Cancer broncho-pulmonaire : est-il un facteur d’infection et d’aggravation au cours du COVID-19

Introduction

Le virus SARS-COV2 a un impact sur la prise en charge de plusieurs patients notamment sur les patients atteints de cancer broncho-pulmonaire (CBP). Nous abordons les caractéristiques de l’infection COVID-19 chez les patients atteints de CBP durant la pandémie COVID-19.

Méthodes

Étude descriptive portant sur 10 cas de COVID-19 chez des patients avec cancers Broncho-pulmonaire (CBP) colligés au service de pneumologie à l’hôpital de Sousse, de mars 2020 à juin 2021. Le diagnostic de COVID-19 a été confirmé par un test RT-PCR.

Résultats

Parmi les 100 cas de CBP confirmés histologiquement et suivis pendant la période de l’épidémie COVID-19, 10 patients avaient une infection confirmée par le SARS Cov2. Il s’agissait de 9 hommes et une femme, dont la moyenne d́âge était de 60,5 ans. Huit patients avaient un adénocarcinome pulmonaire, un patient avait un carcinome épidermoïde et un patient avait un carcinome à petites cellules. Parmi ces patients, 9 étaient au stade localement avancé non opérable et un patient était sous chimiothérapie palliative. Le délai moyen entre le début des symptômes et la confirmation virologique était 11 jours. Une TDM thoracique initiale avait montré une atteinte minime pour 80 % des cas. Un seul cas hospitalisé en réanimation avait une atteinte scannographique étendue. L’évolution clinique et radiologique était favorable dans la plupart des cas. Un seul patient était décédé, il avait une comorbidité cardio-vasculaire.

Conclusion

Il ne semble pas que le cancer du poumon soit un facteur de risque d’infection par le SARS-COV2 ou d’aggravation en cas d’infection, en tout cas, pas plus que les autres comorbidités tels que les maladies cardio-vasculaires, le diabète et l’âge avancé.

Depression in quarantined patients during the COVID-19 pandemic

Introduction

Quarantine for suspected patients of being infected by the COVID-19 can lead to negative consequences for mental health and the appearance of depressive symptoms.

Objectives

To assess the prevalence of depression in quarantined patients, and to analyze the associated factors.

Methods

This was a descriptive and analytical survey, carried out from April 4 to May 30, 2020, with 149 patients consulting the COVID-19 sorting box at the Hedi Chaker CHU in Sfax. Suspected COVID-19 patients were contacted by phone during their quarantine and invited to participate in our study. The Patient Health Questionnaire (PHQ-9) scale was used to assess the severity of depression. Cutoffs of 5, 10, 15, and 20 represent minimal, mild, moderate, moderately severe, and severe levels of depression based on PHQ-9 scores. A cutoff score of 10 determines major depression.

Results

The results showed a prevalence of major depression of 10.7%. Of all patients, 89.3% had minimal to mild depression; 10% had moderate to moderately severe depression and 0.7% had severe depression. The PHQ-9 score was statistically correlated with travel to a suspect area during the 14 days preceding the consultation (p = 0.008), contact with a subject confirmed COVID-19 (p = 0.01), previous follow-up in psychiatry (p = 0.047), the change of residence during quarantine (p = 0.045), the fear of transmitting the disease to relatives (p = 0.00) and the positive result of the nasopharyngeal swab (p = 0.00).

Conclusions

Psychological distress was felt in our patients. We recommend that necessary measures should be taken to combat depression.

Perceived stress among suspected patients during the COVID-19 outbreak in Tunisia

Introduction

Widespread outbreaks of infectious disease, such as COVID-19, are associated with psychological distress and symptoms of mental illness especially for patients with suggestive symptoms.

Objectives

Predict the prevalence of perceived stress and study associated factors among patients with suspected COVID-19 infection.

Methods

A cross sectional study was conducted between April and May 2020. Patients consulting the sorting box at the Hedi Chaker Hospital of Sfax and declared suspect to be infected by COVID-19 were invited to participate in our study after given their cosent. Perceived Stress Scale-10 was used to evaluate prevalence of perceived stress.

Results

In total, 149 participants participated. The mean age was 38.8±15.39 years. Medical or surgical history and psychiatric history were identified respectively in 30,2% and 12.1% of participants. Among all respondents, 74.5% took a nasopharyngeal swab to look for COVID-19 and only 6.4% had a positive test. Close contact with someone with a positive COVID-19 infection was found in 8.05%. Several participants (79,2%) expressed fear of transmitting the disease to their family members. The mean of the PSS-10 score was 11.97±9.83. Moderate to severe perceived stress was found in 44.3% of patients. Significantly higher scores were observed among participants with a positive pharyngeal swab for COVID-19 as well as those who perceived worry of transmetting the disease. No significant differences in perceived stress’ scores according to socio-demographic data.

Conclusions

Perceived stress was high among patients with suspected COVID-19 infection. Perceiving worry of transmetting the disease and having a positive pharyngeal swab for COVID-19 were the principal risk factors.

Disclosure

No significant relationships.

Predicting occupational exposure to trace metals from welding by non-air monitoring based models

Key messages

With a view to assess occupational exposure, non-air monitoring based models, that are time and cost saving tools, showed good prediction abilities for trace metal levels near welding emission sources. The use of non-air monitoring based models would help to control the working environment of occupationally exposed populations to welding fumes, which is useful to comply with air quality standards.

Occupational exposure assessment to per and trichloroethylene in dry cleaning in Sfax city (Tunisia)

Key messages

Our study is the first health risk assessment study of the exposure to chlorinated solvents in dry cleaning in Sfax city. It revealed high levels of trichloroethylene that is a carcinogen to humans. The high exposure levels to per and tri-chloroethylene, in dry cleaning in Sfax city, may induce adverse health effects to workers and even the general population due to residential exposure.

[Evaluation of quality of life (QOL) of Tunisians patients with COPD]

AIM

To test the Arabic version of the St. George's Hospital Respiratory Questionnaire (SGRQ) in stable Tunisian COPD patients.

HYPOTHESES

A correlation coefficient between the post-bronchodilator FEV1 and the "Total" score of SGRQ higher than "-0.40", and QOL scores lower in COPD with "mild to moderate airway obstruction" than in those with "severe to very severe airway obstruction" will be in favor of a possible application of the Arabic version of the SGRQ in Tunisians COPD patients.

METHODS

This is a prospective cross-sectional study including 50 clinically stable COPD patients. The Arabic version of the SGRQ was used. Four scores were calculated for the "Symptoms", "Activities", "Impacts" and "Total" components. Patients were divided into two groups according to the severity of their airway obstruction: "mild to moderate, n=30" and "severe to very severe, n=20". The correlation between the QOL "Total" score and postBD FEV1 was evaluated.

RESULTS

The mean±SD of age, cigarette smoking and post-bronchodilator FEV1 were, respectively, 60±10, 61±36 pack-years and 55±20 %. The correlation between the post-bronchodilator FEV1 and QOL "Total" score was significant at "-0.65". "Symptoms", "Activities", "Impacts" and "Total" scores were significantly less altered in patients with "mild to moderate airway obstruction" than among those with "severe to very severe airway obstruction" (respectively, 52±24 vs. 77±17, 66±28 vs. 87±18, 48±25 vs. 70±23 and 54±22 vs. 76±17).

CONCLUSION

The application of the Arabic version of the SGRQ in stable COPD patients gives reliable results.

[Prevalence of metabolic syndrome in a population of apneic patients: a prospective study with cardiovascular risk estimation]

BACKGROUND

Obstructive sleep apnea syndrome (OSAS) is a highly prevalent clinical condition and frequently associated with obesity. Recent literature has suggested the independent contribution of OSAS in the pathogenesis of metabolic disturbances. Metabolic syndrome (MS), a cardiovascular risk factor, was frequently associated with OSAS.

METHODS

This is a prospective study without intervention. Will be included, all consecutive patients referred to the Department of Pulmonology for suspected OSAS confirmed by respiratory polygraphy. Anthropometric, clinical and biological parameters needed to define the MS will be collected. MS was defined according to the IDF 2005. Assessment of cardiovascular risk related to MS will be performed by appropriate scores.

EXPECTED RESULTS

To determine the prevalence of MS in a sample of OSAS patients recruited in the Department of Pulmonology of Farhat Hached Hospital (Sousse, Tunisia). To identify risk factors independently associated with the presence of MS in patients with OSAS among the following parameters (age, gender, degree of obesity and the various parameters of OSAS severity). To assess compared cardiovascular risks according to the presence of MS by validated scales to demonstrate the impact of MS in patients with OSAS.

[Postpartum pericardic tamponade revealing systemic lupus erythematosus]

Pericarditis is the most common manifestation of systemic lupus erythematosus and is clinically found in 62% of the autopsies. Cardiac tamponade is a deadly but rare complication found in less than 1% of all lupus cases. It is highly revealing. The authors report the case of a 29-year old woman presenting postpartum cardiac tamponade. The diagnosis of systemic lupus erythematosus was based on the association of haematological disorders (anaemia and leukopenia), pericarditis, pleurisy and positive anti-nuclear and anti-native DNA antibodies. The patient was treated with pericardiac drainage and cortisone therapy. The evolution was favourable after 22 months. Using this case study, the authors note the rarity of cardiac tamponade as a manifestation inaugurating lupus and discuss the relationship between pregnancy and lupus disease.