La satisfaction étudiante à l'égard de l'apprentissage en ligne : une étude auprès des étudiants d'une école de médecine du nord du Maroc durant la pandémie de COVID-19

Background: Self-esteem is of great importance for positive and confident social behavior. Assertiveness is the component of self-esteem that allow that confident and forceful behavior while maintaining respect for others. Our study sought to evaluate the impact of an assertiveness training program on medical school students skills in communication and assertiveness. Method:123 first-year students (sex ratio (boys/girls):0,52) submitted to practical workshop training sessions during one month, evaluated at the beginning (T0) and the end (T1) of the training program by adapted auto-questionnaires measuring the feeling of self-efficacy when facing social situations, the assertiveness, self-esteem and also esteem in own communication capacity. Results: A significant improvement was seen in the mean scores of communications [58.51 to 64.62 i.e. + 6.11 (CI95% [4.66 7.56]). but also, in assertiveness [73.45 to 86.4 +12.95 (CI95% [10.46 15.43], for both sexes. Conclusion. Assertiveness programs have a positive impact in students self-esteem, assertiveness and communication skills. They must more seriously be considered as an important in schooling.

Introduction: Coronavirus disease 2019 (COVID-19) is unpredictable and it varies from mild to severe and critical forms that are associated with a higher mortality rate. Risk factors associated with severe forms of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have been investigated worldwide. We aimed to evaluate the clinical course of severe COVID-19 patients and to compare them with the nonsevere patients concerning clinical and epidemiological characteristics, biological parameters and outcomes and thus, highlight the factors associated with severe forms of COVID-19 in our country.Methods: This is a single-center, ambidirectional cohort study, conducted in Tangier's COVID-19 care premises. We included diagnosed COVID-19 patients between August 2020 and October 2021. Sampling was performed through stratification according to clinical forms. All patients were followed-up throughout disease evolution, until remission for mild to moderate forms and 30 days after discharge for hospitalized patient's group (severe to critical forms). Data were collected using the WHO International Severe Acute Respiratory and Emerging Infection (ISARIC) case report form (CRF) and extracted from medical records alongside with interviews with patients and their relatives.Results: Among 915 included COVID-19 patients in Tangier, the non-severe group comprised 344 (37.6%) patients and the severe group comprised 571 (62.4%) patients. Some 514 were males (56.2%) and 401 were females (43.8%) and the mean age was 56.01 years (±16.76). The mean delay from onset of symptoms to diagnosis was 6.65 days ±4.68 in the severe group and 5.4 days ±4.57 in the non-severe group (p<0.001). Among the severe patient's group, 230 (40.3%) patients were admitted to the resuscitation unit, 258 (45.2%) patients were deceased during hospitalization, 313 (54.8%) were discharged alive, and 16 deaths occurred after discharge. Demographic, clinical, and biological characteristics showed significant differences between non-severe group and severe group. Multivariable logistic regression analysis showed increased odds of severity with male gender (adjusted odds ratio, aOR=2.91, p<0.003), age over 65 years old (aOR=2.68, p<0.001), diabetes (aOR=2.18, p<0.03), elevated D-dimers (>1 mg/mL) (aOR=6.09, p<0.001), superinfection (aOR=3.78, p<0.001), and baseline lymphopenia < 1000c/mm3 (aOR=8.66, p<0.001). Conclusion:The high-risk factors for developing severe COVID-19 are age > 65 years, male gender, diabetes, elevated D-dimers, baseline lymphopenia, and superinfection. To predict severe and fatal COVID-19, factors identified may be used in the development of prediction tools for COVID-19 prognosis and risk stratification. Recalling the importance of considering at-risk populations, the management of epidemics must be planned in conjunction with the specificity of each community. Findings from our study may serve for health economic analyses and research in order to assist public health decisions in the future and should be integrated into health ...

BackgroundSince the onset of the Covid-19 pandemic, several studies have been conducted around the world in an attempt to understand this heterogeneous and unpredictable disease and to prevent related death. It was therefore necessary to study the associated risk factors of Covid-19-related mortality. ObjectivesThe aim of this study was to describe the clinical profile and to identify the factors associated with mortality of patients with Covid-19 in Morocco. MethodsWe performed a mixed cohort study (retrospective and prospective) of 615 in-patients with Covid-19 disease, enrolled between August 2020 and October 2021. We followed the cohort throughout the hospitalization until discharge and 30 days thereafter. ResultsThe median age was 64 years old; 62.1% of the patients were male. The mean time from symptom onset to hospitalization was 8.5 days (±4.67), and 68.1% of patients had comorbidities. On admission, the most common symptoms were dyspnea (82.2%), cough (80.3%), and fever (76.8%). The main follow-up complication was secondary infection (56.9%). Based on univariate analysis, male gender (p<0.008 and brut relative risk { b RR}=1.57), advanced age (p<0.001), lung involvement (p<0.001), lymphopenia (p<0.001 and b RR=2.32), D-dimers of >500 µg/l (p<0.007 and b RR=2.47), C-reactive protein (CRP) of >130 mg/l (p<0.001 and b RR=2.45), elevated creatinine (p<0.013 and b RR=1.61), lactate dehydrogenase (LDH) of >500 U/l (p<0.001 and b RR=7.16), receiving corticosteroids (p<0.001 and b RR=5.08), invasive ventilation (p<0.001 and b RR=30.10), the stay in the resuscitation unit (p<0.001 and b RR=13.37), and acute respiratory distress syndrome (ARDS) (p<0.001 and b RR=10.98) were associated with a higher risk of death. In the opposite, receiving azithromycin and hydroxychloroquine (p<0.001 and b RR=0.28) and pre-admission anticoagulants (p<0.005 and b RR=0.46) was associated with a lower risk of mortality. Multivariate regression analysis showed that age of >60 years (p<0.001 and adjusted odds ratio {aOR}=4.90), the use of invasive ventilation (p<0.001 and aOR=9.60), the stay in the resuscitation unit (p<0.001 and aOR=5.09), and acute respiratory distress syndrome (p<0.001 and aOR=6.49) were independent predictors of Covid-19 mortality. ConclusionIn this cohort study focusing on Covid-19 in-patient's mortality, we found that age of >60 years, the use of invasive ventilation, the stay in the resuscitation unit, and acute respiratory distress syndrome were independent predictors of Covid-19 mortality. The results of this study can be used to improve knowledge for better clinical management of Covid-19 in-patients.

Introduction: According to the literature consulted to date, there is epidemiological heterogeneity of Covid-19 between countries depending on their vaccination policy, in particular BCG vaccination. These findings have led to several hypotheses, including the protective role of immunity induced by the BCG tuberculosis vaccine against Covid-19 infection. The immunity induced by the BCG vaccine significantly increases the secretion of pro-inflammatory cytokines, in particular IL-1B, which has been shown to play an essential role in antiviral immunity. This cross-immunity, although not specific, if highlighted, is a real providence that must be taken advantage of in the face of this pandemic. The main objective of this study is to rule out or confirm that anti-tuberculosis immunity protects against SARS-COV-2 in our context. Material and Methods: Two groups will be compared: cases infected with the virus and controls who have never been infected with the virus. Both case and control groups will undergo a tuberculin skin test: the intra dermal tuberculin reaction (IDR). Results: We found that our control group had a high IDR immunity value, with an IDR tuberculin positive percentage of 67.2%. This suggests that immunity to IDR is a protective factor against coronavirus disease. Conclusion: The hypothesis of nonspecific anti-tuberculosis protection deserves further verification studies; it would have large positive repercussions for developing countries.