Hematological and biochemical abnormalities associated with severe forms of COVID-19: A retrospective single-center study from Morocco.

Since December 2019, the coronavirus disease (COVID-19) pandemic has catapulted the world into a marked health crisis, with over 29 million cases and >930,000 deaths. To better detect affected individuals at an early stage and stop disease progression to an advanced stage, several studies have been conducted to identify the clinical, biological, and radiological characteristics of COVID-19. This study aimed to enrich the literature by critically analyzing the clinical and biological characteristics of 134 patients from the North African Mediterranean region, including numerous genetic, epigenetic, and environmental factors that may influence disease evolution. This single-center retrospective study included all patients older than 18 years confirmed to have COVID-19 and hospitalized at the Cheikh Khalifa University Hospital affiliated with Mohammed VI University of Health Sciences, Casablanca, Morocco. Clinical, demographic, and biological data were analyzed in a cohort of severe and non-severe patients. Univariate analysis was performed to identify factors predictive of severity. There were 134 patients: the median age was 53 years, and 54.5% were male. Of these, 89 had mild to moderate disease; 45 had severe to critical disease, of which 14 died and 31 survived. Advanced age, presence of comorbidities, male sex, and infection in ethnic or family groups were risk factors for progression to severe disease. The presence of abnormalities in the following parameters were strongly associated with progression to severe disease: white blood cells (WBC), neutrophils, lymphocytes, C-reactive protein (CRP), procalcitonin, D-dimers, lactate dehydrogenase (LDH), ferritin, creatinine, aspartate aminotransferase (ASAT), and alanine aminotransferase (ALAT) during both admission and hospitalization. Based on these results and an extensive literature review, we recommend that clinicians closely monitor the biological parameters identified herein and perform immunological and genetic studies.

[Impact of population ageing on medical consumption: compulsory health insurance in Morocco]. / L'impact du vieillissement démographique sur la consommation médicale: assurance maladie obligatoire au Maroc.

INTRODUCTION: compulsory health insurance schemes for all employees in public and private sector are causing, on the one hand, continual health care spending growth and, on the other hand, are experiencing an increase in the number of covered population aged over 60 years. The purpose of this study was to analyze the impact of ageing on the estimated average expenditure per covered person with health insurance. METHODS: we conducted Kruskal-Wallis test to assess whether there was any significant difference between populations of different age on medical consumption, depending on whether the person was affected or not by a diseases of long duration. Other indicators were also analyzed, namely the proportion of the population suffering from a disease of long duration demanding health care, the average expenditure per person affected by a diseases of long duration and the average expenditure per covered person not affected by a disease of long duration for both people under 60 years and those over 60 years. RESULTS: Kruskal-Wallis test showed that age is an explanatory variable for the average expenditure per covered person. The examination of the evolution of the main components of average expenditure allowed to highlight other factors. CONCLUSION: population ageing contributes to the increase of medical consumption but there are other factors which have a significant effect on the increase in expenditure.

Detection and analysis of drug-drug interactions among hospitalized cardiac patients in the Mohammed V Military Teaching Hospital in Morocco.

INTRODUCTION: Drug-drug interactions (DDIs) are defined as two or more drugs interacting in such a manner that the effectiveness or toxicity of one or more drugs is altered. Patients with cardiovascular disorders are at higher risk for DDIs because of the types and number of drugs they receive. The aim of the present study was to assess the prevalence of DDIs in patients admitted to the cardiology department of a hospital in Morocco. METHODS: A prospective observational study from June 2016 to September 2016 was carried out in the cardiology department of a hospital in Morocco. Those patients who were taking at least two drugs and had a hospital stay of at least 48 hours were included in the study. The medications of the patients were analysed for possible interactions. All the prescriptions of the study population were screened for drug-drug interactions using a computerized DDI database system (Theriaque®). RESULTS: During the study period, 138 patients were included; 360 interactions were detected among 94 patients, with an average number of drugs taken of 5.2. The prevalence of DDIs was estimated at 68.11%, the most common of which concerned Kardegic/Plavix (12.22%), Kardegic/Heparin (8.33%), and Lasilix/Spironolactone (5.83%). Among the 726 prescribed drugs, (372 [51.24%]) were drugs of the cardiovascular system, followed by blood and hematopoietic organ drugs (288 [39.67%]) according to the Anatomical Therapeutic Chemical Classification codes. These interactions were categorized on the basis of level of severity: interactions with major severity accounted for 11.11% (40) of the total DDIs while those with moderate and minor severity accounted for 37.22% (134) and 51.66% (186), respectively. CONCLUSION: This study reports the prevalence of DDIs in patients admitted to the cardiology department of a hospital in Morocco. This study shows that DDIs are frequent among hospitalized cardiac patients and highlights the need to screen prescriptions of cardiovascular patients for possible DDIs, as this helps in their detection and prevention.Pan African Medical Journal - ISSN: 1937- 8688 (www.panafrican-med-journal.com)Published in partnership with the African Field Epidemiology Network (AFENET). (www.afenet.net)Pan African Medical Journal - ISSN: 1937- 8688 (www.panafrican-med-journal.com)Published in partnership with the African Field Epidemiology Network (AFENET). (www.afenet.net).

[Literature review regarding the impact of population aging on healthcare expenditure growth: Organisation for Economic Co-operation and Development member countries and Morocco]. / Revue de la littérature sur l'impact du vieillissement démographique sur l'évolution des dépenses médicales: pays de l'Organisation de Coopération et de Développement Economiques et Maroc.

This study aims to offer an overview of literature published on the relationship between population aging and healthcare expenditure growth in countries where this phenomenon is already significant and in Morocco. The first 19 most cited articles published over the period 1995-2014 are concerned with Organisation for Economic Co-operation and Development member countries as well as with countries where the impact of aging on healthcare expenditures has been evaluated quantitatively. With regard to Morocco, our research focused on publications from national governments regarding medical consumption growth and its link with age. Reasearch studies on OECD member countries that include proximity of death in explanatory models for healthcare expenditures, conclude that this last can explain better than age healthcare expenditure growth. Four authors highlight that explanatory models for healthcare expenditures which do not take into consideration proximity of death overestimate projection results. Ten studies suggest that healthcare expenditure growth is attributable to factors other than population aging. With regard to Morocco, only a report on compulsory health insurance shows that there is a relationship between age and expenditures since the prevalence of chronic diseases that affect mostly older people entails significant expenditures for compulsory health insurance. Given the speed of the aging in Morocco, it is necessary to conduct studies in order to understand the dynamics of healthcare expenditures.