Strategic and entrepreneurial abilities: Surviving the crisis across countries during the Covid-19 pandemic.

This paper seeks to identify organisational abilities that influence the company's survival during crises. To address this issue, first-through literature review-we identified five groups of crucial organisational abilities that companies pursue during the crisis, i.e., strategic, technological, collaboration, entrepreneurial and relational. We have also identified four objectives that relate to surviving the crisis. Next, we have scrutinised 226 companies from two sides of the world, Poland (Europe) and Morocco (Africa), during the Covid-19 crisis. Quantitative analysis using Structural Equations Modelling demonstrated that surviving during a crisis depends mostly on strategic and entrepreneurial abilities such as the ability to shift resources quickly, organise the work in the firm effectively and plan strategically, as well as diversify its products and services perceived as critical.

Factors associated with recognition at work among nurses and the impact of recognition at work on health-related quality of life, job satisfaction and psychological health: a single-centre, cross-sectional study in Morocco.

OBJECTIVES: To describe the sociodemographic, occupational and health factors that influence nurses' recognition at work and to examine a recognition pathway model to assess the relationship between recognition at work and health-related quality of life (HRQOL), job satisfaction, anxiety and depression. DESIGN: This is a cross-sectional observational study with prospective data collection based on a self-report questionnaire. SETTING: University hospital centre in Morocco. PARTICIPANTS: The study included 223 nurses with at least 1 year of practice at the bedside in care units. MEASURES: We included the sociodemographic, occupational and health characteristics of each participant. The Fall Amar instrument was used to measure job recognition. HRQOL was measured using the Medical Outcome Study Short Form 12. The Hospital Anxiety and Depression Scale was used to assess anxiety and depression. Job satisfaction was measured using a rating scale (ranging from 0 to 10). Path analysis was used to examine the nurse recognition pathway model to assess the relationship between nurse recognition at work and key variables. RESULTS: The participation rate in this study was 79.3%. Institutional recognition was significantly correlated with gender, midwifery specialty and normal work schedule: ß=-5.10 (-8.06, -2.14), ß=-5.13 (-8.66, -1.60) and ß=-4.28 (-6.85, -1.71), respectively. Significant correlations were found between recognition from superiors and gender, mental health specialisation and normal work schedule: ß=-5.71 (-9.39, -2.03), ß=-5.96 (-11.17, -0.75) and ß=-4.04(-7.23, -0.85), respectively. Recognition from coworkers was significantly associated with mental health specialisation: ß=-5.09 (-9.16, -1.01). The trajectory analysis model found that supervisor recognition had the best impact on anxiety, job satisfaction and HRQOL. CONCLUSIONS: Recognition from superiors is important in maintaining nurses' psychological health, HRQOL and job satisfaction. Therefore, managers in hospitals should address the issue of recognition at work as a potential personal, professional and organisational lever.

Quantification of impact of COVID-19 pandemic on cancer screening programmes - a case study from Argentina, Bangladesh, Colombia, Morocco, Sri Lanka, and Thailand.

It is quite well documented that the COVID-19 pandemic disrupted cancer screening services in all countries, irrespective of their resources and healthcare settings. While quantitative estimates on reduction in volume of screening tests or diagnostic evaluation are readily available from the high-income countries, very little data are available from the low- and middle-income countries (LMICs). From the CanScreen5 global cancer screening data repository we identified six LMICs through purposive sampling based on the availability of cancer screening data at least for the years 2019 and 2020. These countries represented those in high human development index (HDI) categories (Argentina, Colombia, Sri Lanka, and Thailand) and medium HDI categories (Bangladesh and Morocco). No data were available from low HDI countries to perform similar analysis. The reduction in the volume of tests in 2020 compared to the previous year ranged from 14.1% in Bangladesh to 72.9% in Argentina (regional programme) for cervical screening, from 14.2% in Bangladesh to 49.4% in Morocco for breast cancer screening and 30.7% in Thailand for colorectal cancer screening. Number of colposcopies was reduced in 2020 compared to previous year by 88.9% in Argentina, 38.2% in Colombia, 27.4% in Bangladesh, and 52.2% in Morocco. The reduction in detection rates of CIN 2 or worse lesions ranged from 20.7% in Morocco to 45.4% in Argentina. Reduction of breast cancer detection by 19.1% was reported from Morocco. No association of the impact of pandemic could be seen with HDI categories. Quantifying the impact of service disruptions in screening and diagnostic tests will allow the programmes to strategize how to ramp up services to clear the backlogs in screening and more crucially in further evaluation of screen positives. The data can be used to estimate the impact on stage distribution and avoidable mortality from these common cancers.

COVID-19 in Morocco's region: Observational study of prevalence in symptomatic adults using the PANBIOS® rapid antigen test September 2021.

Background: Rapid antigen tests have emerged to deal with the COVID-19 pandemic. Rapid diagnosis of SARS-CoV-2 infection is essential to reduce the spread of the disease. The aim of this study was to estimate the prevalence of COVID-19 infection and test the sensitivity and specificity in Temara-Skhirat in symptomatic adults through PANBIOS® test. Methods: A prospective observational study was conducted in mid-September 2021. Two investigators conducted data collection from symptomatic adult patients. The diagnostic performance of the PANBIOS®, and the PCR was assessed to calculate sensitivity and the specificity. Results: Among 206 symptomatic participants, the mean age was 38 ± 12 years, and the majority were women (59%). In our population, 80% had benefited from the anti-COVID vaccine. The median duration of symptoms was 4 days; the most common symptoms were fatigue (62%), headache (52%), fever (48%), cough (34%), loss of smell (25%), loss of taste (24%), and sore throat (22%). Results revealed 23% of cases tested positive with PANBIOS® test versus 30% with the PCR test. The calculated medical decision between PCR versus PANBIOS® test showed high specificity of 95.7% and a sensitivity of 69.4%. There was concordance between the PANBIOS® test and the PCR. Conclusion: The prevalence tested remain high, and the sensitivity and specificity of the PANBIOS® versus PCR test are similar to other literatures and close to value described in WHO recommendations. PANBIOS® is a useful test for controlling the spread of COVID-19 allowing identification of active infection.

Intention de vacciner les enfants de moins de 12 ans contre la COVID-19 chez les parents de la préfecture de Meknès (Maroc)

Contexte: Deux jours avant la rentrée scolaire 2021, plus de deux millions d’élèves marocains (âgés de 12 à 17 ans) avaient reçu la première dose du vaccin contre la maladie à coronavirus 2019 (COVID-19) et 416 810 élèves avaient bénéficié des deux doses. La vaccination des jeunes enfants contre la COVID-19 contribuerait au contrôle de la pandémie et à « l’immunisation de troupeau » ou immunité collective. Objectif: La présente étude vise à évaluer dans quelle mesure les parents marocains sont susceptibles de fairevacciner leurs enfants de moins de 12 ans contre la COVID-19. Méthodes: Nous avons mené une étude descriptive sous forme d´enquête électronique anonyme au cours des moisd’août et de septembre 2021. L’administration du questionnaire a été effectuée dans un échantillon de 384 parents qui consultaient dans des cabinets de pédiatre au niveau de la préfecture de Meknès. Résultats: Notre étude montre que la majorité des parents étaient vaccinés (67,2 %), mais refusaient de faire vacciner leurs enfants de moins de 12 ans (83,6 %). Par contre, 72 % de l’ensemble des parents déclaraient qu’ils étaient prêts à faire administrer le vaccin à leurs enfants au cas où la mortalité augmenterait dans ce groupe de population. Conclusion: La plupart des parents qui refusaient de faire vacciner leurs enfants étaient analphabètes ou n’avaient qu’une éducation primaire. Il est donc nécessaire de comprendre les craintes des parents et de renforcer les campagnes d’information sur les avantages du vaccin anti-COVID-19.

Teleconsultation use and satisfaction among cancerologists during the COVID-19 pandemic in Morocco.

Introduction: health care benefits have undergone major changes during the COVID-19 pandemic. This has led to an explosive growth in teleconsultation services mainly for cancer patients. The purpose of this study was to assess the perception and experience of Moroccan oncologists with the use of teleconsultation during the COVID-19 pandemic. Methods: a 17-question anonymous cross-sectional survey was conducted on Google forms and emailed to all Moroccan oncologists. Statistical analysis was performed using the statistical software Jamovi (version 2.2). Results: out of a total of 500 oncologists who received the questionnaire, 126 responded, with a response rate of 25%. During the pandemic, only 59.5% of oncologists used teleconsultation, with no significant differences among the three groups (radiation oncologists, medical oncologists and cancer surgeons (p=0.294)). Most participants were satisfied with being able to explain medical diagnosis, provide assessment results, and provide treatment recommendations during teleconsultation. Finally, 47.2% of participants were willing to continue conducting teleconsultations after the COVID-19 pandemic, with no significant differences among the three groups. Conclusion: oncology physicians were satisfied with their experiences with teleconsultation and agreed that it is likely to be part of their long-term practice. Future studies are needed to assess patient satisfaction with teleconsultation and to improve patient care through this virtual technology.

Uncertainty Quantification for Epidemic Risk Management: Case of SARS-CoV-2 in Morocco.

In this paper, we propose a new method for epidemic risk modelling and prediction, based on uncertainty quantification (UQ) approaches. In UQ, we consider the state variables as members of a convenient separable Hilbert space, and we look for their representation in finite dimensional subspaces generated by truncations of a suitable Hilbert basis. The coefficients of the finite expansion can be determined by approaches established in the literature, adapted to the determination of the probability distribution of epidemic risk variables. Here, we consider two approaches: collocation (COL) and moment matching (MM). Both are applied to the case of SARS-CoV-2 in Morocco, as an epidemic risk example. For all the epidemic risk indicators computed in this study (number of detections, number of deaths, number of new cases, predictions and human impact probabilities), the proposed models were able to estimate the values of the state variables with precision, i.e., with very low root mean square errors (RMSE) between predicted values and observed ones. Finally, the proposed approaches are used to generate a decision-making tool for future epidemic risk management, or, more generally, a quantitative disaster management approach in the humanitarian supply chain.

The Study of the Heterogeneity of the Qualities of Argan Oils and Pomaces from Different Cooperatives in the Essaouira Region (Morocco).

In this study, a comparison of the intra-regional variation in the quality of Argan oil and pomace collected from 12 cooperatives in the Essaouira region (Morocco) during the COVID-19 period was carried out. All studied Argan pomaces together with the extraction solvents showed a significant difference (p ≤ 0.05) in the total phenolic compounds, flavonoids, and tannins contents. The proteins, residual oils, total sugars, and total reducing sugars contents in the collected pomaces vary considerably among cooperatives of origin, with maximum averages of 50.45%; 30.05%; 3.82 milligrams of glucose equivalent per gram of dry matter; and 0.53 milligrams of glucose equivalent per gram of dry matter, respectively. Therefore, it is a very valuable ingredient for livestock feed and some cosmetic products that may contain it. The remaining Argan oil content in the pomace varied significantly among cooperatives, ranging from 8.74 to 30.05%. Pomace from traditional extraction recorded the highest content (30.05%), showing that the artisanal and modern extraction processes are not standardized. The measurements of acidity, peroxide value, specific extinction coefficient at 232 nm and 270 nm, and conjugated dienes were carried out in accordance with Moroccan Standard 08.5.090 in order to qualitatively classify all investigated Argan oils. Accordingly, the analyzed oils were categorized as "extra virgin Argan oil," "fine virgin Argan oil," "ordinary virgin Argan oil," and "lampante virgin Argan oil." Therefore, several factors can explain these variations in quality grades, both endogenous and exogenous. Overall, the variation observed in the obtained result allows us to deduce the most significant variables impacting the quality of Argan products and by-products.

Factors affecting nursing and health technician students' satisfaction with distance learning during the COVID-19 pandemic in Morocco: a survey-based observational study.

PURPOSE: Distance learning describes any learning based on the use of new multimedia technologies and the internet to allow students to acquire new knowledge and skills at a distance. This study aimed to deter-mine satisfaction levels with distance learning and associated factors among nursing and health technician students during the coronavirus disease 2019 pandemic in Morocco. METHODS: An observational, cross-sectional study was conducted between April and June 2022 among nursing and health technician students using a self-administered instrument. The student satisfaction ques-tionnaire consists of 24 questions categorized into 6 subscales: instructor, technology, course setup, interac-tion, outcomes, and overall satisfaction. It was based on a 5-point Likert scale, ranging from 1 (strongly disagree) to 5 (strongly agree). Univariate and multivariate logistic regression analyses were conducted to identify factors associated with student satisfaction during distance learning. RESULTS: A total of 330 students participated in this study, and 176 students (53.3%) were satisfied with the distance learning activities. A mean score higher than 2.8 out of 5 was obtained for all subscales. Multiple regression analysis showed that students' year of study (adjusted odds ratio [aOR]=2.34; 95% CI, 1.28-4.27) and internet quality (aOR=0.47; 95% CI, 0.29-0.77) were the significant factors associated with students' satisfaction during distance learning. CONCLUSION: This study highlights the satisfaction level of students and factors that influenced it during distance learning. A thorough understanding of student satisfaction with digital environments will contrib-ute to the successfully implementation of distance learning devices in nursing.

Anxiety, Stress, and Depression Among Healthcare Professionals During the COVID-19 Pandemic: A Cross-Sectional Study in Morocco.

The COVID-19 pandemic has caused an enormous psychological impact worldwide. This study aimed to assess anxiety, depression, stress, and compensatory behaviors among Moroccan healthcare workers (HCWs) during COVID-19. This descriptive cross-sectional study was conducted using a snowball sampling strategy. This descriptive cross-sectional study was conducted using a snowball sampling strategy. Online surveys were sent to groups of HCWs working in Casablanca and Fez cities. Post-traumatic stress disorder (PTSD) was measured using the Impact of Event Scale revised (IES-R) scale, and the DASS-21 was used to measure anxiety, depression, and stress among participants. Compensatory behaviors used by HCWs to manage these symptoms were also investigated. The majority of participants (72.5%) experienced moderate to severe distress during the COVID-19 pandemic. The majority of participants (53.1%) reported symptoms of mild to extremely severe depression. Overall, nurses, female, and frontline HCWs experienced more stress, anxiety, and depression (P < .001). Leisure activities (29%), sport (19%), and drinking tea/coffee (19%) were the most common compensatory behaviors. Our findings suggest that psychological support and interventions targeting high-risk HCWs with heavy psychological distress are needed. It is of paramount importance to improve the psychological endurance and safeguard the mental and physical well-being of HCWs, who find themselves on the frontline of health and humanitarian crises, when they are needed the most.

The cultural epidemiology of stigma among people with schizophrenia : Adaptation and cross-cultural validation of the Explanatory Model Interview Catalogue (EMIC), in Dialectal Arabic (Darija), Morocco.

INTRODUCTION: Stigma underlies the violation of certain social, economic, and cultural rights of patients with schizophrenia, including their access to treatment and care. Measurement of stigma remains as complex and multifaceted as the phenomenon itself. Several measurement tools are available to assess the prevalence, intensity and qualities of stigma. The aim of the study was to carry out a cross-cultural adaptation of the Explanatory Model Interview Catalogue (EMIC), in the Moroccan Arabic dialect commonly known as "Darija". PATIENTS AND METHOD: The study was conducted in three psychiatric departments of public hospitals in the Souss-Massa region, located in southern Morocco. For the diagnosis of schizophrenia, the study was based on the decisions of the psychiatrists practicing at the study sites. The cross-cultural adaptation in Moroccan Darija of the stigma scale developed by Michel Weiss in the EMIC was carried out according to the six-step scientific method developed by Dorcas et al. RESULTS: Cronbach's alpha (internal consistency) was 0.845. Convergent validity determined by Pearson's coefficient showed a significant inter-item correlation and the intra-class correlation coefficient (test-retest) was 0.975 (0.993; 0.991). The item added in relation to the COVID-19 situation presented psychometric values similar to the others. CONCLUSION: The Darija version is culturally acceptable and can be used to approach the phenomenon of stigmatization in Morocco.

Knowledge, attitudes and practices related to Covid-19 among health professionals in El Jadida Province, Morocco.

Background: During the COVID-19 pandemic, concerns were raised about the lack of knowledge and awareness of health workers (HW) in hampering the implementation of COVID-19 preventive strategies in hospitals. Objective: This cross-sectional study aims to explore the knowledge, attitudes, and practices (KAP) of the health workers related to COVID-19 in Moroccan hospitals and health facilities. Materials and methods: We administered an adapted questionnaire to 242 HW working in Azemmour and El Jadida hospital (two sites) and in 41 health centers in El Jadida province. We carried out a bivariate analysis and used contingency tables and logistic regression models to identify factors associated with different KAP levels. Results: We found that 90.1%, 8.3% and 60.3% of HW had respectively high levels of knowledge, risk perception attitudes and preventive practices towards COVID-19. High level of knowledge was associated with gender (OR: 0.267; 95% CI: 0.113-0.634; p=0.002), and professional profile (p<0.001). Levels of attitudes were associated with gender (OR: 17.143; 95% CI: 5.450-53.932; p<0.001) whereas levels of preventive practices were associated with position of the HW in COVID-19 (frontline or not frontline) (OR: 0.404; 95% CI: 0.236-0.691; p=0.001) and the overworked status of the HW (OR: 0.421; 95% CI: 0.242-0.730; p=0.002). Conclusion: Professionals' knowledge and practice levels were higher than their COVID-19 risk perception attitudes. Therefore, efforts should be made to improve the attitudes of health professionals.

Intention to vaccinate under-12 children against COVID-19 by parents in the Meknes Prefecture of Morocco.

Background: Two days before the start of the 2021 school year, more than 2 million Moroccan students (12-17 years old) had received the first dose of the anti-COVID-19 vaccine and 416 810 students had received both doses. Vaccination of young children against COVID-19 would contribute to pandemic control and "herd immunity". Aims: This study aimed to assess the extent to which Moroccan parents were likely to vaccinate their under-12 children against COVID-19. Methods: We conducted a cross-sectional study in the form of an anonymous and confidential electronic survey among parents visiting pediatric clinics in Meknes Prefecture in August and September 2021. Results: Our study shows that the majority of parents were vaccinated (67.2%), but refused to vaccinate their under-12 children (83.6%). But 72% of all parents were willing to vaccinate their children if COVID-19 mortality increased among children. Conclusion: Most parents who refused to have their children vaccinated were illiterate or had only primary education. There is therefore a need to increase awareness and information campaigns on the benefits of the COVID-19 vaccine among adults and children.

Morocco's National Response to the COVID-19 Pandemic: Public Health Challenges and Lessons Learned.

This report aimed to provide an overview of the epidemiological situation of COVID-19 in Morocco and to review the actions carried out as part of the national response to this pandemic. The methodology adopted was based on literature review, interviews with officials and actors in the field, and remote discussion workshops with a multidisciplinary and multisectoral working group. Morocco took advantage of the capacities already strengthened within the framework of the application of the provisions of the International Health Regulations (IHR) of 2005. A SWOT analysis made it possible to note that an unprecedented political commitment enabled all the necessary means to face the pandemic and carry out all the response activities, including a campaign of relentless communication. Nevertheless, and despite the efforts made, the shortage of human resources, especially those qualified in intensive care and resuscitation, has been the main drawback to be addressed. The main lesson learned is a need to further strengthen national capacities to prepare for and respond to possible public health emergencies and to embark on a process overhaul of the health system, including research into innovative tools to ensure the continuity of the various disease prevention and control activities. In addition, response to a health crisis is not only the responsibility of the health sector but also intersectoral collaboration is needed to guarantee an optimal coordinated fight. Community-oriented approaches in public health have to be strengthened through more participation and involvement of nongovernmental organizations (NGOs) and civil society in operational and strategic planning.

What happened during COVID-19 in African ICUs? An observational study of pulmonary co-infections, superinfections, and mortality in Morocco.

BACKGROUND: There is a growing literature showing that critically ill COVID-19 patients have an increased risk of pulmonary co-infections and superinfections. However, studies in developing countries, especially African countries, are lacking. The objective was to describe the prevalence of bacterial co-infections and superinfections in critically ill adults with severe COVID-19 pneumonia in Morocco, the micro-organisms involved, and the impact of these infections on survival. METHODS: This retrospective study included severe COVID-19 patients admitted to the intensive care unit (ICU) between April 2020 and April 2021. The diagnosis of pulmonary co-infections and superinfections was based on the identification of pathogens from lower respiratory tract samples. Co-infection was defined as the identification of a respiratory pathogen, diagnosed concurrently with SARS-Cov2 pneumonia. Superinfections include hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). A multivariate regression analysis was performed to identify factors independently associated with mortality. RESULTS: Data from 155 patients were analyzed. The median age was 68 years [62-72] with 87% of patients being male. A large proportion of patients (68%) received antibiotics before ICU admission. Regarding ventilatory management, the majority of patients (88%) underwent non-invasive ventilation (NIV). Sixty-five patients (42%) were placed under invasive mechanical ventilation, mostly after failure of NIV. The prevalence of co-infections, HAP and VAP was respectively 4%, 12% and 40% (64 VAP/1000 ventilation days). The most isolated pathogens were Enterobacterales for HAP and Acinetobacter sp. for VAP. The proportion of extra-drug resistant (XDR) bacteria was 78% for Acinetobacter sp. and 24% for Enterobacterales. Overall ICU mortality in this cohort was 64.5%. Patients with superinfection showed a higher risk of death (OR = 6.4, 95% CI: 1.8-22; p = 0.004). CONCLUSIONS: In this single-ICU Moroccan COVID-19 cohort, bacterial co-infections were relatively uncommon. Conversely, high rates of superinfections were observed, with an increased frequency of antimicrobial resistance. Patients with superinfections showed a higher risk of death.

The Urban Development in Relation to the Occurrence of Diseases in the Casa-Settat Region of Morocco during the Emergence of SARS-CoV-2.

The Casa-Settat region is experiencing very worrying environmental and epidemiological problems and challenges, namely, population growth, the significant development of unsupervised industrial activities, road traffic, the significant weight of the spread of diseases with high epidemiological potential such as SARS-CoV-2, the increase in hospital activities, and the significant discharge of hospital effluents highly contaminated and untreated. To understand and analyze the factors influencing the high prevalence of deaths and the occurrence of diseases under surveillance, among others SARS-CoV-2, on the quantitative data recorded relating to ten regions of Morocco, and informing, on the one hand, on intrinsic data linked to the urban development, and on the other hand, on the evolution of diseases under epidemiological surveillance, a multidimensional analysis was made. The results reveal the typological framework highlighted by the factorial map F1 × F2 which showed the individualization of the region of Casablanca explained by a large number of variables and diseases that affect it. Finally, these results call for a diagnosis that will make it possible to model new approaches and implement new actions promoting the dynamics of environmental and epidemiological change in one of the most polluted and infected regions of Morocco.

Has the "Covid-19" lockdown an impact on beach faunal communities? The central Atlantic coast of Morocco as a case study.

The restrictions related to the COVID-19 pandemic have led to a global hiatus in anthropogenic activities; several scientists have utilized this unique opportunity to assess the human impact on biological systems. In this study, the study describes for a period of five years (2018-2022) how the faunal community have been affected by human disturbances, as well as the effect of the "anthropause" period driven by the COVID-19 lockdown. The results confirmed human disturbances on faunal communities related to coastal urbanization. It was found that the "anthropause" period showed the highest values of abundance and biomass, hence the "COVID-19 lockdown" allowed recovery of faunal communities. The findings highlight the impact of human disturbances and that the community showed resilience. Overall, the authorities must perform restrictive measures aiming to mitigate the impact of anthropogenic activities in the study area including the banning of off-road and recreational vehicles, carrying out efficient cleaning and grooming operations, monitoring the severe harvesting of edible species, as well as penalizing the disposal of anthropogenic waste and sewage discharge from the touristic facilities. Likewise, management actions such as the temporal beach closures and the regular surveillance could be advantageous to provide a more sustainable exploitation of sandy beaches.

Seroprevalence of SARS-CoV-2 antibodies in vaccinated healthcare workers in Marrakech (Morocco).

INTRODUCTION: The SARS-CoV-2 pandemic has had a considerable impact, causing millions of deaths worldwide, including many healthcare workers (HCWs). The pharmaceutical industry has been working diligently since the start of the pandemic to develop various vaccines to fight the spread of the virus and protect the population. OBJECTIVE: To study the seroprevalence of neutralizing anti-SARS-CoV-2 antibodies in vaccinated HCWs at the Mohamed VI University Hospital in Marrakech and to determine the parameters that can influence immune response. METHODS: A cross-sectional study of 138 HCWs was performed between October and December 2021 by measuring IgG antibodies directed against the spike antigen of SARS-CoV-2 using an Abbott Architect® SARS-CoV-2 IgG II assay. RESULTS: The mean age was 31.42 years, the sex ratio was 2.94 women to each man, and the overall prevalence was 97%. We found 39.5% of the participants had experienced COVID-19 infections pre-vaccination, which decreased to 26.8% after vaccination. Neutralizing antibody titers were dependent on the type of vaccine: they were higher with the Pfizer-BioNTech vaccine, the number of doses (p < .001), and post-vaccine COVID-19 form. The post-vaccine COVID-19 infection rates were lower with the Sinopharm vaccine. CONCLUSION: Heterologous vaccination with non-mRNA and mRNA vaccines and the consideration of post-vaccination COVID-19 infection as a booster could help optimize vaccine results while reducing potential side effects.

Medico-demographic characteristics and outcomes of COVID-19 patients admitted to a provincial hospital in Center-West of Morocco.

The current Coronavirus Disease 2019 (COVID-19) pandemic that emerged in December 2019 in China continues to claim a thousand lives worldwide. This study aimed to report characteristics and in-hospital outcomes of a Moroccan COVID-19 cohort, and identify factors which predispose patients to hospitalization and mortality from COVID-19. We conducted a cross-sectional study of symptomatic COVID-19 patients referred to COVID-19 ward of the Settat Provincial Hospital, during October 2020. A confirmed COVID-19 case was defined by a positive detection of SARS-CoV-2 genome using real-time RT-PCR assay performed on nasopharyngeal swabs. Patients´ demographic and clinical characteristics were collected and analyzed using SPSS V22.0. Univariate followed by multivariate logistic regression analysis was performed to identify factors associated with mortality due to COVID-19. In total, 269 patients were reported. The median age was 64 years [IQR 54-73], 48.7% were elderly (≥ 65 years), 51.7% were men, and the case-fatality rate (CFR) was 5.58%. Males had a higher CFR (6.5%) than females (4.6%). In deceased people: 60% males, 73.3% were elderly, and oxygen saturation values of 90% or less on admission were more frequent (86.7%) than in recovered ones (10.9%). Most patients (80.3%) had at least one comorbidity: 100% of deaths, 59% older than 60 years, CFR was 6.94% and the most prevalent diseases were diabetes (54.6%), hypertension (41.7%), and cardiac disease (40.7%). The most common symptoms on presentation were dyspnea (67.7%), fever (65.4%) and cough (58.4%). Multivariable logistic regression analysis showed that only older age (AOR: 10.860, 95% CI: 3.382-34.86; p<0.001) and cardiac disease (AOR: 0.244, 95% CI: 0.074-0.799; p=0.02) were associated with higher mortality rates. Categorizing patients at admission according to risk factors identified by multivariate and also univariate analyses (mainly dyspnea) is essential to help in deciding the hospitalization priority and the strategy that will eventually reduce death risk.

Phylogeography and genomic analysis of SARS-CoV-2 delta variant in Morocco.

INTRODUCTION: Since the COVID-19 pandemic began in December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has continuously evolved with many variants of concern emerging across the world. METHODOLOGY: In order to monitor the evolution of these variants in Morocco, we analyzed a total of 2130 genomes of the delta variant circulating around the world. We also included 164 Moroccan delta variant sequences in our analysis. RESULTS: Our findings suggest at least four introductions from multiple international sources and a rise of a dominant delta sub-lineage AY.33 in Morocco. Moreover, we report three mutations in the N-terminal domain of the S protein specific to the Moroccan AY.33 isolates, T29A, T250I and T299I. The effect of these mutations on the secondary structure and the dynamic behavior of the S protein N-terminal domain was further determined. CONCLUSIONS: We conclude that these mutations might have functional consequences on the S protein of SARS-CoV-2.