Impact of the first lockdown related to the COVID-19 pandemic on ophthalmic emergencies in a French University Hospital.

INTRODUCTION: At the beginning of the COVID-19 pandemic, the French government implemented its first national lockdown between March and May 2020 in order to limit the dissemination of the virus. This historic measure affected patients' daily lives and transportation, resulting in changes in the delivery of medical care, particularly emergency care. This study aimed to assess the impact of this restriction policy on the number and severity of ophthalmic emergencies seen in an ophthalmology emergency department. METHODS: This retrospective study conducted at the regional university Hospital of Tours included all patients presenting to the ophthalmology emergency department over four periods: lockdown (03/16/2020 to 05/10/2020), post-lockdown (05/11/2020 to 06/12/2020) and the two corresponding periods in 2019. The following data were recorded: sex, age, time of visit, reason for visit, diagnosis, severity of emergency graded on the BaSe SCOrE, time from first symptoms until visit, existence of a work-related injury, and referral source (ophthalmologist or other). RESULTS: A total of 1186 and 1905 patients were respectively included during the 2020 lockdown period and the corresponding period in 2019. The study populations for the 2019 and 2020 post-lockdown periods consisted of 1242 and 1086 patients respectively. During the lockdown, the number of consultations decreased significantly (-37.7%), affecting mild and severe emergencies similarly. During the post-lockdown period, the number of emergencies gradually increased but did not reach the level of the corresponding period in 2019 (-12.6%). CONCLUSION: The first French lockdown resulted in a significant decrease in ophthalmic emergency visits, similar for all levels of severity. All age groups were impacted similarly, without the expected exaggerated decrease for patients over 50 years of age, who are considered to be at greater risk for developing a severe form of COVID-19. The post-lockdown period showed a gradual increase in ophthalmic emergency visits, although these remained fewer than the previous year.

Colonization of preservation solution in kidney transplantation: Clinical impact and risk of secondary acute graft pyelonephritis.

INTRODUCTION: Bacterial colonization of preservative solutions (PS) remains poorly described in renal transplantation. We investigated the bacterial colonization of the PS and its influence on graft pyelonephritis within one year from the renal transplantation. PATIENTS AND METHODS: We cultured 2 samples of PS from 424 patients who underwent a renal transplantation. The follow-up period was one year. An acute graft pyelonephritis was defined as a positive bacteriological urine analysis, with temperature higher than 38.5°C or graft pain. RESULTS: In total, 424 samples of PS were tested and 195 were positive for colonization (46%). Forty-five patients developed an acute graft pyelonephritis during the follow-up period (10.6%), of which, 21 (46.7%) showed a colonization of their PS. Twenty-four had no colonization (53.3%). This difference was not significant (P=0.697). DISCUSSION: Our data suggest that the bacterial colonization of PS samples does not seem to increase the risk of acute graft pyelonephritis in renal transplant recipients. LEVEL OF EVIDENCE: -3.

Impact on the medical decision-making process of multiplex PCR assay for respiratory pathogens.

The objective of this study was to determine how clinicians make use of the modern multiplex PCR assays (MPAs) to manage patients hospitalized for community-acquired pneumonia (CAP). We studied the use of MPAs in 1648 patients hospitalized for CAP over a 3-year period at the moment of the setup of the new PCR assay. We observed that the use of MPAs for the identification of multiple respiratory pathogens marks a radical change in the investigation of CAP etiology. Surprisingly, the contribution of MPAs to the medical decision-making process varies drastically according to the units of care.