Objectives To describe the clinical evolution and predictors of symptom persistence during 2-month follow-up in adults with non-critical COVID-19. Methods Descriptive clinical follow-up (days 7, 30 [D30] and 60 [D60]) of 150 patients with non-critical COVID-19 confirmed by RT-PCR at Tours University Hospital from March 17 to June 3, 2020, including demographic, clinical and laboratory data collected from the electronic medical records and by phone call. Persisting symptoms were defined by the presence at D30 or D60 of at least one of the following: weight loss ≥ 5%, severe dyspnea or asthenia, chest pain, palpitations, anosmia/ageusia, headache, cutaneous signs, arthralgia, myalgia, digestive disorders, fever or sick leave. Results At D30, 68% (n=103/150) of patients presented at least one symptom and 66% (n=86/130) at D60, mainly anosmia/ageusia: (59% (n=89/150) at symptom onset, 28% (n=40/150) at D30 and 23% (n=29/130) at D60). Dyspnea concerned 36.7% (n=55/150) patients at D30 and 30% (n=39/130) at D60. Half of the patients (n=74/150) at D30 and 40% (n=52/130) at D60 reported asthenia. Persistent symptoms at D60 were significantly associated with age 40 to 60 years old, hospital admission and abnormal auscultation at symptom onset. At D30, severe COVID-19 and/or dyspnea at symptom onset were additional factors associated with persistent symptoms. Conclusions Up to 2 months after symptom onset, two thirds of adults with non-critical COVID-19 had complaints, mainly anosmia/ageusia, dyspnea or asthenia. A prolonged medical follow-up of patients with COVID-19 seems essential, whatever the initial clinical presentation.

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Abstract Primary fungal infection of the central nervous system (CNS) is rare but often associated with severe prognosis. Diagnosis is complicated since cerebrospinal fluid (CSF) samples obtained from lumbar puncture usually remain sterile. Testing for fungal antigens in CSF could be a complementary diagnostic tool. We conducted such measurements in CSF from patients with CNS fungal infection and now discuss the usefulness of ventricular puncture. Mannan and (1→3)ß-D-glucan (BDG) testing were retrospectively performed in CSF samples from three patients with proven chronic CNS fungal infection (excluding Cryptococcus), and subsequently compared to 16 controls. Results from lumbar punctures and those from cerebral ventricles were confronted. BDG detection was positive in all the CSF samples (from lumbar and/or ventricular puncture) from the three confirmed cases. In case of Candida infection, mannan antigen measurement was positive in 75% of the CSF samples. In the control group, all antigen detections were negative (n = 15), except for one false positive. Faced with suspected chronic CNS fungal infection, measurement of BDG levels appears to be a complementary diagnostic tool to circumvent the limitations of mycological cultures from lumbar punctures. In the event of negative results, more invasive procedures should be considered, such as ventricular puncture.

A 37-year-old man with no prior medical history except chronic alcohol and tobacco consumption was admitted for fever at 38.5°C and abdominal pain starting two days before. Physical examination confirmed tenderness of the left flank with no other abnormalities.…