ABSTRACT
Coagulation disorders are commonly reported in patients suffering from COVID-19 pneumonia. These are associated to an increase incidence of thrombotic disorders associated with an increase mortality rate. D-Dimers concentrations > 3 µg/L, fibrinogen > 8 g/L and decreased platelets count are associated with an increased thrombotic risk. These biological markers have to be closely monitored during ICU stay. The diagnosis of pulmonary embolism could be difficult in this setting. However, it has to be evoked in case of worsening hypoxemia unexplained by other reason and/or right ventricular failure. The thrombotic risk can be scored to adapt the thromboprophylactic treatment, impaired renal function and overweight making it even more difficult.
ABSTRACT
Social distancing steps have been set during the 2020 COVID-19 pandemic. Patients' families brought their relatives to the emergency department and did not see them again for weeks due to lockdown of the whole population. Caregivers understood and approved the restriction of visits in ICU, in order to limit epidemic spreading, worried by overwhelming of their capacity would be overwhelmed and that they would not be able to admit all the patients requiring intensive care. However, they quickly sought to compensate by creating different relationships with relatives, using new ways of communication enabling patients and their relatives to keep in touch. Letters, messages services, phone calls and e-visits were set up. This brought new risks such as patient' images diffusion on social networks. In addition, relatives, caught with contradictory stressful information provided by medias, did not always understand that they could not have a direct access to patients and put psychological pressure on healthcare providers. Considering that previous recommendations support an unrestricted access of relatives to the ICU patients, caregivers have had to deal with new rules and have got experience that will be useful in case of the occurrence of comparable events.
