OBJECTIVES: High-flow nasal cannula (HFNC) was widely used during the COVID-19 pandemic in intensive care units (ICU), but there is no recommendation for elderly patients non-eligible for ICU management. We aimed to describe the outcomes of HFNC treatment in patients with COVID-19 who are not eligible for ICU management. METHODS: Retrospective bicentric cohort study performed between September 1, 2020 and June 30, 2021 in two infectious diseases departments of Colmar Hospital and Antoine Beclere University Hospital, France. RESULTS: Sixty-four patients were treated with HFNC: 33 in Colmar and 31 in Beclere hospital (median age: 85 years; IQ, 82-92). Of these, 16 patients survived (25%). Surviving patients had a lower Charlson comorbidity index score than deceased patients (five vs six; p = 0.02). CONCLUSIONS: Despite a high death rate, with survivors being younger and having fewer comorbidities, HFNC is an easy tool to implement in non-ICU wards for the frailest patients.
COVID-19 , Cannula , Humans , Aged , Aged, 80 and over , Cohort Studies , Retrospective Studies , Pandemics , Frail Elderly , COVID-19/therapy , SARS-CoV-2 , Intensive Care Units
BACKGROUND: Beyond sex, age, and various comorbidities, geographical origin and socioeconomic deprivation are associated with Coronavirus Disease (COVID-19) morbidity and mortality in the general population. We aimed to assess factors associated with severe forms of COVID-19 after a hospital emergency department visit, focusing on socioeconomic factors. METHODS: Patients with laboratory-confirmed COVID-19 attending the emergency department of Béclère Hospital (France) in March-April 2020 were included. Postal addresses were used to obtain two geographical deprivation indices at the neighborhood level. Factors associated with hospitalization and factors associated with adverse outcomes, i.e. mechanical ventilation or death, were studied using logistic and Cox analyses, respectively. RESULTS: Among 399 included patients, 321 were hospitalized. Neither geographical origin nor socioeconomic deprivation was associated with any of the outcomes. Being male, older, overweight or obese, diabetic, or having a neuropsychiatric disorder were independent risk factors for hospitalization. Among 296 patients hospitalized at Béclère Hospital, 91 experienced an adverse outcome. Older age, being overweight or obese, desaturation and extent of chest CT scan lesions>25% at admission (aHR: 2.2 [95% CI: 1.3-3.5]) and higher peak CRP levels and acute kidney failure (aHR: 2.0 [1.2-3.3]) during follow-up were independently associated with adverse outcomes, whereas treatment with hydrocortisone reduced the risk of mechanical ventilation or death by half (aHR: 0.5 [0.3-0.8]). CONCLUSION: No association between geographical origin or socioeconomic deprivation and the occurrence of a severe form of COVID-19 was observed in our population after arrival to the emergency department. Empirical corticosteroid use with hydrocortisone had a strong protective impact.
COVID-19 , COVID-19/epidemiology , Female , Hospitalization , Hospitals , Humans , Hydrocortisone , Male , Obesity/epidemiology , Overweight , SARS-CoV-2 , Social Factors
Vector magnetic field observations of the martian crust were acquired by the Mars Global Surveyor (MGS) magnetic field experiment/electron reflectometer (MAG/ER) during the aerobraking and science phasing orbits, at altitudes between approximately 100 and 200 kilometers. Magnetic field sources of multiple scales, strength, and geometry were observed. There is a correlation between the location of the sources and the ancient cratered terrain of the martian highlands. The absence of crustal magnetism near large impact basins such as Hellas and Argyre implies cessation of internal dynamo action during the early Naochian epoch ( approximately 4 billion years ago). Sources with equivalent magnetic moments as large as 1.3 x 10(17) ampere-meter2 in the Terra Sirenum region contribute to the development of an asymmetrical, time-variable obstacle to solar wind flow around Mars.
The Mars Global Surveyor spacecraft, in a highly elliptical polar orbit, obtained vector magnetic field measurements above the surface of Mars (altitudes >100 kilometers). Crustal magnetization, mainly confined to the most ancient, heavily cratered martian highlands, is frequently organized in east-west-trending linear features, the longest extending over 2000 kilometers. Crustal remanent magnetization exceeds that of terrestrial crust by more than an order of magnitude. Groups of quasi-parallel linear features of alternating magnetic polarity were found. They are reminiscent of similar magnetic features associated with sea floor spreading and crustal genesis on Earth but with a much larger spatial scale. They may be a relic of an era of plate tectonics on Mars.
