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Master Thesis

Profil évolutif clinique des patients adultes infectés à SARS-CoV-2 et hospitalisés à partir de la structure des urgences de Strasbourg

Abstract : Background: taking care of patients with coronavirus disease 2019 (Covid-19) in emergency departments needs an accurate evaluation of severity criteria, in particular during the epidemic period. Covid-19 is a progressive disease and the respiratory deterioration holds an important part in the prognosis. The focus of this study is to describe the clinical evolving pattern of Covid-19, in a French population, and to determine whether or not this pattern represents mortality criteria. Methods: this observational retrospective study, led in the teaching hospitals of Strasbourg, included patients who were hospitalized for an infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the emergency departments in 2020. The study evaluates the time period between disease onset and the introduction of oxygen therapy, and the period between disease onset and development of hospital complications. By multivariate analysis, we researched the features associated with early oxygen therapy and in-hospital mortality. Findings: of the 699 patients included in the study, the mean period from disease onset to initiate oxygen therapy was 7 days ± 4 days, whereas the mean time to initiate mechanical ventilation was 9 days ± 4 days. The early introduction of oxygen therapy (i.e. before 6 days after disease onset) was independently related to the female gender, and in-hospital mortality. The absence of high blood pressure was a protector from the early introduction of oxygen therapy. By multivariate analysis, in-hospital mortality was related to elderly patients (i.e. aged ≥ 75 years), ischaemic heart disease, and immunosuppression. The mean period from disease onset to in-hospital death was 16 days ± 14 days. Conclusion: the mean period from disease onset to the initiation of oxygen therapy is 7 days ± 4 days. Early oxygen therapy, elderly age, ischaemic heart disease and immunosuppression are related to severe cases of Covid-19. All these features could be combined in an overall score, to quickly identify, upon admission to the emergency departments, patients requiring increased vigilance and hospitalization.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03187070
Contributor : Bibliothèque Universitaire de Médecine Nice <>
Submitted on : Wednesday, March 31, 2021 - 4:24:03 PM
Last modification on : Thursday, July 22, 2021 - 3:20:07 AM

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  • HAL Id : dumas-03187070, version 1

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Tamara Santiago. Profil évolutif clinique des patients adultes infectés à SARS-CoV-2 et hospitalisés à partir de la structure des urgences de Strasbourg. Médecine humaine et pathologie. 2020. ⟨dumas-03187070⟩

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