RESUMO
INTRODUCTION: Since December 2019, an emerging infectious viral disease triggered by SARS-CoV-2 has caused a global pandemic. Elderly people, being more fragile, are the most affected by the severity and lethality of this disease. The residential care facility for dependent elderly people (Ehpad) and the long-term care facilities at the Amiens University Hospital registered their first COVID-19 cases in February 2020, which lead to the opening of a dedicated COVID-19 unit and aspecific protocol for isolation. METHODS: This descriptive study analysed the prevalence of COVID-19 seroconversion within the Ehpad and the long-term care facilities at the Amiens University Hospital. Both this screening test and the nasopharyngeal swab PCRs were used to assess the impact of the COVID-19 epidemic on the residents of the Ehpad and the long-term care facilities. RESULTS: On 15 and 16 June 2020, the serological tests for COVID-19 were positive for 146 (66.1%) of the residents tested. The seroconversion rate was significantly different (p < 0.001) between the Ehpad (88.7%) and the long-term care facility (45.6%). DISCUSSION: During the epidemic, there was no excess mortality index within the Ehpad and the long-term care facility services of the Amiens University Hospital. Among frail patients, the role of immunosenescence can be evoked to account for the absence of this inflammatory reaction. This study showed that isolating the infected patient in a dedicated unit significantly reduces the risk of seroconversion and contamination compared to isolating them within their own unit.
RESUMO
Since December 2019, an emerging infectious viral disease implicating a coronavirus SARS-CoV-2 has caused a global pandemic. Elderly people, being more fragile, are the most affected by the severity and lethality of this disease. The NH and LTCU of the Amiens University Hospital registered their first Covid-19 cases in February 2020, which lead to the opening of a Covid-19 dedicated unit and of specific protocol for confinement. This descriptive study was analyzing the prevalence of Covid-19 seroconversion within the NH and the LTCU of the Amiens University Hospital. Both this screening test and the nasopharyngeal swab PCRs were in order to assess the impact of the Covid-19 epidemic in NH and LTCU. On June 15th and 16th, the serological tests for Covid-19 were positive for 146 (66.1%) of the residents tested. The seroconversion rate was significantly different (p < 0.001) between the NH (88.7%) and the LTCU (45.6%). During the epidemic, there was no excess mortality index within the NH and LTCU services of the Amiens University Hospital. Among frail patients, the role of immunosenescence can be discussed to account for the absence of this inflammatory reaction. This study showed that isolating the infected patient in a dedicated unit significantly reduces the risk of seroconversion and contamination compared to isolating them within their own unit.
Assuntos
COVID-19/diagnóstico , Assistência de Longa Duração , SARS-CoV-2/imunologia , Soroconversão , Idoso , COVID-19/epidemiologia , COVID-19/imunologia , COVID-19/terapia , Teste Sorológico para COVID-19 , Hospitais , Humanos , Imunização Passiva , Imunossenescência , Casas de Saúde , Prevalência , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Testes Sorológicos , Soroterapia para COVID-19RESUMO
BACKGROUND: Demodicoses are thought to be rare, occurring mainly for patients with immunosuppression. OBJECTIVE: We sought to demonstrate the high frequency of demodicoses and the overlapping with papulopustular rosacea (PPR) . METHODS: We conducted a prospective epidemiologic study among 10 dermatologists. High Demodex density (Dd) was confirmed by standardized skin surface biopsy. RESULTS: In all, 4372 diagnoses, in which 115 were demodicoses, were collected among 3213 patients. Demodicosis was the 9th most frequent diagnosis (13th new). Each dermatologist observed an average of 2.4 demodicoses a week (1.2 new). The proportion of demodicoses varied greatly according to the dermatologist. The general status was good in 110 patients; only 3 had known immunodeficiency. The most frequent symptoms were follicular scales (71%) and telangiectasia (63%). The mean Dd was higher in pityriasis folliculorum (m = 61 D/cm 2 ) than in PPR (m = 36 D/cm 2 ; P = .04); 42 patients with PPR had a high Dd, 6 had a low Dd. CONCLUSION: Demodicoses are frequent and occur among patients who are immunocompetent. PPR with normal Dd are rare.