Incidence and risk factors of SARS-CoV-2 infection among workers in a public health laboratory in Tunisia.

The aim of this study was to measure the extent of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among workers at the Institut Pasteur de Tunis (IPT), a public health laboratory involved in the management of the COVID-19 pandemic in Tunisia, and to identify risk factors for infection in this occupational setting. A cross-sectional survey was conducted on IPT workers not vaccinated against coronavirus disease 2019 (COVID-19). Participants completed a questionnaire that included a history of reverse transcription-polymerase chain reaction (RT-PCR)-confirmed SARS-CoV-2 infection. Immunoglobulin G antibodies against the receptor-binding domain of the spike antigen (anti-S-RBD IgG) and the nucleocapsid protein (anti-N IgG) of the SARS-CoV-2 virus were detected by enzyme-linked immunoassay (ELISA). A multivariate analysis was used to identify factors significantly associated with SARS-CoV-2 infection. A total of 428 workers were enrolled in the study. The prevalence of anti-S-RBD and/or anti-N IgG antibodies was 32.9% [28.7-37.4]. The cumulative incidence of SARS-CoV-2 infection (positive serology and/or previous positive RT-PCR test) was 40.0% [35.5-44.9], while the proportion with asymptomatic infection was 32.9%. One-third of the participants with RT-PCR-confirmed infection tested seronegative more than 90 days postinfection. Participants aged over 40 and laborers were more susceptible to infection (adjusted OR [AOR] = 1.65 [1.08-2.51] and AOR = 2.67 [1.45-4.89], respectively), while tobacco smokers had a lower risk of infection (AOR = 0.54 [0.29-0.97]). The SARS-CoV-2 infection rate among IPT workers was not significantly different from that detected concurrently in the general population. Hence, the professional activities conducted in this public health laboratory did not generate additional risk to that incurred outside the institute in day-to-day activities.

[Management of pheochromocytoma during pregnancy: about three cases]. / Prise en charge du phéochromocytome au cours de la grossesse: à propos de trois cas.

BACKGROUND: Pheochromocytoma is a rare disease that can be diagnosed for the first time during pregnancy. Diagnosis is difficult because it can mimic common gravid hypertension. Maternal and fetal prognosis depends on early diagnosis and adequate multidisciplinary management. AIM: We report 3 cases of pregnant patients with pheochromocytoma. CASES: For the first patient, diagnosis was made before pregnancy and pheochromocytoma was treated surgically at 20 weeks of pregnancy with good evolution. The second patient was hospitalized in a severe preeclampsia, acute pulmonary edema and fetal demise with fatal outcome. Pheochromocytoma was diagnosed during autopsy. The third patient had medical abortion of pregnancy because of tumor recurrence after surgical treatment. Rare association to pregnancy and clinical signs of pheochromoytoma as hypertension renders diagnosis difficult. A systematic etiology research to early hypertension during pregnancy can allow better screening of pheochromocytoma and improvement of foeto-maternal prognosis.