[Method and impact of allografts cryopreservation during the Covid-19 pandemic: guidelines from the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC)]. / Modalités et impact de la cryopréservation des greffons allogéniques en contexte pandémique : recommandations de la Société Francophone de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC).

The COVID-19 pandemic disorganized the allogeneic stem cell transplantation activities all over the world, with the necessity to cryopreserve allografts to secure the procedure for both the recipient and the donor. Cryopreservation, usually anecdotal, has been used by all the French speaking centers; data collected from 24 centers were assessed in order to determine the impact of cryopreservation on the quality of allografts. Our analysis clearly demonstrates that increasing transit time (more than 48hours) is deleterious for CD34+ recovery, legitimates the slight increase of the requested CD34+ cell dose with respect to the average recovery rate as well as the importance of the quality control on the infused product.

[COVID-19 Pandemic: Psychosocial impact among healthcare professionals in Tunisia]. / Pandémie COVID-19 : impact psychosocial sur le personnel de santé en Tunisie.

OBJECTIVE: To determine the psycho-affective impact of the Covid-19 pandemic on the mental health of health professionals in Tunisia and to estimate the associated factors. METHODS: This is a multicenter, cross-sectional, descriptive and analytical study of health professionals carried out from May 2, 2020 to June 30, 2020 in Tunisia. Healthcare professionals included doctors, nurses, dentists and pharmacists. The participants answered a pre-established questionnaire using an electronic "Google Form". This questionnaire gathered demographic data and medical history. It included two psychometric scales, the GAD-7 (General Anxiety Disorder-7) and the PHQ-9 (Patient Health Questionnaire-9) to assess the prevalence and intensity of anxiety symptoms and depressive symptoms respectively. RESULTS: The study included 203 healthcare professionals. The professionals had a mean age of 30.74±6.33years, 69.5 % were women, and the majority were doctors (77.8 %). Among professionals, 9.4 % were nurses, 7.4 % were dentists, and 5.4 % were pharmacists. A third of the participants 34.3 % worked in departments with Covid-19 patienfor having moderate to severe anxiety symptoms. CONCLUSION: In order to ensure better patient care, early detection of psychiatric disorders and the implementation of specific strategies to ensure better mental health among healthcare professionals are priorities not only during the current pandemic but also in the event of a future similar pandemic.

[Medication reconciliation on admission: One year of practice in health care institutions during the COVID-19 pandemic]. / Conciliation médicamenteuse à l'admission : bilan d'une année d'activité en établissement de santé durant la crise COVID-19.

OBJECTIVES: Medication reconciliation is a key point of the v2020 certification. The main objective of this study was to evaluate this activity over one year, including the first epidemic wave at COVID-19. The secondary objectives were to identify the obstacles and levers and to evaluate doctor satisfaction. METHODS: This was a retrospective study of drug reconciliations performed on admission during 12 months of the emergence of COVID-19. Patients aged 65 years and older from orthopedic and visceral surgery, acute hospitalization and conventional medicine units were included. Unintentional discrepancies were analyzed. The obstacles and levers were identified by means of a focus group. Doctors' satisfaction was collected using online quiz. RESULTS: A total of 760 patients were conciliated, of which 27% (n=208) by hospital pharmacy technicians. A decrease in activity was observed during the first epidemic wave. An unintentional discrepancy was found in 77% of patients, and only 48% were corrected by the prescriber. These results were impacted by the pandemic. The pharmaceutical team was mobilized in the logistical management of the crisis, but it was able to adapt in order to perpetuate the activity. Doctors are satisfied with the process. CONCLUSIONS: Medication reconciliation on admission is essential for the prevention of iatrogeny, particularly with the impact of the COVID-19 pandemic in healthcare institutions.

Étude rétrospective et comparative de l’impact de la crise sanitaire sur l’activité d’une unité d’urgence pédopsychiatrique

Résumé Objectifs Le but de la présente étude est de questionner les conséquences de la crise sanitaire sur le plan psychologique en population pédiatrique, à travers une analyse des variations des données d’activité d’un service de consultations d’urgences pédopsychiatriques. Matériels et méthodes Le travail réalisé est une étude épidémiologique observationnelle rétrospective et comparative reposant sur une analyse des données d’activité d’une consultation d’urgences pédopsychiatriques du centre hospitalo-universitaire de Lille. Les données recueillies sur la période contemporaine aux mesures de restrictions sociales du 17 mars 2020 au 19 mai 2021 ainsi que celles recueillies après la levée de ces mesures du 19 mai 2021 au 31 mai 2022 ont été comparées à l’activité sur ce même dispositif sur les périodes équivalentes entre le 1er janvier 2017 et 17 mars 2020. Des comparaisons centrées sur les 3 périodes de confinement ont également été réalisées. Tout patient entre 0 et 18 ans pris en charge sur la consultation d’urgence était inclus dans cette étude. Résultats Une augmentation significative des prescriptions médicamenteuses et consultations pour idées suicidaires était observée pendant mais aussi à distance des mesures de restrictions sociales. Le premier confinement était quant à lui marqué par une baisse importante du nombre de consultations et une augmentation significative de la rédaction d’écrits judiciaires. Discussion Ces résultats étaient donc en faveur d’une augmentation de la suicidalité en population pédiatrique pendant et après levée des mesures de restrictions sociales, mais aussi d’une augmentation des situations relevant de la protection de l’enfance au cours du 1er confinement. La hausse significative des prescriptions médicamenteuses à l’issue des consultations discordante avec la hausse plus modeste des hospitalisations laissait présager une inadéquation entre besoins et capacités d’accueil en hospitalisation. Conclusion Un impact de la crise sanitaire a donc pu être observé sur l’activité d’une consultation d’urgence pédopsychiatrique pendant, mais aussi à distance de la levée des mesures de restrictions sociales. Cela souligne l’importance de ne pas limiter la recherche aux périodes de confinements, ainsi que la question de la réversibilité des variations observées pour la génération considérée. Objectives The aim of this retrospective study was to question the psychological consequences of the health crisis in a pediatric population, through an analysis of the variations in the activity data of a pedopsychiatric emergency consultation service. Materials and methods The present study is a retrospective and comparative epidemiological study based on an analysis of activity data from a pedopsychiatric emergency consultation at the Lille University Hospital center collected over the period contemporary of the social restriction measures of March 17th, 2020 to May 19th, 2021 as well as those collected after the lifting of these measures from May 19th, 2021 to May 31st, 2022 by comparing them to the activity on this same service over the equivalent periods between January 1st, 2017 and March 17th, 2020. Comparisons centered around the three confinement periods were also carried out. Any patient between 0 and 18 years old taken care of in this emergency consultation was included in this study. Results A significant increase in drug prescriptions and consultations for suicidal ideations was observed during, but also at a distance from social restriction measures. The first confinement was marked by a significant drop in the number of consultations and a significant increase in the drafting of child protection documents. Discussion These results were therefore in favor of an increase in suicidality in the pediatric population during and after the lifting of social restriction measures, as well as an increase in situations relating to child protection during the first confinemen . The significant increase in discordant discharge drug prescriptions with the more modest increase in hospitalizations foreshadowed a mismatch between needs and hospitalization capacity. Conclusion An impact of the health crisis could therefore be observed on the activity of a pedopsychiatric emergency consultation during, but also after the lifting of social restriction measures. This raises the importance of not limiting research to periods of confinement, as well as the question of the reversibility of the variations observed for the generation considered.

Regard de soignant, regard de citoyen à propos de la pandémie Covid-19

Résumé La pandémie de Covid-19 a fait émerger la notion des droits à la liberté : liberté d’expression, de déplacement, de vaccination, etc. Cet article s’intéresse plus particulièrement à la démarche vaccinale. Entre pro-vaccinations, « antivaxs » et indécis se pose la question de la liberté, de l’autonomie décisionnelle individuelle du citoyen et du bénéfice collectif/ sociétal à s’orienter vers un choix. La dispense d’information, via les médias (télévisés, écrits, radiophoniques) et la multitude de sources disponibles sur Internet, peuvent faciliter ou non la prise de décision. Qu’en est-il du positionnement du soignant ? Au-delà du principe de vouloir soigner sans compter, du serment d’Hippocrate (« je respecterai toutes les personnes, leur autonomie et leur volonté, sans aucune discrimination selon leur état ou leurs convictions »), est-il aisé de garder ses-ces convictions ? Est-il légitime de se poser la question « Serait-il éthique de prioriser en réanimation les malades atteints de Covid-19 vaccinés ? », question abordée par certains médecins de Wallonie (Belgique) dans une démarche de débat éthique. Un regard sur la littérature tente de comprendre ce questionnement qui peut interpeller positivement ou interloquer. Niveau de preuve : NA The pandemic linked to Covid-19 let the notion of freedom rights arise: freedom of expression, of movement, of vaccination, etc. In this context, this article focuses on the vaccination process. Between pro-vaccination, "anti-vax" and undecided, the question of freedom, of the individual decisional autonomy of the citizen and the collective/societal benefit to be oriented towards a choice arises. The dispensation of information, via the media (television, written, radio) and the multitude of sources available on the Web, may or may not facilitate decision-making. But what about the position of caregivers? Beyond the principle of wanting to care without counting, the Hippocratic oath ("I will respect all persons, their autonomy and their will, without any discrimination according to their condition or their convictions"), is it easy to keep these convictions? Is it legitimate to ask the question "Would it be ethical to prioritize vaccinated patients in intensive care?”, a question joined by certain doctors of Wallonia (Belgium) in an approach of ethical debate. A look at the literature tries to understand this questioning, which can be both positive and disturbing. Level of evidence: NA

Medical and psychological support during the COVID-19 pandemic in Overseas France

France has developed medical and psychological expertise and has equipped all the 15 (french medical service) centres with Medical and Psychological Emergency Units (CUMPs) composed of medical and paramedical teams of referral psychiatrists, psychologists and nurses, reinforced by volunteers (mental health professionals, trained in this discipline). The attacks endured by France heavily called on the services of the teams in mainland France, particularly in Paris in 2015 and Nice in 2016, with reinforcements between teams in mainland France. The COVID-19 pandemic led to the dispatching of teams outside mainland France to overseas territories hard hit by the pandemic, to the point of creating a real health disaster. These situations have been presented to European partners in the framework of the NO-FEAR project. The article relates the human and ethical experience of these teams as well as their preparation. Résumé La France a développé une expertise médicale et psychologique et a équipé tous les centres 15 (service médical français) de cellules d’urgence médico-psychologique (CUMP) composées d’équipes médicales et paramédicales, de psychiatres référents, de psychologues et d’infirmiers, renforcés par des volontaires (professionnels de la santé mentale, formés à cette discipline). Les attentats subis par la France ont fortement sollicité les services des équipes en métropole, notamment à Paris en 2015 et à Nice en 2016, avec des renforts entre équipes en métropole. La pandémie COVID-19 a conduit à l’envoi d’équipes hors métropole dans des territoires d’outre-mer durement touchés par la pandémie, au point de créer une véritable catastrophe sanitaire. Ces situations ont été présentées aux partenaires européens dans le cadre du projet NO-FEAR. L’article relate l’expérience humaine et éthique de ces équipes ainsi que leur préparation.

THE ROLE OF EMERGENCY PSYCHIATRY SOCIAL WORK IN A VIRTUAL CLINIC DURING THE COVID-19 PANDEMIC

The Psychiatry Emergency Services (PES) virtual clinic is an innovative clinical program that was established to enhance access to psychiatric crisis follow-up care during COVID-19. The clinic provides psychiatric follow-up via scheduled phone calls or videoconference for patients that have been seen by the PES team. The social worker has an important role on the PES virtual clinic team: they initiate initial assessments, collaboratively develop follow-up plans, and facilitate community care. The clinic meets the provincial agenda to reduce Emergency Department (ED) visits, ED/PES wait times, ED/PES overcrowding, and inappropriate admissions, while addressing both psychiatric needs and social determinants of health in an acute care setting. Throughout our survey of relevant literature, we found little research to inform the implementation of virtual care in Canadian healthcare emergency services (Hensel et al., 2020;Serhal et al., 2017). More specifically, there is a void in research regarding a collaborative psychiatric and social work care model in the context of a global pandemic. Further robust studies are needed and encouraged that use emergency psychiatric settings as critical prevention sites of mental health crises.Alternate :La clinique virtuelle des Psychiatry Emergency Services (PES) est un programme clinique innovant qui a été mis en place pour améliorer l’accès aux suivis lors des crises psychiatriques pendant la pandémie de la COVID-19. La clinique assure un suivi psychiatrique par le biais d’appels téléphoniques ou de vidéoconférences pour les patients qui ont été vus par l’équipe des PES. La travailleuse sociale joue un rôle important au sein de l’équipe de la clinique virtuelle du PES : elle initie les évaluations initiales, élabore en collaboration des plans de suivi et facilite les soins de proximité. La clinique répond au plan provincial visant à réduire les visites aux services d’urgence, les temps d’attente aux services d’urgence/PES, l’engorgement des services d’urgence/PES et les admissions inappropriées, tout en répondant à la fois aux besoins psychiatriques et aux déterminants sociaux de la santé dans un contexte de soins aigus. Lors de la recension des écrits, nous avons trouvé peu de recherches permettant d’informer la mise en oeuvre des soins virtuels dans les services d’urgence canadiens (Hensel et coll., 2020;Serhal et coll., 2017). Plus précisément, il n’existe pas de recherche concernant un modèle de soins psychiatriques et sociaux collaboratifs dans un contexte de pandémie mondiale. D’autres études approfondies au sujet des milieux psychiatriques d’urgence utilisés comme sites de prévention des crises en santé mentale sont nécessaires.

WHEN TWO PANDEMICS COLLIDE: RACISM, COVID-19 AND THE ASSOCIATION OF BLACK SOCIAL WORKERS EMERGENCY RESPONSE

In the spring of 2020, African Nova Scotians were faced with two emerging pandemics: the ongoing pandemic of anti-Black racism, and the pandemic of COVID-19. The Association of Black Social Workers created a response specific to the needs of African Nova Scotians, employing the six practice principles of Africentric social work. They established a partnership with community and government partners to manage a phone line to triage based on need, and a virtual community check-in to connect about the pressing Black Lives Matter movement. This paper contextualizes the historic and current systemic racial inequities faced by African Nova Scotians within the context of the current public health emergency, and the need for an equitable, community-based emergency response. This specialized, Africentric service provision model can be used to inform the development of emergency responses for other Black communities in Canada.Alternate :Au printemps 2020, les Néo-Écossais d’origine africaine ont été confrontés à deux pandémies émergentes : la pandémie continuelle de racisme anti-Noir et la pandémie de la COVID-19. L ’Association of Black Social Workers a créé une réponse spécifique aux besoins des Néo-Écossais d’origine africaine, en utilisant les six principes d’intervention du travail social afrocentrique. Elle a établi un partenariat avec des partenaires communautaires et gouvernementaux pour gérer une ligne téléphonique de triage en fonction des besoins, et une communauté virtuelle permettant de rester connecter au sujet du mouvement « La vie des Noirs compte » (Black Lives Matter). Ce document met en contexte les inégalités raciales systémiques, historiques et actuelles, auxquelles sont confrontés les Néo-Écossais d’origine africaine dans le contexte de l’urgence sanitaire actuelle, et la nécessité de mesures d’urgence équitables et communautaires. Ce modèle de prestation de services afrocentriques spécialisés peut être utilisé pour éclairer l’élaboration de mesures d’urgence pour les autres communautés noires du Canada.

Logistique médicale des évacuations aériennes de la première vague COVID-19

Résumé La gestion des flux de patients pendant la pandémie COVID-19 a conduit les établissements de santé à s’entraider de façon à diminuer la charge de travail et le manque de lits de réanimation dans certaines régions de France, dont l’Ile de France. Cet article décrit le rationnel des prises de décision et leur déclinaison en termes d’organisation des transports aériens avec la création d’un centre médical d’évacuation (CME) sur un aéroport. Summary The management of patient flows during the COVID-19 pandemic led health care institutions to help each other in order to reduce the workload and the lack of resuscitation beds in some regions of France, including the Ile de France. This article describes the rationale for decision-making and its application in terms of the organization of air transport with the creation of an evacuation medical center (CME) at an airport.

[CONFAMI study: Effects of home confinement during the COVID-19 epidemic on the lives of children and their families]. / Étude CONFAMI : effets du confinement durant l'épidémie de la COVID-19 sur la vie des enfants et leur famille.

OBJECTIVES: The aim of this study is to understand the changes within families during confinement motivated by the COVID-19 pandemic and to explore the psycho-emotional experiences of children and their parents in this new situation. Confinement necessarily induced significant changes in daily family routines, particularly for work, education, leisure and social activities. In the more vulnerable pediatric population, several authors have warned of the need to consider the impact of lockdown measures during COVID-19 on the psychological impact and well-being. METHOD: This is an anonymous online survey with methodology combining quantitative and qualitative analyses. The questions targeted several themes such as life context, emotional experience and the impact on daily habits in children and adolescents, as perceived by parents. Participants are adults and parents of at least one child. They were recruited through social media and email. RESULTS: A total of 439 parents responded to the questionnaire. The families generally stayed in their usual place of residence and managed to adapt well. On average, the children's level of worry (as estimated by parents) was lower than the level of worry parents attributed to themselves. For the majority, the parents did not observe any change, the psychological state of the children and adolescents was generally stable, but for those who experienced more negative emotions than usual, it was an increase in boredom, irritability and anger. A decrease in the quality of sleep was also observed by a third of the respondents. On the other hand, an increase in autonomy was noted. Regarding the quality of family cohabitation, an important result showed that confinement had improved family relationships for 41% parents but at the expense of usual social ties inducing a feeling of deprivation. Indeed, the participants evoke a lack of "social link" and "social contact with friends". Lack became synonymous with absence, a feeling of loneliness and separation. CONCLUSION: Our results confirm European and international data collected in children in countries where strict lockdown measures have been applied. Despite the negative emotions felt in some children, confinement has helped develop new resources in most families. Families seem to have been successful in maintaining a stable and secure routine which has certainly been a protective factor against anxiety. Some reported factors, such as bonding, could be protective factors and constitute good leads in interventions to be offered to children and their families.

Impact of lockdown during the COVID-19 outbreak on ophthalmological emergencies in a referral center in France.

PURPOSE: In March 2020, the sudden rise in the number of SARS-CoV-2 infections in France led the government to impose a strict lockdown during which all non-urgent medical consultations were postponed. From March 17 to May 10, 2020, private medical practices were closed, and telemedicine was encouraged. The consequences on ophthalmic care were dramatic, with over 90% of scheduled consultations canceled. The goal of this study was to describe consultations during the 2-month strict lockdown in Paris and to analyze its impact on the visual outcomes of patients consulting in the ophthalmology emergency department (OED). METHODS: Data of patients who presented to the OED of the A. de Rothschild Foundation Hospital (RFH), a tertiary ophthalmology center in Paris, France, during the lockdown period and its immediate aftermath were analyzed. The results were compared to the same time periods in the years 2018 and 2019. Four time periods were defined and numbered chronologically: March 17 to May 10, 2018 (period 1); March 17 to May 10, 2019 (period 2); March 17 to May 10, 2020 (period 3, the lockdown period); May 11 to June 9, 2020 (period 4, the post-lockdown period). RESULTS: The number of consultations was reduced by more than 50% during the lockdown period (n=2909 patients) and by 30% during the post-lockdown period (n=2622) when compared to periods 1 (n=7125) and 2 (n=8058). Even though LP4 saw an increase in the number of patients consulting, there was no increase in the rate of severe diseases (12.8% during LP3 vs. 11.1% during LP4), and the proportion of patients who were admitted was statistically similar (4.3% vs. 3.6%). Neuro-ophthalmic diseases were the most common during LP3 and LP4. Neovascular glaucoma was twice as common during post-LP4 (P=0.08). We noted a significant increase in patients with graft rejection consulting in our OED during the post-LP4 (P<0.001). These results were likely related to a delay in follow-up consultations due to the lockdown measures. CONCLUSION: The reduction in the number of consultations in our OED during the lockdown period affected both minor emergencies and severe ophthalmic diseases, but with no significant delay in diagnosis. More longitudinal and longer study is needed to confirm this and to retrospectively analyze the effects of the COVID-19 outbreak and lockdown.

[Impact of the SARS-CoV-2 pandemic on diabetic macular edema and prognostic factors]. / Impact de la pandémie du SARS-CoV-2 sur l'œdème maculaire diabétique et facteurs pronostiques.

PURPOSE: To assess functional and anatomical consequences of the delay in intravitreal injections for diabetic macular edema (DME) patients during the corona virus pandemic lockdown in Morocco as well as to evaluate factors associated with disease progression. PATIENTS AND METHODS: This cross-sectional study included DME patients who did not complete their scheduled intravitreal bevacizumab injections during the Lockdown period (March 20, 2020 to May 20, 2020). Data recorded included age, duration of diabetes, number of previous intravitreal injections, best-corrected visual acuity, and central macular thickness before and after the lockdown. RESULTS: One hundred and fifty four eyes of 104 patients were analyzed. 57.8% were male. The mean age was 59.4±9.04 years. The mean duration of delay of intravitreal injections was 57.3±6.7 days. The mean number of intravitreal bevacizumab injections received before the lockdown was 2.29±2.1. Worsening of visual acuity was noted in 44.8% of patients and was associated with a lower number of intravitreal injections performed prior to the lockdown (P=0.001) and with glycemic imbalance (P=0.04). An increase in central macular thickness was noted in 26.6% of patients and was associated with a lower number of intravitreal injections (P=0.038). CONCLUSION: The delay in intravitreal injections during the lockdown had negative effects on visual acuity and central macular thickness in eyes with DME. Prolonged delay in intravitreal anti-VEGF injections in diabetic patients should be avoided.

Emergency visits and mortality caused by ischemic heart disease attributable to fine particulate matter during the COVID-19 pandemic in Chile.

POSITION DU PROBLèME: Le confinement mis en place au deuxième trimestre 2020 a entrainé une amélioration de la qualité de l'air de Santiago, capitale et plus grande ville du Chili, caractérisée par de fortes concentrations en particules fines PM2,5 liées, en grande partie, au trafic routier. L'objectif était de mettre en évidence une potentielle réduction des visites aux urgences pour infarctus du myocarde aigu (IDM) et des décès dus à une cardiopathie ischémique (CPI) attribuable à l'émission de PM2,5, en comparant les périodes équivalentes de 2019 et de 2020. MéTHODES: À Santiago, la surveillance de la qualité de l'air se fait grâce à neuf moniteurs situés dans neuf communes différentes : Cerro Navia, Cerrillos, El Bosque, Pudahuel, Independencia, La Florida, Quilicura, Santiago centre-ville et Las Condes (classées de la plus haute à la plus basse en matière de pauvreté multidimensionnelle). La concentration moyenne quotidienne de PM2,5 a été décrite avec des séries temporelles, et les visites aux urgences pour IDM et les décès dus à une CPI ont été analysés de façon trimestrielle pour chaque année. Pour estimer l'impact de l'excès de PM2,5, les fractions de risque attribuables (FRA) pour les visites aux urgences pour IDM et les décès pour CPI ont été calculées. RéSULTATS: La moyenne quotidienne des PM2,5 a diminué dans huit des neuf communes de Santiago. Cependant, la réduction n'a été significative que dans trois communes. Les visites aux urgences pour IDM et les décès par CPI attribuables aux PM2,5 ont diminué légèrement mais significativement dans ces trois communes. Les FRA dans les autres communes sont restées similaires à 2019. CONCLUSIONS: Une réduction significative de la FRA des PM2,5 pour les décès par CPI et les visites aux urgences d'IDM n'a été observée que dans les communes avec une réduction significative de la concentration quotidienne moyenne de PM2,5 pendant la pandémie de COVID-19.

[An example of Clinical Investigations Center reorganization during the COVID-19 pandemic French national lockdown]. / Un exemple de réorganisation dans le fonctionnement d'un Centre d'investigations cliniques en période de confinement national suite à la pandémie COVID-19.

BACKGROUND: The Clinical Investigations Center of Saint-Louis Hospital (CIC-1427) is a structure dedicated to clinical trials and mainly early phase trials (first-in-man administration, phase 1 and 2). These trials are conducted in a French Regional Health Agency (ARS) authorized structure. In March 2020, faced to the global COVID-19 pandemic and the French national lockdown measures, the CIC-1427 had to rapidly adapt its operating procedures to ensure the safety of both patients and staff. STUDY OBJECTIVE: Ensuring optimal management of patients included in early phase clinical trials, while respecting the good clinical and professional practices (GCP/GPP) of the CICs protocol sponsors' requirements, patients' safety and clinical research multidisciplinary staff safety (nurses, caregivers' assistants (AS), clinical research assistants (CRA), clinical trial coordinators (CTC), project leaders, health executive and investigating physicians), in the context of the health crisis related to COVID-19. METHODS AND RESULTS: Due to their activity, requiring on-site presence, each staff member of the CIC-1427 clinical research team had to adapt their daily activity to the constraints of the health crisis. New specific procedures were quickly developed to deal with the pandemic. Most of the on-site medical visits were replaced by virtual consults with biological assessments in the local laboratories. "Remote monitoring" replaced on-site monitoring visits. Treatments were sent to each patient's home via couriers after agreement of the CPPs of each protocol (Committee for the Protection of Persons). The essential visits were maintained on site thanks to the unfailing involvement of our clinical care team, with implementation of a specific sanitary protocol. CONCLUSION: The involvement of our entire multidisciplinary research team ensured that each patient was able to benefit from a personalized follow-up and to continue the treatment on-trial. The newly introduced procedures also allowed collection of a maximum of safety and efficacy data for clinical trial sponsors while complying with good regulatory practices. This set of procedures developed during the first epidemic wave, fundamentally helped setting the frame for a better coping during the subsequent pandemic waves.

[Role of the French national registry REIN in the health monitoring of patients with end-stage chronic renal failure infected with SARS-CoV-2: Organization and initial data]. / Le rôle du registre national REIN en France dans la veille sanitaire des patients en insuffisance rénale chronique terminale infectés par le SARS-CoV-2 : organisation et premières données.

The REIN registry is a national registry held by the French Biomedicine Agency. Its objective is the epidemiological monitoring of patients with end-stage chronic renal failure. This registry, backed by its expertise and its national network, has been able to very quickly set up epidemiological monitoring of chronic dialysis and/or transplant patients affected by SARS-CoV-2. The first results show a relatively low frequency of COVID-19 in dialysis patients (4.9%) contrary to what one might have feared. The frequency of SARS-CoV-2 infection in kidney transplant patients is 1.8% nationwide. All regions of France have not been affected in the same way. The prevalence of COVID-19 patients varied by region, reaching up to 10%. The probability of being affected was higher in men and diabetic patients. At October 19, among 3209 infected patients (dialysis and transplant), 573 died from a cause related to SARS-CoV-2. The case fatality in diagnosed cases was 18%. A weekly newsletter has been set up by the Biomedicine Agency using information transmitted by all of the epidemiological support units in the registry. The REIN registry was able to adapt to become a reactive health monitoring tool.

The role of the critical care pharmacist during the COVID-19 pandemic.

On January 4 2020, the World Health Organization (WHO) reported the emergence of a cluster of pneumonia cases in Wuhan, China due to a new coronavirus, the SARS-CoV-2. A few weeks later, hospitals had to put in place a series of drastic measures to deal with the massive influx of suspected COVID-19 (COronaroVIrus Disease) patients while securing regular patient care, in particular in the intensive care units (ICU). Since March 12th, 77 of the 685 COVID-19 patients admitted to our hospital required hospitalization in the ICU. What are the roles and the added-value of the critical care pharmacist during this period? His missions have evolved although they have remained focused on providing health services for the patients. Indeed, integrated into a steering committee created to organize the crisis in the intensive care units, the role of the clinical pharmacist was focused on the organization and coordination between ICU and the pharmacy, the implementation of actions to secure practices, to train new professionals and the adaptation of therapeutic strategies. He participated to literature monitoring and increased his involvement in the clinical research team. He provided a link between the ICU and the pharmacy thanks to his knowledges of practices and needs.