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1.
Ann Med Surg (Lond) ; 74: 103230, 2022 Feb.
Article in English | MEDLINE | ID: mdl-35003720

ABSTRACT

INTRODUCTION: Corona virus disease (Covid-19) affects the airways and induces pulmonary lesions, patients with this disease require oxygen therapy as the disease progresses. Several oxygenation options have been used, l'HFNO had showed beneficial effects. THE OBJECTIVE OF THIS STUDY: To evaluate the efficacy of high-flow nasal oxygen HFNO versus non-invasive ventilation in COVID-19. METHODS: This is a retrospective and comparative study conducted over a period of 10 months from March 2020 to December 2020 and involving 600 patients hospitalized in the intensive care unit of the CHU Mohammed VI of Oujda for the management of acute respiratory failure caused by COVID-19. RESULTS: Out of 600 patients with acute respiratory failure, 265 patients were included in the analyses. 162 (61.10%) patients were treated with HFNO, the intubation rate was 49.7% (80 patients out of 162) of which 63 died intubated (78.8%). Concerning the 82 non-intubated patients, only 16 died (19.8%).The total number of patients who received NIV was 71 (26.8%), 33 (46.5%) required mechanical ventilation. In-hospital mortality in patients treated with NIV was 100%.The difference in mortality outcome between the two groups was significantly (P < 0.0001) reduced in HFNO. CONCLUSIONS: Treatment with high-flow oxygen improved survival in patients with acute hypoxemic respiratory failure compared with noninvasive ventilation, although no difference was observed in intubation rate.

2.
Ann Med Surg (Lond) ; 72: 103095, 2021 Dec.
Article in English | MEDLINE | ID: mdl-34840736

ABSTRACT

INTRODUCTION: Since the appearance of the first case of the SARS CoV 2 infection, several studies have been conducted to identify the predictive factors of mortality in patients with COVID-19. According to previous reports, diabetes seems to be associated with severe clinical forms of the new coronavirus (SARS CoV 2).Our study aimed to identify the epidemiological, clinical, radiological and prognostic profile of diabetic patients with COVID-19. METHODS: This retrospective study included diabetic patients diagnosed with COVID-19 and admitted to the Resuscitation Department of our university hospital center From Mars 1st 2020, to December 31st, 2020. RESULTS AND DISCUSSION: In this study, we collected the data of 600 patients admitted to the Anesthesia and Resuscitation Department of the Mohammed VI University Hospital of Oujda, a group of 188 (31.3%) had diabetes.The median age of our patients was 67 [25-75]. Were noted in the majority, of patients 69.6% with diabetes have developed a severe or critical injuries in the Chest CT Scan. Furthermore, we found that the mortality rate in this category of patients was higher 65/188 (34.60%) compared to non-diabetic patients, 130/412 (31.60%) (34.60%vs 31.60%; p: 0.464). CONCLUSION: Based on the results of this retrospective study, we concluded that diabetes is predictive factor for the need of an intensive care as well as a high risk of mortality related to COVID-19.Practically speaking, diabetic patients should be monitored more closely and need an aggressive preventive management protocols in order to prevent severe forms of the disease and a drastic evolution.More research is direly needed to identify patients of a higher risk of developing severe forms of COVID-19.

3.
Ann Med Surg (Lond) ; 70: 102858, 2021 Oct.
Article in English | MEDLINE | ID: mdl-34545308

ABSTRACT

BACKGROUNDS: Corona virus disease 19 (Covid-19) affects especially the respiratory tract, and induces lung injury which may progress to the acute respiratory distress syndrome (ARDS). Various treatment options were tried all over the world, corticosteroids had showed beneficial effects.The Objective of this study, is to compare the safety and efficiency of two corticosteroids: dexamethasone and prednisolone in the treatment of Covid-19 infection. METHODS: This retrospective and comparative study included 513 patients diagnosed with Covid-19 infection and were admitted to intensive care unit of our university hospital center of MOHAMMED VI Oujda from March 1, 2020, to December 31st, 2020. RESULTS: In this study, 513 cases were included, 230 patients were received methylprednisolone, and 283 were treated with dexamethasone. The median age in methylprednisolone group was 64 years, and 63 years in the second group treated with dexamethasone. Patients treated with dexamethasone had more critically lesions compared to patients treated with methylprednisolone (67.6%), these patients had a good evolution with a significant reduction of oxygen supplementation, lower use of invasive ventilation and a significant improvement in biological parameters. The difference in outcome between the two groups in terms of mortality was significantly reduced in the second group. CONCLUSION: Both steroids are efficient in the management of mild, moderate and severe Covid-19 pneumonia with a clear superiority of dexamethasone especially in severe forms.

4.
Ann Med Surg (Lond) ; 67: 102524, 2021 Jul.
Article in English | MEDLINE | ID: mdl-34178315

ABSTRACT

INTRODUCTION: Guillain-Barre syndrome (GBS) is an inflammatory poly-radiculoneuropathy occurring usually two weeks after a viral infection.Covid-19 infection represent with respiratory symptoms, but it might manifests with extra pulmonary symptoms, and especially neurological including Guillain-Barre syndrom. CASE REPORT: A 3 years old female patient admitted to the intensive care unit for an acute symmetric and progressive ascending quadriparesis two weeks after an upper respiratory infection, the diagnosis of post covid GBS was maintained, and the evolution was favorable after intraveneous immunoglobulins. CONCLUSION: This case report suggest the probable causal link between COVID 19 and GBS.

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