Nosocomial infection with SARS-Cov-2 within Departments of Digestive Surgery.

INTRODUCTION: The COVID-19 pandemic imposed a drastic reduction in surgical activity in order to respond to the influx of hospital patients and to protect uninfected patients by avoiding hospitalization. However, little is known about the risk of infection during hospitalization or its consequences. The aim of this work was to report a series of patients hospitalized on digestive surgery services who developed a nosocomial infection with SARS-Cov-2 virus. METHODS: This is a non-interventional retrospective study carried out within three departments of digestive surgery. The clinical, biological and radiological data of the patients who developed a nosocomial infection with SARS-Cov-2 were collected from the computerized medical record. RESULTS: From March 1, 2020 to April 5, 2020, among 305 patients admitted to digestive surgery departments, 15 (4.9%) developed evident nosocomial infection with SARS-Cov-2. There were nine men and six women, with a median age of 62 years (35-68 years). All patients had co-morbidities. The reasons for hospitalization were: surgical treatment of cancer (n=5), complex emergencies (n=5), treatment of complications linked to cancer or its treatment (n=3), gastroplasty (n=1), and stoma closure (n=1). The median time from admission to diagnosis of SARS-Cov-2 infection was 34 days (5-61 days). In 12 patients (80%), the diagnosis was made after a hospital stay of more than 14 days (15-63 days). At the end of the follow-up, two patients had died, seven were still hospitalized with two of them on respiratory assistance, and six patients were discharged post-hospitalization. CONCLUSIONS: The risk of SARS-Cov-2 infection during hospitalization or following digestive surgery is a real and potentially serious risk. Measures are necessary to minimize this risk in order to return to safe surgical activity.

[Nosocomial infection with SARS-Cov-2 within departments of digestive surgery]. / Infection nosocomiale à SARS-Cov-2 dans les services de chirurgie digestive.

INTRODUCTION: The COVID-19 pandemic imposed a drastic reduction in surgical activity in order to respond to the influx of hospital patients and to protect uninfected patients by avoiding hospitalization. However, little is known about the risk of infection during hospitalization or its consequences. The aim of this work was to report a series of patients hospitalized on digestive surgery services who developed a nosocomial infection with SARS-Cov-2 virus. METHODS: This is a non-interventional retrospective study carried out within three departments of digestive surgery. The clinical, biological and radiological data of the patients who developed a nosocomial infection with SARS-Cov-2 were collected from the computerized medical record. RESULTS: From March 1, 2020 to April 5, 2020, among 305 patients admitted to digestive surgery departments, 15 (4.9 %) developed evident nosocomial infection with SARS-Cov-2. There were nine men and six women, with a median age of 62 years (35-68 years). All patients had co-morbidities. The reasons for hospitalization were: surgical treatment of cancer (n = 5), complex emergencies (n = 5), treatment of complications linked to cancer or its treatment (n = 3), gastroplasty (n = 1), and stoma closure (n = 1). The median time from admission to diagnosis of SARS-Cov-2 infection was 34 days (5-61 days). In 12 patients (80%), the diagnosis was made after a hospital stay of more than 14 days (15-63 days). At the end of the follow-up, two patients had died, seven were still hospitalized with two of them on respiratory assistance, and six patients were discharged post-hospitalization. CONCLUSIONS: The risk of SARS-Cov-2 infection during hospitalization or following digestive surgery is a real and potentially serious risk. Measures are necessary to minimize this risk in order to return to safe surgical activity.

[Rehabilitation of chronic pulmonary patients. Critical study of objectives and methods. Current state of the problem]. / La réadaptation des pulmonaires chroniques. Etude critique des objectifs et des méthodes. Etat actuel du problème.

Having given a definition of chronic pulmonary patients and of readaptation by reference to the W.H.O. and to the results of an international survey and the study group of the special Unit of the European Society of respiratory Physiopathology, the authors report a critical study of the conception and the present aims of readaptation. They successively present the therapeutical, medico-social and psychological aspects of readaptation, the different techniques used today, and summarize the present functioning of Europeans centres of readaptation. Finally they draw the main lines of a program of readaptation with the public health scheme and envisage the problems of organization and functioning.