is a rare species of slow-growing nontuberculous mycobacteria (NTM). From 2002 to 2017, we conducted a retrospective study that included all patients with NTM-positive respiratory samples detected in two university hospitals of the French overseas department of Reunion Island. We recorded the prevalence of in this cohort, as well as the clinical, radiological, and microbiological features of patients with at least 1 sample positive for In our cohort, 97 patients (15.1%) were positive for Twenty-one patients (21.6%) met the American Thoracic Society (ATS) criteria for infection. infection was associated with bronchiectasis, micronodular lesions, and weight loss. Antibiotic susceptibility testing was performed for 60 patients, and the isolates were found to have low susceptibility to antibiotics, except for amikacin, fluoroquinolones, and clarithromycin. Treatment failed for 4 of the 8 patients treated for infection. Here, we describe a specific cluster corresponding to a large cohort of patients with, a rare nontuberculous mycobacterium associated with low pathogenicity and poor susceptibility to antibiotics.

. The aim of this study was to evaluate the occurrence of pulmonary embolism in returning travelers with hypoxemic pneumonia due to COVID-19. All returning travelers to Reunion Island with hypoxemic pneumonia due to COVID-19 underwent computed tomography pulmonary angiography (CTPA) and were included in the cohort. Thirty-five patients were returning travelers with hypoxemic pneumonia due to COVID-19 and had recently returned from one of the countries most affected by the COVID-19 outbreak (mainly from France and Comoros archipelago). Five patients (14.3%) were found to have pulmonary embolism and two (5.9%) were incidentally found to have deep vein thrombosis on CTPA. Patients with pulmonary embolism or deep vein thrombosis had higher D-dimer levels than those without pulmonary embolism or deep vein thrombosis ( P = 0.04). Returning travelers with hypoxemic pneumonia due to COVID-19 should be systematically screened for pulmonary embolism.

This study aimed to evaluate the incidence of co-infection with different types of pathogens in patients with hypoxemic pneumonia due to coronavirus disease 2019 (COVID-19) in Reunion Island. This observational study using a prospectively collected database of hypoxemic pneumonia due to COVID-19 cases was conducted at Félix Guyon University Hospital in Reunion Island, France. Between 18 March 2020 and 15 April 2020, 156 patients were admitted to our hospital for COVID-19. A total of 36 patients had hypoxemic pneumonia (23.1%) due to COVID-19. Thirty of these cases (83.3%) were imported by travelers returning mainly from metropolitan France and Spain. Patients were screened for co-infection with other pathogens at admission: 31 (86.1%) by multiplex polymerase chain reaction (PCR) and 16 (44.4%) by cytobacteriological examination of sputum culture. Five patients (13.9%) were found to have co-infection: 1 with influenza virus A H1N1 (pdm09) associated with Branhamella catarrhalis , 1 with Streptococcus pneumoniae associated with Haemophilus influenzae , 1 with Human Coronavirus 229E, 1 with Rhinovirus, and 1 with methicillin-susceptible Staphylococcus aureus . Patients with co-infection had higher D-dimer levels than those without co-infection (1.36 [1.34–2.36] μg/mL vs 0.63 [0.51–1.12] μg/mL, P = .05). The incidence of co-infection in our cohort was higher than expected (13.9%). Three co-infections (with influenza virus A(H1N1) pdm09, Streptococcus pneumoniae , and Staphylococcus aureus ) required specific treatment. Patients with hypoxemic pneumonia due to COVID-19 should be screened for co-infection using respiratory cultures or multiplex PCR. Whilst our study has a number of limitations, the results from our study suggest that in the absence of screening, patients should be commenced on treatment for co-infection in the presence of an elevated D-dimer.

Objective To identify the differential diagnoses of severe COVID‐19 and the distinguishing characteristics of critically ill COVID‐19 patients in Reunion Island to help improve the triage and management of patients in this tropical setting. Methods This retrospective observational study was conducted from 11 March to 4 May 2020 in the only intensive care unit (ICU) authorised to manage COVID‐19 patients in Reunion Island, a French overseas department located in the Indian Ocean region. All patients with unknown COVID‐19 status were tested by polymerase chain reaction (PCR) on ICU admission; those who tested negative were transferred to the COVID‐19‐free area of the ICU. Results Over the study period, 99 patients were admitted to our ICU. A total of 33 patients were hospitalised in the COVID‐19 isolation ward, of whom 11 were positive for COVID‐19. The main differential diagnoses of severe COVID‐19 were as follows: community‐acquired pneumonia, dengue, leptospirosis causing intra‐alveolar haemorrhage and cardiogenic pulmonary oedema. The median age of COVID‐19‐positive patients was higher than that of COVID‐19‐negative patients (71 [58–74] vs. 54 [46–63.5] years, P = 0.045). No distinguishing clinical, biological or radiological characteristics were found between the two groups of patients. All COVID‐19‐positive patients had recently travelled or been in contact with a recent traveller. Conclusions In Reunion Island, dengue and leptospirosis are key differential diagnoses of severe COVID‐19, and travel is the only distinguishing characteristic of COVID‐19‐positive patients. Our findings apply only to the particular context of Reunion Island at this time of the epidemic.

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