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Introduction the objective was to identify the predictive factors contributing to COVID-related deaths in Intensive Care Unit. Methods this was a 4-month (12 th March to 12 th July 2020) cross sectional study carried out in the intensive care unit of the COVID treatment center of Donka National Hospital, the only hospital with a COVID intensive care unit in Guinea. Results during our period of study 140 patients were hospitalized in the COVID intensive care unit and 35 patients died (25%). In univariate analysis, the occurrence of death was associated with: confusional syndrome (p<0.001), time to admission (p<0.001), use of an inotropic or vasopressor (p<0.001), Brescia score ≥ 2 (p=0.004), non-invasive ventilation (p=0.011), stroke (p=0.014), Acute Respiratory Distress Syndrome (ARDS) (p=0.015), male (p=0.021), provenance (p=0.021), acute renal failure (p=0.022), pulmonary embolism (p=0.022), invasive ventilation (p=0.022), and age > 60 years (p=0.047). In multivariate analysis, the factors predictive of mortality were: Acute Respiratory Distress Syndrome (ARDS) (OR= 6.33, 95% CI [1.66-29]; p=0.007), a Brescia score ≥ 2 (OR =5.8, 95% CI [1.7-19.2]; p=0.004) and admission delay (OR =5.6, 95% CI [1.8-17.5]; p=0.003). Conclusion our study shows that the acute respiratory distress syndrome, then the Brescia score ≥ 2, and finally the time to admission to intensive care were all associated with an increased risk of death for patients. These results are different from those reported in Asia, Europe and North America.

Objectif Décrire les caractéristiques épidémiologiques et cliniques des patients COVID-19 admis au service de réanimation. Méthodes Il s’agissait d’une étude prospective observationnelle de 4 mois (12 mars au 12 juillet) réalisée au service de réanimation du Centre de Traitement COVID-19 de l’hôpital national Donka. Résultats Durant la période d’étude, 6044 malades ont été testés positifs au SARS-CoV-2,140 parmi eux ont été admis en réanimation soit une prévalence de 2,3 %. L’âge moyen des patients était de 59 ± 14 ans. La majorité des patients (79 %) était de sexe masculin. Concernant les comorbidités, 77 % des patients avaient au moins une comorbidité médicale dont l’hypertension artérielle (55 %) et le diabète (38 %). Les signes cliniques les plus fréquents étaient la dyspnée, (81 %), l’asthénie physique (64 %) et la toux (60 %). La majorité de nos patients (91 %) a bénéficié d’une oxygénothérapie classique. Le Syndrome de Détresse Respiratoire Aiguë (SDRA) était la complication la plus représentée (38 %). Le taux de létalité était de 25 % sur l’ensemble des patients admis en réanimation. Conclusion Une faible proportion de patients COVID-19 ont été admis en réanimation. Ces patients étaient principalement des personnes âgées, de sexe masculin ayant au moins une comorbidité. La symptomatologie était dominée par la dyspnée et les complications par le SDRA. La létalité était comparable en Europe et aux États-Unis.

Cognitive impairment and behavioral changes following post-traumatic brain injury are disabling sequelae of traumatic brain injury. Processing speed, attention, executive functions and memory are usually the most impaired functions and may go unnoticed during a routine follow up neurologic consult. The aim of this study was to evaluate the degree of impairment of cognitive functions in a Guinean population of moderate traumatic brain injury by assessing the adaptability of classical Western neuropsychological tests to Guinean socio-cultural context. Twenty-three patients treated in neurosurgery at the Ignace Deen Hospital of Conakry were retrospectively assessed with a mean follow-up of 8.2months, a sex ratio of 4.6.1 and a mean age of 30.5years. Patients were subjected to the Bell test, and to the measurement of verbal and visio-spatial memory scores compared to a group of 23 control patients. The results showed significant differences between the two groups with impaired short recall memory and intact attention functions although quickly exhausted (mental fatigability). Our results designate these 3 tests as simple and reliable neuropsychological evaluation tools to be put in place early during the skull trauma care network, to improve the neuropsychological outcomes in Africa.