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4.
Rev Med Suisse ; 18(805): 2233-2235, 2022 11 23.
Article in French | MEDLINE | ID: covidwho-2164877
5.
Rech Soins Infirm ; 148(1): 89-106, 2022.
Article in French | MEDLINE | ID: covidwho-2143942

ABSTRACT

Introduction : At the beginning of 2020, a public health emergency was declared in France following the emergence of the SARS-CoV-2 pandemic.Context : Nurses involved in an advanced practice mobilized their specific skills during this health crisis by drawing on the available resources.Objectives : To analyze personal resources used by those nurses in the process of skill mobilization during the pandemic.Method : Sequential mixed research, first quantitative and then qualitative, concerning nurses or students enrolled in an advanced practice curriculum.Results : Our analysis highlighted two groups of activity for those nurses : frontline workers against COVID-19 or coordination. Coordination seemed to present more opportunities to use the specific skills of advance practice nursing.Discussion : Adjustment strategies for stress (coping and hardiness) boost nurses' commitment to their professional practice. Disciplinary knowledge contributes to the enrichment of the knowledge necessary for the mobilization of skills.Conclusion : Future research should explore resources and the mobilization of skills in the implementation of advance practice nursing.


Subject(s)
COVID-19 , Nurses , Resilience, Psychological , COVID-19/epidemiology , France , Humans , Pandemics , Practice Patterns, Nurses' , Public Health , SARS-CoV-2
6.
Rech Soins Infirm ; 149(2): 19-30, 2022.
Article in French | MEDLINE | ID: covidwho-2123938

ABSTRACT

Introduction : At the beginning of 2020, a state of health emergency was declared in France following the emergence of the COVID-19 pandemic.Context : Entrepreneurial management of health institutions requires internal nursing mobility to compensate for unexpected absenteeism.Reference framework : Based on the clinic of activity, the aim of this study was to analyze the reality of early-career health managers’ work in order to understand how, in a constrained environment, they are able to manage this mobility when not chosen by the substitute caregiver.Method : An indirect qualitative method—“instructions to the double”—combined two successive co-analysis sessions with four junior health managers : an individual session with the researcher and a collective session with the peers who participated in the study.Results : Data triangulation revealed three axes : the issues at stake for these managers ; their compromises made to transform compulsory nursing mobility into voluntary mobility ; the development of their power to act.Discussion : These results raise various issues related to the psychological and social resources of the occupational health of junior health managers as well as to the organization of work.


Subject(s)
COVID-19 , Pandemics , COVID-19/epidemiology , Caregivers , France , Humans
7.
Fam Pract ; 38(Suppl 1): i37-i44, 2021 Aug 27.
Article in English | MEDLINE | ID: covidwho-2115231

ABSTRACT

INTRODUCTION: The early identification of COVID-19 patients is of outmost importance in the current pandemic. As with other pathogens, presenting symptoms of SARS-CoV-2 may vary, depending on sociodemographic factors. We aimed to describe the clinical characteristics of COVID-19 patients by age/gender and to assess whether the diagnostic performance of these symptoms varied according to these variables. METHODS: We analysed data from a cross-sectional study involving primary care patients undergoing RT-PCR testing in Lyon, France. Among patients who tested positive, we examined whether there was an association between age/gender and various symptoms. In addition, we calculated the diagnostic performance of the most specific symptoms (smell/taste disorder). RESULTS: Among 1543 consecutive patients, 253 tested positive (16%). There were significant age/gender-related differences in symptoms. In middle-aged women, the diagnostic performance of smell/taste disorders were AUC = 0.65 [95%CI 0.59-0.71] and PPV = 72% [95%CI 53-87%], that is higher than in the entire sample (smell/taste disorders: AUC = 0.59 [95%CI 0.57-0.62] and PPV = 57% [95%CI 47-67%]. In contrast, the negative predictive values of smell/taste disorders were similar in both groups (85% [95%CI 81-89%] for middle-age women and 86% [95%CI 85-88%] for the entire sample). CONCLUSION: We found significant age/gender-related differences in the clinical characteristics of COVID-19 patients. Screening strategies based on smell/taste disorders performed better in middle-aged women, but could not ensure a diagnosis of COVID-19 in any subgroup of patients. Future diagnostic strategies should use age/gender differentiated approaches.


Subject(s)
COVID-19/epidemiology , Olfaction Disorders/epidemiology , Primary Health Care , Self Report , Taste Disorders/epidemiology , Adult , Age Factors , Aged , Cross-Sectional Studies , Female , France/epidemiology , Humans , Male , Middle Aged , Pandemics , SARS-CoV-2 , Sex Factors
8.
Eur Ann Otorhinolaryngol Head Neck Dis ; 139(5): 311-312, 2022 10.
Article in English | MEDLINE | ID: covidwho-2104347
10.
Soc Sci Med ; 313: 115160, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2096035

ABSTRACT

BACKGROUND: Immigrants in Western countries have been particularly affected by the COVID-19 crisis. OBJECTIVE: We analysed excess mortality rates among the foreign-born population and changes in their distinctive mortality profiles ("migrant mortality advantage") during the first pandemic wave in France. DATA AND METHODS: Deaths from all causes in metropolitan France from March 18 to May 19, 2020 were used, with information on sex, age, region of residence and country of birth. Similar data from 2016 through 2019 were used for comparisons. RESULTS: During the pre-pandemic period (2016-2019), immigrant populations (except those from Central and Eastern Europe) had lower standardized mortality rates than the native-born population, with a particularly large advantage for immigrants from sub-Saharan Africa. In the regions most affected by COVID-19 (Grand-Est and Île-de-France), the differences in excess mortality by country of birth were large, especially in the working-age groups (40-69 years), with rates 8 to 9 times higher for immigrants from sub-Saharan Africa, and about 3 to 4 times higher for immigrants from North Africa, from the Americas and from Asia and Oceania relative to the native-born population. The relative overall mortality risk for men born in sub-Saharan Africa compared to native-born men, which was 0.8 before the pandemic, shifted to 1.8 during the first wave (0.9 to 1.5 for women). It also shifted from 0.8 to 1.1 for men from North Africa (0.9 to 1.1 for women), 0.7 to 1.0 for men from the Americas (0.9 to 1.3 for women), and 0.7 to 1.2 for men from Asia and Oceania (0.9 to 1.3 for women). CONCLUSION: Our findings shed light on the disproportionate impact of the first wave of the pandemic on the mortality of populations born outside Europe, with a specific burden of excess mortality within the working-age range, and a complete reversal of their mortality advantage.


Subject(s)
COVID-19 , Emigrants and Immigrants , Male , Humans , Female , Adult , Middle Aged , Aged , Pandemics , France/epidemiology , Europe
11.
Rev Epidemiol Sante Publique ; 70(6): 265-276, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2095960

ABSTRACT

INTRODUCTION: Even though France was severely hit by the COVID-19 pandemic, few studies have addressed the dynamics of the first wave on an exhaustive, nationwide basis. We aimed to describe the geographic and temporal distribution of COVID-19 hospitalisations and in-hospital mortality in France during the first epidemic wave, from January to June 2020. METHODS: This retrospective cohort study used the French national database for all acute care hospital admissions (PMSI). Contiguous stays were assembled into "care sequences" for analysis so as to limit bias when estimating incidence and mortality. The incidence rate and its evolution, mortality and hospitalized case fatality rates (HCFR) were compared between geographic areas. Correlations between incidence, mortality, and HCFR were analyzed. RESULTS: During the first epidemic wave, 98,366 COVID-19 patients were hospitalized (incidence rate of 146.7/100,000 inhabitants), of whom 18.8% died. The median age was 71 years, the male/female ratio was 1.16, and 26.2% of patients required critical care. The Paris area and the North-East region were the first and most severely hit areas. A rapid increase of incidence and mortality within 4 weeks was followed by a slow decrease over 10 weeks. HCFRs decreased during the study period, and correlated positively with incidence and mortality rates. DISCUSSION: By detailing the geographical and temporal evolution of the COVID-19 epidemic in France, this study revealed major interregional differences, which were otherwise undetectable in global analyses. The precision afforded should help to understand the dynamics of future epidemic waves.


Subject(s)
COVID-19 , Humans , Female , Male , Aged , COVID-19/epidemiology , COVID-19/therapy , Pandemics , Retrospective Studies , France/epidemiology , Hospitalization
13.
Sci Rep ; 12(1): 17504, 2022 Oct 19.
Article in English | MEDLINE | ID: covidwho-2077111

ABSTRACT

Since the start of the COVID-19 pandemic, French health authorities have encouraged barrier measures and implemented three lockdowns to slow SARS-CoV-2 transmission. We aimed to examine the impact of these measures on the epidemiology of acute gastroenteritis (AGE) in France, from November 2019 to August 2021. We describe trends in AGE indicators from syndromic surveillance and a sentinel surveillance network. Additionally, we describe reported AGE illness data from a community based cohort, and frequencies of adherence to COVID-19 barrier measures from repeated quantitative surveys. From week 7 in 2020, all AGE indicators reached the lowest levels observed since the last decade. During the first lockdown, the median incidence rate reported by the sentinel network was 32 per 100,000 inhabitants, 1.9 times lower than the minimum registered during the 2010-2019 period. Low activity persisted until April 2021. Reported illness from the community cohort mirrored these trends. Adherence to COVID-19 barrier measures was highest during the first lockdown, coinciding with the steep decrease in AGE incidence. Among children under 5 years, AGE incidence increased after the third lockdown in June and July 2021, but remained lower than previous winter-season peaks. Our study indicates that a reduction in adherence to COVID-19 barrier measures, and the end of the lockdowns, coincided with an increase in AGE incidence, particularly among young children. We therefore strongly recommend maintaining adherence to barrier measures in order to in order to limit the transmission of AGE related pathogens.


Subject(s)
COVID-19 , Gastroenteritis , Child , Humans , Child, Preschool , COVID-19/epidemiology , Pandemics , SARS-CoV-2 , Communicable Disease Control , Gastroenteritis/epidemiology , France/epidemiology
14.
J Clin Psychiatry ; 82(1)2020 12 08.
Article in English | MEDLINE | ID: covidwho-2066784

ABSTRACT

OBJECTIVE: To assess the prevalence of and risk factors for posttraumatic stress disorder (PTSD) in patients with COVID-19. METHODS: We conducted a cohort study between March and May 2020 at the Lille University Hospital (France), including all patients with laboratory-confirmed COVID-19. Psychological distress symptoms were measured 3 weeks after onset of COVID-19 symptoms using the Impact of Event Scale-6 items (IES-6). The evaluation of PTSD symptoms using the PTSD Checklist for DSM-5 (PCL-5) took place 1 month later. Bivariate analyses were performed to analyze the relationship between PCL-5 scores and the demographic and health variables. The significant variables were then introduced into a multivariable linear regression analysis to establish their relative contributions to the severity of PTSD symptoms. RESULTS: 180 patients were included in this study, and 138 patients completed the 2 evaluations. Among the 180 patients, 70.4% patients required hospitalization, and 30.7% were admitted to the intensive care unit. The prevalence of PTSD was 6.5%, and the predictive factors of PTSD included psychological distress at the onset of the illness and a stay in an intensive care unit. CONCLUSIONS: The prevalence of PTSD in patients with COVID-19 is not as high as that reported among patients during previous epidemics. Initial psychological responses were predictive of a PTSD diagnosis, even though most patients showing acute psychological distress (33.5% of the sample) improved in the following weeks. PTSD symptoms also increased following a stay in an intensive care unit. Future studies should assess the long-term consequences of COVID-19 on patients' mental health.


Subject(s)
COVID-19 , Hospitalization/statistics & numerical data , Intensive Care Units/statistics & numerical data , Psychological Distress , Stress Disorders, Post-Traumatic , Acute Disease , Adult , Aged , Aged, 80 and over , COVID-19/complications , COVID-19/epidemiology , COVID-19/psychology , COVID-19/therapy , Female , Follow-Up Studies , France/epidemiology , Humans , Male , Middle Aged , Prevalence , Severity of Illness Index , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/etiology
15.
Emerg Infect Dis ; 28(11): 2341-2343, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2054905

ABSTRACT

We describe 188 patients in France who were successively infected with different SARS-CoV-2 Omicron subvariants, including BA.1, BA.2, and BA.5. Time between 2 infections was <90 days for 50 (26.6%) patients and <60 days for 28 (14.9%) patients. This finding suggests that definitions for SARS-CoV-2 reinfection require revision.


Subject(s)
COVID-19 , Reinfection , Humans , SARS-CoV-2 , France/epidemiology
16.
Transplantation ; 106(12): 2416-2425, 2022 Dec 01.
Article in English | MEDLINE | ID: covidwho-2051795

ABSTRACT

BACKGROUND: The COVID-19 pandemic has resulted in worldwide kidney transplantation (KT) moratoriums. The impacts of these moratoriums on the life expectancy of KT candidates remain unclear. METHODS: We simulated the evolution of several French candidate populations for KT using a multistate semi-Markovian approach and according to moratorium durations ranging from 0 to 24 mo. The transition rates were modeled from the 63 927 French patients who began dialysis or were registered on the waiting list for KT between 2011 and 2019. RESULTS: Among the 8350 patients active on the waiting list at the time of the French KT moratorium decided on March 16, 2020, for 2.5 mo, we predicted 4.0 additional months (confidence interval [CI], 2.8-5.0) on the waiting list and 42 additional deaths (CI, -70 to 150) up to March 16, 2030, compared with the scenario without moratorium. In this population, we reported a significant impact for a 9-mo moratorium duration: 135 attributable deaths (CI, 31-257) up to March 16, 2030. Patients who became active on the list after March 2020 were less impacted; there was a significant impact for an 18-mo moratorium (175 additional deaths [CI, 21-359]) in the 10 862 prevalent end-stage renal disease patients on March 16, 2020 and for a 24-mo moratorium (189 additional deaths [CI, 10-367]) in the 16 355 incident end-stage renal disease patients after this date. CONCLUSION: The temporary moratorium of KT during a COVID-19 peak represents a sustainable decision to free up hospitals' resources if the moratorium does not exceed a prolonged period.


Subject(s)
COVID-19 , Kidney Failure, Chronic , Kidney Transplantation , Humans , COVID-19/epidemiology , Pandemics , Kidney Failure, Chronic/surgery , Kidney Failure, Chronic/epidemiology , Renal Dialysis , Waiting Lists , France/epidemiology
17.
Joint Bone Spine ; 89(6): 105450, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2049406

ABSTRACT

OBJECTIVE: To determine the prevalence of musculoskeletal (MSK) symptoms appearing after a SARS-CoV-2 infection. METHODS: This was an observational cohort based on data available at the Assistance publique-Hôpitaux de Paris (AP-HP) Clinical Data Warehouse (which includes data of more than 11 million patients treated in the 39 hospitals from AP-HP). The data collected included both ICD-10 codes in discharge summaries, and recurring wording expressions search on medical electronic documents. To be included in the analysis, patients had to have a positive RT-PCR for SARS-CoV-2 and be admitted in any department of AP-HP. Patients with previous history of any MSK condition were excluded. MSK conditions were considered if occurring up to 90days after the positive RT-PCR. Demographics and disease characteristics including treatment were compared in both groups (MSK yes/no) by t-test or Chi2 test, accordingly. RESULTS: In total, 17,771 patients had a positive SARS-CoV-2 RT-PCR at APHP and were admitted in any department of AP-HP. Among them, 15,601 had no previous history of MSK condition and among them, 1370 (8.8%) presented with MSK symptoms after the viral infection. The most prevalent MSK symptoms were back pain (32.9%), followed by arthralgia (29.9%), radicular pain (20.2%) and arthritis (22.8%). Patients with MSK symptoms (MSK+) were older (67 y vs. 64 y, P<0.01), more frequently obese (29% vs. 25%, P=0.03), hypertensive (34% vs. 30%, P<0.01) and with diabetes (21% vs. 18%, P<0.01). Treatment for SARS-CoV-2 was slightly different in both groups, with higher corticosteroids (40.7% vs. 29.0%, P<0.01), antivirals (21.5% vs. 15.3%, P<0.01) and immunosuppressors (8.5% vs. 4.5%, P<0.01) prescription rates in the MSK+ group. CONCLUSION: MSK symptoms occurred in almost 9% of patients admitted to the hospital after a SARS-CoV-2 infection, particularly in older and more comorbid patients. Further analysis evaluating whether these symptoms remain over time are needed.


Subject(s)
COVID-19 , SARS-CoV-2 , Humans , Aged , COVID-19/diagnosis , COVID-19/epidemiology , Data Warehousing , Prevalence , France/epidemiology , Hospitals
18.
BMC Public Health ; 22(1): 1765, 2022 09 17.
Article in English | MEDLINE | ID: covidwho-2038702

ABSTRACT

BACKGROUND: European countries are still searching to eliminate or contain the Covid-19 pandemic. A variety of approaches have achieved different levels of success in limiting the spread of the disease early and preventing avoidable deaths. Governmental policy responses may explain these differences and this study aims to describe evidence about the effectiveness of containment measures throughout the course of the pandemic in five European countries (France, Germany, Italy, Spain and the UK). METHODS: The research approach adopted consisted of three steps: 1) Build a Containment Index (C.I.) that considers nine parameters to make an assessment on the strength of measures; 2) Develop dynamic epidemiological models for forecasting purposes; 3) Predict case numbers by assuming containment measures remain constant for a period of 30 days. RESULTS: Our analysis revealed that in the five European countries we compared, the use of different approaches definitively affected the effectiveness of containment measures for the Covid-19 pandemic. CONCLUSION: The evidence found in our research can be useful to inform policy makers' decisions when deciding to introduce or relax containment measures and their timing, both during the current pandemic or in addressing possible future health crises.


Subject(s)
COVID-19 , COVID-19/epidemiology , COVID-19/prevention & control , Europe/epidemiology , France/epidemiology , Germany , Humans , Pandemics/prevention & control
19.
Eur J Epidemiol ; 37(10): 1049-1059, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2035119

ABSTRACT

Since pandemic start, patients may have faced difficulties in accessing to care and treatment. This study aimed at assessing the impact of COVID-19 pandemic and its control measures on the use of drugs indicated in cardiovascular prevention and diabetes mellitus in France. From 09/17/2018 to 09/20/2020, a repeated cohort analysis was performed using the French nationwide health insurance databases. The pandemic impact was assessed using time-series analyses and unobserved components model for the weekly number of patients with (i) drug dispensing, (ii) ongoing treatment, (iii) treatment initiation, (iv) treatment disruption. Overall, 14,822,132 patients with cardiovascular drug dispensings and 3,231,618 with antidiabetic ones were identified. After a sharp spike in the amount of dispensings in the week the first national lockdown was announced, the period was marked by decreased levels and trends. Altogether, the estimated impact of the pandemic on dispensings appeared limited over the lockdown period (1-3% lack in dispensings). During lockdown, the weekly numbers of treatment disruptions remained stable whereas a significant decrease in treatment initiations was observed for almost all drug classes (e.g. ß-blockers initiations: - 8.9%). Conversely, the post-lockdown period showed increases in treatment disruptions especially for antihypertensive and lipid lowering drugs (e.g. statins disruptions: + 4.9%). The pandemic and associated measures had a significant impact on cardiovascular and antidiabetic drugs use in France, mostly consisting in decreases of treatment initiations over lockdown and increases in treatment disruptions afterwards. Both could result in increased morbimortality that remains to be assessed.


Subject(s)
COVID-19 , Pandemics , Humans , Pandemics/prevention & control , COVID-19/epidemiology , Cohort Studies , Hypoglycemic Agents/therapeutic use , Communicable Disease Control , France/epidemiology
20.
J Pediatr Nurs ; 66: 179-183, 2022.
Article in English | MEDLINE | ID: covidwho-2015916

ABSTRACT

BACKGROUND: Sickle cell disease (SCD) is a lifelong disease for which outcomes may be influenced by patients' self-care knowledge. Therapeutic education (TPE) is a patient-centered teaching instrument based on patient's adaptative processes and needs. TPE was developed in the Paris area by a pediatric health network using interactive face-to-face meetings. The COVID-19 pandemic has impacted the TPE modalities by promoting online training. Our aims were to evaluate the accessibility of patients with SCD to online TPE. METHODS: We compared sessions of TPE before and after the onset of the pandemic: the number of sessions, performed face-to-face or online, individual or in a group. We also recorded the number of participants in each session and their age, school level, and department in France. FINDINGS: We observed an increase in the total number of trained children, but participation varied greatly according to the geographical area of residence, with a decrease from 22.4% to 4.9% in the proportion of attendees living in the most socio-economically deprived French departments. DISCUSSION: Online TPE is feasible for patients with SCD but with unequal access according to socio-economic status. APPLICATION TO PRACTICE: Access to TPE needs to be improved for patients living in socially disadvantaged areas.


Subject(s)
Anemia, Sickle Cell , COVID-19 , Education, Distance , Child , France , Humans , Pandemics
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