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Abstract


RÉSUMÉ
Objectif. Décrire les aspects épidémiologiques et déterminer les facteurs de mauvais pronostic des patients COVID19 admis en Réanimation au Centre Hospitalier Universitaire (CHU) de Libreville. Patients et méthodes. Il s’agit d’une étude transversale rétrospective, descriptive et analytique qui s’est déroulée sur une période de 16 mois allant d’avril 2020 à juillet 2021. Etaient inclus les patients dont le diagnostic de pneumopathie à SARS CoV2 avait été retenu. Les variables étudiées étaient l’âge, le sexe, les comorbidités, les signes cliniques et paracliniques, les modalités thérapeutiques et évolutives. Résultats. 187 patients ont été inclus. L’âge moyen était de 53,5 ± 15,5 ans avec un sex ratio de 1,36. L’hypertension artérielle, l’obésité, le diabète étaient les comorbidités plus retrouvées. La détresse respiratoire était le motif d’admission le plus fréquent. Près de la moitié des patients avaient des lésions pulmonaires de plus de 50% à la tomodensitométrie thoracique. 16,6% des patients étaient intubés. Le taux de mortalité était de 41,7%. La durée moyenne d’hospitalisation était de 8,5± 6,5 jours. Les facteurs de mauvais pronostic étaient : l’âge, le diabète, le score de Glasgow, le score quick SOFA, les D-dimères, l’insuffisance rénale, l’hyperleucocytose, la lymphopénie, l’atteinte pulmonaire, la ventilation non invasive (VNI) et l’intubation. Conclusion. La Covid-19 est une pathologie dont la forme grave est associée à plusieurs facteurs de mauvais pronostic à l’origine d’une mortalité élevée. Une prise en charge précoce et bien codifiée doit être réalisée afin d’améliorer l’issue de cette affection.
ABSTRACT
Objective. To describe the epidemiology and establish the poor prognostic factors of COVID19 patients admitted to the Intensive Care Unit of the University Hospital of Libreville. Patients and methods. This was a cross sectional retrospective, descriptive and analytical study which took place over a period of 16 months from April 2020 to July 2021. Patients with a diagnosis of SARS Cov2 pneumonia were included. The variables studied were age, sex, comorbidities, clinical and paraclinical signs, therapeutic and evolutionary modalities. Results. 187 patients were included. The mean age was 53.5 ± 15.5 years with a sex ratio of 1.36. Arterial hypertension, obesity and diabetes were the most common comorbidities. Respiratory distress was the most frequent reason for admission. Almost half of the patients had lung lesions of more than 50% on chest CT. 16.6% of patients were intubated. The mortality rate was 41.7%. The average length of hospitalization was 8.5± 6.5 days. Poor prognostic factors were: age, diabetes, Glasgow score, quick SOFA score, D-dimer, renal failure, hyperleukocytosis, lymphopenia, pulmonary involvement, non-invasive ventilation (NIV) and intubation. Conclusion. Covid-19 is a pathology whose severe form is associated with several poor prognostic factors leading to a high mortality. An early and well codified management must be performed to improve the outcome of this condition.

Keywords

COVID-19 risk factors resuscitation Libreville Covid-19 facteurs de risque réanimation Libreville

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Ngomas JF, Ifoudji Makao A, Nze Obiang PC, Nyangui DEM, Manga F, Bitegue L, ila UD, Igala M, Ayo Bivigou E, Essola-Rerambiah L, & Sima Zué A. (2022). Aspects Epidémiologiques et Facteurs de Mauvais Pronostic des Patients Atteints de COVID-19 Admis en Réanimation au Centre Hospitalier Universitaire de Libreville au Cours des Trois Premières Vagues de la Pandémie: Epidemiology and poor prognostic factors of patients with COVID-19 admitted in the intensive care unit of the University Teaching Hospital of Libreville during the first three waves of the pandemic. HEALTH SCIENCES AND DISEASE, 23(6). https://doi.org/10.5281/hsd.v23i6.3668
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