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INTRODUCTION: During the COVID-19(coronavirus-19 disease) pandemic, health care workers (HCWs) faced the risk of infection and distressing work to meet health requirements. The aim of the present stud ywas to evaluate perceptions of HCWs of their security at work in COVID-19 units and their coping strategies, at the military hospital of Tunis, during the second wave of COVID-19. METHODS: A cross-sectional study was conducted via an auto-questionnaire on February 2021.HCWs of the military hospital of Tunis were included. Participants were asked about their perceived security at work in COVID-19 units and their coping behaviors. Mental disorders were assessed, via qualitative questionnaires. RESULTS: A total of 110 HCWs' responses were collected. Fifty-eight participants (52.7%) were females. The mean age was 33.7 years (SD 9.3). They were doctors at 45.5% and nurses at 39.1%. HCWs declared having worked in COVID-19 units in 81.8% of cases. The participants reported their fears about being infected in 58.2% and infecting family members in 85.5% of cases. Protective factors included information about the disease (80%), availability of personal protective equipment (PPE) (80.9%), support from colleagues(72.7%)or superiors at work (50.9%), and ability to communicate with others (63.6%). Depression, anxiety, and insomnia were found in respectively 25.5%, 30%, and 41.8% of HCWs. In multivariate analysis, suffering from a traumatic distress was significantly associated with anxiety and depression (p (p<0.01 and, p<0.05 respectively). In addition, insomnia severity was linked to age (p=0.05) and having colleagues infected with COVID-19 (p<0.05). CONCLUSION: In the present study, HCWs of the military hospital of Tunis stated having high levels of insomnia, anxiety, and depression since the early outbreak of the COVID-19 pandemic. These mental disorders may have a negative impact on the quality of life of HCWs and should be enhanced by psychological support and preventive measures.
Subject(s)
COVID-19 , Sleep Initiation and Maintenance Disorders , Female , Humans , Adult , Male , COVID-19/epidemiology , Pandemics , SARS-CoV-2 , Quality of Life , Cross-Sectional Studies , Health Personnel/psychology , HospitalsABSTRACT
Introduction: Since December 2019, a novel coronavirus (SARS-CoV-2) has triggered a global pandemic with a heavy medical and societal-economic toll. The health consequences were not similar during the successive waves that affected several countries. The aim of our study was to compare the sociodemographic, clinical and evolutionary features of COVID-19 patients hospitalized at the Military Hospital of Tunis (HMPIT) during the 2nd and 3rd waves that affected the country. Patients and methods: Observational prospective study involving 1,527 COVID-19 patients hospitalized at HMPIT over 11 months, divided into two periods: from July 2020 to December 2020 called the second wave (V2) and from January 2021 to May 2021 called the third wave (V3). We compared the epidemiological data, the clinical form and the evolution of the patients for each period. Results: The number of hospitalized patients was 636 during V2 compared to 891 during V3. Average age was 63.5 ± 15.3 years during V2 versus 65.8 ± 17.8 years during V3 (P = not significant [NS]). The percentage of young adults [18-40 years] was 6.5% during V2 compared to 6.7% during V3 (P = NS). The gender ratio (M/F) was 1.59 for V2 and 1.42 for V3 (P = NS). Comorbidities were present in 65% of V2 patients and 66.3% of V3 patients (P = NS), with hypertension being the most prevalent one in both groups (47.2% for V2 versus 44.9% for V3; P = NS), followed by overweight, dyslipidemia and diabetes (33% for V2 versus 39.3% for V3; P = 0.012). The median duration between symptoms onset and hospitalization was 7 days [5-10] during V2 versus 8.5 days during V3 [5-12] (P = 0.0004). The severe clinical form was present in 49% of patients admitted during V2 compared to 34.8% during V3 (P < 10-3). The critical form represented 18.6% of cases during V2 against 16.8% during V3 (P = NS). The average hospital length of stay in COVID units (outside of intensive care unit) was 8.4 ± 5.4 days during V2 and 9.8 ± 5.7 days during V3. The average length of stay was significantly longer for the intensive care unit (11.3 ± 3.4 days for V2 versus 13.8 ± 3.9 days for V3; P = 0.01). The case fatality rate was 24.5% during V2 and 20.7% during V3 (P = NS). Median age of death was 70.2 years [42-88] during V2 and 70.4 years [22-96] during V3 with 2 patients less than 40 years of age (1%) for the latter period. The gender ratio (M/F) of deceased patients was 3.21 for V2 and 1.5 for V3 (P = 0.001). The case fatality rate was higher in the intensive care unit (65.4% for V2 versus 69.7% for V3; P = NS). Causes of death were dominated by ARDS (acute respiratory distress syndrome) for both periods (55.1% for V2 versus 70.8% for V3; P = 0.002), followed by septic shock (12.8% for V2 versus 10.8% for V3; P = NS) and multi-organ failure (9.6% for V2 versus 7.0% for V3; P = NS). Conclusion: This study revealed a decrease in severe and critical clinical forms during the 3rd wave, as well as a decrease in the case fatality rate compared to the previous wave, due to improved management and vaccination. On the other hand, the percentage of ARDS was significantly higher during this wave probably related to the beginning of circulation in our country of the Delta variant causing more severe clinical cases.
Subject(s)
COVID-19 , Respiratory Distress Syndrome , Young Adult , Humans , Middle Aged , Aged , COVID-19/epidemiology , SARS-CoV-2 , Tunisia/epidemiology , Prospective Studies , HospitalizationABSTRACT
Parsonage-Turner syndrome (PTS) is a peripheral inflammatory neuropathy of unknown etiology. We present a rare case of a 50-year-old male patient with PTS post-COVID-19 BNT162b2 mRNA vaccine. Symptoms occurred 15 days after the second dose. He was treated with corticosteroids, analgesics, and physical rehabilitation with a partial recovery.
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Résumé Introduction Le nouveau coronavirus (SARS-CoV-2) a déclenché une pandémie mondiale avec des conséquences sanitaires qui n’étaient pas similaires lors des vagues successives qui ont touché plusieurs pays. Le but de notre étude était de comparer les caractéristiques socio-démographiques, cliniques et évolutives des patients atteints de la COVID-19 hospitalisés au cours des 2e et 3e vagues survenues en Tunisie. Patients et méthodes Étude prospective observationnelle incluant 1 527 patients atteints de la COVID-19 et hospitalisés à l'Hôpital militaire de Tunis, s’étalant sur 11 mois, répartie en deux périodes : de juillet 2020 jusqu'en décembre 2020 appelée la deuxième vague (V2) et de janvier 2021 jusqu'en mai 2021 appelée la troisième vague (V3). Résultats 636 patients ont été hospitalisés au cours de V2 contre 891 au cours de V3. L’âge moyen était de 63,5 ± 15,3 ans au cours de V2 contre 65,8 ± 17,8 ans au cours de V3 (P = non significatif [NS]). Le sexe-ratio (H/F) était de 1,59 pour V2 et de 1,42 pour V3 (P = NS). La forme clinique sévère représentait 49% des cas pendant V2 contre 34,8% pendant V3 (P < 10-3). La forme critique représentait 18,6% des cas au cours de V2 contre 16,8% au cours de V3 (P = NS). Le taux de létalité était de 24,5% au cours de V2 et de 20,7% au cours de V3 (P = NS). L’âge médian des patients décédés était de 70,2 ans [42-88 ans] au cours de V2 et de 70,4 ans [22-96 ans] au cours de V3. Le sexe-ratio (H/F) des patients décédés était de 3,21 pour V2 et de 1,5 pour V3 (P = 0,001). Le taux de létalité était plus élevé dans le service de réanimation (65,4% pour V2 versus 69,7% pour V3;P = NS). Les causes de décès étaient dominées par le SDRA (syndrome de détresse respiratoire aiguë) pour les deux périodes (55,1% pour V2 versus 70,8% pour V3;P = 0,002), suivi de l’état de choc septique (12,8% pour V2 versus 10,8% pour V3;P = NS) et de la défaillance multiviscérale (9,6% pour V2 versus 7,0% pour V3;P = NS). Conclusion Nous avons observé une diminution des formes cliniques sévères et critiques au cours de V3, ainsi qu'une baisse du taux de létalité par rapport à V2 grâce à l'amélioration de la prise en charge ainsi qu’à la vaccination. En revanche, le pourcentage de SDRA était significativement plus élevé au cours de V3 probablement en rapport avec le début de circulation dans notre pays de la souche Delta à l'origine de tableaux cliniques plus sévères.
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Background: Massive haemoptysis is a rare symptom ofcoronavirus disease 2019 (COVID-19). Management can be very challenging due to the lack of clear recommendations. Case description: We report a case of massive recurrent haemoptysis in a young patient who tested positive for COVID-19 with successful management using endovascular embolization. Discussion: Life-threatening massive haemoptysis has rarely been reported as the only manifestation of COVID-19. Embolisation was the therapeutic option chosen to manage this emergency. LEARNING POINTS: Haemoptysis is a rare atypical presentation that can reveal COVID-19, highlighting the complexity of its pathogenesis.Atypical manifestations should raise suspicion for COVID-19.In this patient with COVID-19, life-threatening massive haemoptysis was successfully treated with endovascular embolisation.