Pneumopathies graves liées au COVID-19 : facteurs prédictifs de mortalité après traitement par tocilizumab

Introduction

Matériels et méthodes

Résultats

Conclusion

Tocilizumab therapy reduced intensive care unit admissions and/or mortality in COVID-19 patients

INTRODUCTION

No therapy has yet proven effective in COVID-19. Tocilizumab (TCZ) in patients with severe COVID-19 could be an effective treatment.

METHOD

We conducted a retrospective case-control study in the Nord Franche-Comté Hospital, France. We compared the outcome of patients treated with TCZ and patients without TCZ considering a combined primary endpoint: death and/or ICU admissions.

RESULTS

Patients with TCZ (n=20) had a higher Charlson comorbidity index (5.3 [±2.4] vs 3.4 [±2.6], P=0.014), presented with more severe forms (higher level of oxygen therapy at 13L/min vs 6L/min, P<0.001), and had poorer biological findings (severe lymphopenia: 676/mm³ vs 914/mm³, P=0.037 and higher CRP level: 158mg/L vs 105mg/L, P=0.017) than patients without TCZ (n=25). However, death and/or ICU admissions were higher in patients without TCZ than in the TCZ group (72% vs 25%, P=0.002).

CONCLUSION

Despite the small sample size and retrospective nature of the work, this result strongly suggests that TCZ may reduce the number of ICU admissions and/or mortality in patients with severe SARS-CoV-2 pneumonia.

Features of anosmia in COVID-19

BACKGROUND

Medical publications about anosmia with COVID-19 are scarce. We aimed to describe the prevalence and features of anosmia in COVID-19 patients.

METHODS

We retrospectively included COVID-19 patients with anosmia between March 1st and March 17th, 2020. We used SARS-CoV-2 real time PCR in respiratory samples to confirm the cases.

RESULTS

Fifty-four of 114 patients (47%) with confirmed COVID-19 reported anosmia. Mean age of the 54 patients was 47 (±16) years; 67% were females and 37% were hospitalised. The median Charlson comorbidity index was 0.70 (±1.6 [0-7]). Forty-six patients (85%) had dysgeusia and 28% presented with pneumonia. Anosmia began 4.4 (±1.9 [1-8]) days after infection onset. The mean duration of anosmia was 8.9 (±6.3 [1-21]) days and 98% of patients recovered within 28 days.

CONCLUSIONS

Anosmia was present in half of our European COVID-19 patients and was often associated with dysgeusia.

ST93-Queensland community-acquired meticillin-resistant Staphylococcus aureus clone in France: outbreak in a scout camp and sporadic cases, July to August 2012

We describe the occurrence in France of a Panton-Valentine leukocidin (PVL)-positive meticillin-resistant Staphylococcus aureus (MRSA) ST93 clone, a predominant community-acquired (CA)-MRSA in Australia. In July to August 2012, an outbreak in a scout camp (n=3) and sporadic cases (n=2) of skin and soft tissue infections were reported. Investigations suggested importation of the clone through travel and onward transmission. This illustrates the epidemic potential of this lineage and the role of travellers in the spread of PVL-positive CA-MRSA.