Surveillance of Severe Viral Respiratory Infections among Children Presenting to Hopital Saint Damien in Haiti

Background. Learning the burden and seasonality of respiratory viral infections in children in resource-limited settings is critical for hospital infection care and prevention and national public health programs. We built a prospective surveillance program of severe acute respiratory illness (SARI) in hospitalized children at Hopital Saint Damien - Nos Petits Freres et Soeurs to gather local evidence and support informed clinical and policy decision-making. The COVID-19 pandemic erupted as we were launching our project, requiring the use of available point-of-care diagnostics. Methods. Children < 18 years of age with cough, history of fever >= 38 Cdegree, of < 10 days evolution, and requiring hospitalization were included in the study. We obtained a nasopharyngeal swab and collected demographic and clinical data for eligible patients. Samples were tested using antigen test on-site for influenza A (Flu A) and B (Flu B), respiratory syncytial virus (RSV), and SARS-CoV-2. Afterwards, all specimens (both negative and positive) were stored and shipped for molecular studies. Results. We obtained and tested 167 samples from patients since April 30, 2021, through January 31, 2022. Single isolates were detected in 88 samples (53%), multiple isolates in 20 samples (12%), and no isolates in 59 samples (35%). Positive cases for RSV, Flu A, and Flu B peaked between November and January. Rhinovirus 1A (RhV) was detected throughout the study period, with peaks around August-September and was the most often detected viral isolate (49, 38%), followed by RSV (37, 29%). Co-infections were seen with RSV, Flu A, RhV, and SARS-CoV-2. Molecular studies detected 7 isolates of Flu A not detected by rapid test, 1 isolate of Flu B, and 1 isolate of SARS-CoV-2. However, it failed to detect 2 isolates of Flu A detected by rapid test, 1 isolate of Flu B, and 1 isolate of SARS-CoV-2. Conclusion. Our study captured circulating respiratory viruses in children with SARI in Haiti during the COVID-19 pandemic. Preliminary data suggest an increase in respiratory viruses between August and January. Improving point-of-care diagnostics can better inform providers of the local epidemiology of respiratory viruses and support clinical decision-making, such as good use of antibiotics. However, we confirmed the sensitivity of molecular testing. (Figure Presented).

COVID-19 geoviz for spatio-temporal structures detection

The spread of COVID-19 has motivated a wide interest in visualization tools to represent the pandemic's spatio-temporal evolution. This tools usually rely on dashboard environments which depict COVID-19 data as temporal series related to different indicators (number of cases, deaths) calculated for several spatial entities at different scales (countries or regions). In these tools, diagrams (line charts or histograms) display the temporal component of data, and 2D cartographic representations display the spatial distribution of data at one moment in time. In this paper, we aim at proposing novel visualization designs in order to help medical experts to detect spatio-temporal structures such as clusters of cases and spatial axes of propagation of the epidemic, through a visual analysis of detailed COVID-19 event data. In this context, we investigate and revisit two visualizations, one based on the Growth Ring Map technique and the other based on the space-time cube applied on a spatial hexagonal grid. We assess the potential of these visualizations for the visual analysis of COVID-19 event data, through two proofs of concept using synthetic cases data and web-based prototypes. The Grow Ring Map visualization appears to facilitate the identification of clusters and propagation axes in the cases distribution, while the space-time cube appears to be suited for the identification of local temporal trends.

Hypercalcemia as a Biomarker of Poor Prognosis in Frail Elderly Patients with COVID-19.

The objective of this cohort study was to determine whether hypercalcemia in early COVID-19 was associated with 3-month mortality in frail elderly patients. Circulating calcium and albumin concentrations at hospital admission and 3-month mortality were assessed in geriatric patients hospitalized for COVID-19 with normal-to-high calcium concentrations. Hypercalcemia was defined as corrected calcium >2.5mmol/L. Covariables were age, sex, functional abilities, malignancies, hypertension, cardiomyopathy, number of acute health issues, use antibiotics and respiratory treatments. In total, 94 participants (mean±SD 88.0±5.5years; 47.9% women; 22.3% hypercalcemia; 0% hypocalcemia) were included. Sixty-five participants who survived at 3months exhibited less often hypercalcemia at baseline than the others (13.9% versus 41.4%, P=0.003). Hypercalcemia was associated with 3-month mortality (fully-adjusted HR=3.03, P=0.009) with specificity=0.86 and sensitivity=0.41. Those with hypercalcemia had shorter survival time than those with normocalcemia (log-rank P=0.002). In conclusion, hypercalcemia was associated with poorer survival in hospitalized frail elderly COVID-19 patients.

Towards individualised and optimalised positioning of non-ventilated COVID-19 patients: Putting the affected parts of the lung(s) on top?

The outbreak of COVID-19 led to an unprecedented inflow of hospitalised patients with severe acute respiratory syndrome (SARS), requiring high-flow non-invasive oxygenation, if not invasive mechanical ventilation. While the best option in terms of non-invasive systems of oxygen delivery is still a matter of debate, it also remains unclear as to whether or not the optimal in-bed positioning of patients might also help to improve their oxygen saturation levels. On the basis of three representative cases, it is possible to propose the following hypotheses: (i) how patients are positioned has a strong influence on their oxygen saturation levels; (ii) saturation-optimalised positions are patient-specific; (iii) prone positions require ergonomic devices; and (iv) saturation-optimalised positions should aim to place the most affected part(s) of the lung(s) on top. Considered together, these hypotheses have led us to recommend that COVID-19 patients should undergo a specific assessment at admission to determine their saturation-optimalised in-bed position. However, further studies are still needed to assess the benefits of such a strategy on clinical outcomes.

[Recommendations of the Urolithiasis Committee of the French Urology Association for the management and the treatment of the stone formers patients during the COVID-19 pandemic crisis]. / Recommandations du Comité Lithiase de l'Association Française d'Urologie pour la prise en charge des calculs urinaires durant la crise sanitaire liée à la pandémie à COVID-19.

For the first time, faced with a crisis with an exceptional magnitude due to the COVID-19 pandemic responsible for saturation of emergency services and intensive care units, the urolithiasis committee of the French Urology Association designed the recommendations for care and treatment of stone-forming patients and their treatment during crisis.