Assoc. Generale des Hygienistes et Techniciens Municipaux. All rights reserved.

Stroke Thrombectomy in Patients with COVID-19: Initial Experience in 13 Cases.

We performed a retrospective review in both comprehensive stroke units of a region affected early by the coronavirus disease 2019 (COVID-19) pandemic, between March 1 and April 26, 2020, including patients with COVID-19 who underwent mechanical thrombectomy for ischemic stroke. We identified 13 cases, representing 38.2% of 34 thrombectomies performed during this period. We observed increased mortality and a high incidence of thrombotic complications during hospitalization. Given the high rate of infected patients, systematic use of full personal protection measures seems justified.

Impact of the COVID-19 outbreak on acute stroke pathways - insights from the Alsace region in France.

BACKGROUND AND PURPOSE: To date, no study has attempted to quantify the impact of the COVID-19 outbreak on the incidence and treatment of acute stroke. METHODS: This was a retrospective review of acute stroke pathway parameters in all three stroke units in the Alsace region during the first month of the outbreak (1-31 March 2020), using the similar period from 2019 as a comparator. A secondary detailed analysis of all stroke alerts and stroke unit admissions was performed in the centre with the largest case volume. RESULTS: Compared to the same period in 2019, in March 2020 there were 39.6% fewer stroke alerts and 33.3% fewer acute revascularization treatments [40.9% less intravenous thrombolysis (IVT) and 27.6% less mechanical thrombectomy (MT)]. No marked variation was observed in the number of stroke unit admissions (-0.6%). The proportion of patients with acute revascularization treatments (IVT or MT) out of the total number of stroke unit admissions was significantly lower in March 2020 (21.3%) compared to 2019 (31.8%), P = 0.034. There were no significant differences in time delays or severity of clinical symptoms for patients treated by IVT or MT, nor in the distribution of final diagnosis amongst stroke alerts and stroke unit admissions. CONCLUSION: These results suggest that the overall incidence of stroke remained the same, but fewer patients presented within the therapeutic time window. Increased public awareness and corrective measures are needed to mitigate the deleterious effects of the COVID-19 outbreak on acute stroke care.