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Aims of the study: to identify The charateristics of patients with pulmonary post covid fibrosis Methods: This was a prospective study conducted betwwen january and june 2021. All patients admitted in our hospital and diagnosed with COVID 19 disease were followed up at 3 months after discharge. We compared clinical, biological and ventilator characteristics of two groups : G1 with post covid pulmonary fibrosis and G2 without post covid pulmonary fibrosis Results: Eighty-seven COVID-19 survivors who had undergone a follow-up CT scans after 3 months of discharge from hospital were G1(n=20) and G2 (n=67). Compared to G2,G1 patients were older (p<0.001) without gender predominance ;they had significantly lower oxygen saturation at 3 months of follow up with a median of 96,5 (94,2- 98) vs 98(97-98) p=0.001 . On the biological level the median of CRP in G1 was higher than G2, 15(5-23) vs 2(0-4) p=0,001 and the median of lymphocytes was lower in the group with fibrosis 1100 (970-1600) vs 2095 (1721-2685). The majority of patients had a restrictive ventilatory disorder with no significant difference between the two groups . Conclusion(s): Post-COVID-19 pulmonary fibrosis is a severe complication that leads to permanent lung damage or death. Early detection may help to prevent or at least delay its development. Thus the interest to recognize the profil of fibrotic patients.
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Declaration de liens d'interets: Les auteurs declarent ne pas avoir de liens d'interets. Copyright © 2022
ABSTRACT
Declaration de liens d'interets: Les auteurs declarent ne pas avoir de liens d'interets. Copyright © 2022
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Introduction: Mortality rates of coronavirus disease 2019 (COVID-19) continue to rise across the world. The predictors of mortality in COVID- 19 patients are under study. Objectives: we aim to evaluate the risk factors associated with the death of patients with COVID-19 pneumonia. Methods: We analysed data of laboratory confirmed hospitalized patients at the COVID-19 unit of a university hospital in the Tunisian center, between September 2020 and January 2021.Patients' characteristics, comorbidities, and laboratory abnormalities were recorded. Potential predictors of in-hospital mortality were identified by multivariable Cox regression model. Results: A total of 256 patients were included.Mean age was 66 years (SD, 14 years) and 62% (n = 158) patients were males. Forty-eight percent (n = 123) of patients had at least two co-morbidity with hypertension and diabetesas the most common comorbidities.Severe cases accounted for 52% of the study population.The overall in-hospital mortality rate was 29% (n = 72). multivariate analysisrevealed that Age > = 60 years (HR 5.87, p < 0.001);The presence of coronary heart disease (HR 2.47, p = 0.027) and leukocytes ≥ 10,000 (HR 2.25, p = 0.012),were independently associated with increased in-hospital mortality. Conclusion: Predictors could assist clinicians to identify patients with a poor prognosis at an early stage to reduce the Covid-19-related mortality and rationalize the use of limited medical resources.
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Objective: To assess the effectiveness of Hand Hygiene (HH) in preventing infections and the transmission of pathogens, in an epidemic context, in community and hospital settings. Method: It is a systematic review of the literature based on a document request, conducted on PubMed, using the following search equation: «(« Hand Hygiene «[All Fields] OR» Hand Disinfection «[All Fields]) AND («Epidemics» [All Fields] OR «Pandemics» [All Fields]) «. All publications related to the effectiveness of the preventive intervention for HH in an epidemic setting were Included. Results: A total of 16 publications were included, of which the majority proved the effectiveness of HH and its promotion in reducing infections during an epidemic. In a clinical trial, promoting HH in an intervention group significantly reduced the prevalence of infections (24.4% vs. 11.1%). Two systematic reviews have shown the effectiveness of HH in preventing the transmission of germs with ORs between 0.52 and 0.62. Four case-control studies and three cross-sectional studies concluded with the protective effect of HH with ORs varying between 0.06 and 0.71. A cohort study showed that low adherence to HH recommendations was associated with a higher infection rate (77.5% vs 95%;p = 0.02). A single systematic review did not conclude that HH was effective in the epidemic setting. Conclusion: The effectiveness of HH in the fight against epidemics has been demonstrated. It is dependent on the engagement and the active participation of the different intervenient. Hence the need to increase accessibility to different methods of HH and to promote the importance of this prevention strategy could be assured through education and awareness.