ABSTRACT
Introduction Les infections associées aux soins (IAS) sont associées à une augmentation de la morbi-mortalité chez les patients hospitalisés en réanimation. L'objectif de la présente étude est de déterminer l'incidence des IAS et de décrire leurs profils bactériologiques dans le contexte particulier de la pandémie COVID-19. Matériels et méthodes Il s'agit d'une étude rétrospective réalisée entre le 1er septembre 2020 et le 30 septembre 2021 au service de réanimation polyvalente colligeant les observations des patients admis pour SDRA à COVID-19 dont le séjour était compliqué d' infection liée aux soins. Ont été analysées les caractéristiques démographiques, cliniques et évolutives ainsi que les résultats des prélèvements microbiologiques effectués chez ces malades. Résultats quatre cent quarante patients ont été admis dans le service, 79 patients ont développé une infection nosocomiale (18 %). Il s'agissait de 45 hommes ayant un âge moyen de 65 ans. Le site d'infection le plus fréquent était le site pulmonaire (52 %) suivi par l'infection hémato-vasculaire (9 %) et urinaire (2 %). Les germes isolés sont dominés par Acinetobacter baumannii résistant à l'imipénème (ABRI) (24 %) suivi par Pseudomonas aeruginosa résistant à l'imipénème (PARI) (3,8 %) et Klebsiella pneumoniae productrice de bétalactamase à spectre élargi (3 %). A noter que, 17 % des IAS étaient une infection polymicrobienne et dans 30 % des cas le germe n'a pas été identifié. La durée médiane de séjour était de 15 jours avec un délai médian de 5 jours pour la survenue d'une IAS. L'antibiothérapie curative était empirique dans 62 % des cas, basée sur l'association tigécycline/colimycine (63 %). La complication la plus fréquente était le choc septique dans 81 % associée à une défaillance multi-viscérale dans 71 % des cas. Le taux de mortalité était de 84,8 %. Conclusion Dans cette étude, l'incidence des IAS était importante avec un impact substantiel sur le devenir des patients avec une mortalité élevée en cas d'infection par des bactéries multirésistantes. Aucun lien d'intérêt
ABSTRACT
The high number of COVID-19 studies has attracted scholars to produce many studies on the topic. However, while we know the impact of these studies on academia by analyzing their citation score in different indexing outlets, little is known about their impact on social networks. The current study aims to measure the impact of the top 100 vaccination papers on social networks. An Altmetrics analysis is conducted to measure the Altmetrics attention scores of the paper. We retrieved the data through the Web of Science and Scopus. The researchers selected Altmetric.com as a tool to obtain social media and mainstream internet outlet counts. The findings of the study revealed that there is a significant correlation between the citations and Altmetric indicators. Our findings indicate that Twitter and Mendeley represent the most contributes social networks in the final AAS in almost all journals included in the study. The study’s findings have confirmed that COVID-19 vaccination papers have gained many citations and attention on social networks. The study’s main limitation is that it only measured the Altmetrics score for the top 100 papers. Hence, while the current paper gave us insight into the performance of vaccination papers on the social web, there is a need to conduct further studies covering a larger sample. © 2021 IEEE.
ABSTRACT
Across every sphere of life—health, economy, social security, livelihood and education—the impacts of COVID-19 are exacerbated for women due to persisting gender inequalities. Women are not only more likely to contract COVID-19, but also lockdowns have affected women’s economic and social security disproportionately due to increased unpaid care work at home, women’s high representation in vulnerable employment or employment in the informal labour sector. Upon the declaration of COVID-19 as a pandemic by the World Health Organization (WHO) on 11 March 2020, the Egyptian Government adopted a variety of public health measures to contain the widespread of the virus on 14 March 2020, accompanied by certain mitigation measures to reduce disproportionate impacts on women. Against this backdrop, this article examines the existence and scope of an international obligation to adopt mitigation measures to reduce disproportionate impacts on women and analyzes Egypt’s COVID-19 response against such obligation. © Koninklijke Brill NV, Leiden, 2021
ABSTRACT
The reported incidence rate of venous and arterial thrombotic events in critically ill patients with COVID-19 infections is high, ranging from 20% to 60%. We adopted a patient-tailored thromboprophylaxis protocol based on clinical and laboratory presentations for these patients in our institution. We hypothesised that patients who received high-intensity thromboprophylaxis treatment would experience fewer thrombotic events. The aims of our study were to explore the incidence of thrombotic events in this population; to assess independent factors associated with thrombotic events and to evaluate the incidence of haemorrhagic events. A retrospective review of all adult patients with confirmed SARS-CoV-2 infection admitted to the intensive care unit (ICU) between 1 March and 29 May 2020 was performed. The primary outcome was a composite of venous and arterial thrombotic events diagnosed during the ICU stay. Multivariable logistic regression was used to identify the independent factors associated with thrombotic events. A total of 188 patients met the inclusion criteria. All received some type of thromboprophylaxis treatment except for six patients who did not receive any prophylaxis. Of the 182 patients who received thromboprophylaxis, 75 (40%) received high-intensity thromboprophylaxis and 24 (12.8%) were treated with therapeutic anticoagulation. Twenty-one patients (11.2%) experienced 23 thrombotic events (incidence rate of 12.2% (95%CI 7.9-17.8)), including 12 deep venous thromboses, 9 pulmonary emboli and 2 peripheral arterial thromboses. The multivariable logistic regression analysis showed that only D-dimer (OR 2.80, p = 0.002) and high-intensity thromboprophylaxis regimen (OR 0.20, p = 0.01) were independently associated with thrombotic events. Thirty-one patients (16.5%) experienced haemorrhagic events; among them, 13 were classified as major bleeding according to the International Society on Thrombosis and Haemostasis criteria. Therapeutic anticoagulation, but not the high-intensity thromboprophylaxis regimen, was associated with major bleeding. A proactive approach to the management of thromboembolism in critically ill COVID-19 patients utilising a high-intensity thromboprophylaxis regimen in appropriately selected patients may result in lower thrombotic events without increasing the risk of bleeding.