Introduction Corona virus disease (Covid-19) affects the airways and induces pulmonary lesions, patients with this disease require oxygen therapy as the disease progresses. Several oxygenation options have been used, l’HFNO had showed beneficial effects The objective of this study To evaluate the efficacy of high-flow nasal oxygen HFNO versus non-invasive ventilation in COVID-19. Methods This is a retrospective and comparative study conducted over a period of 10 months from March 2020 to December 2020 and involving 600 patients hospitalized in the intensive care unit of the CHU Mohammed VI of Oujda for the management of acute respiratory failure caused by COVID-19. Results Out of 600 patients with acute respiratory failure, 265 patients were included in the analyses. 162 (61.10%) patients were treated with HFNO, the intubation rate was 49.7% (80 patients out of 162) of which 63 died intubated (78.8%). Concerning the 82 non-intubated patients, only 16 died (19.8%). The total number of patients who received NIV was 71 (26.8%), 33 (46.5%) required mechanical ventilation. In-hospital mortality in patients treated with NIV was 100%. The difference in mortality outcome between the two groups was significantly (P < 0.0001) reduced in HFNO. Conclusions Treatment with high-flow oxygen improved survival in patients with acute hypoxemic respiratory failure compared with noninvasive ventilation, although no difference was observed in intubation rate

Introduction: COVID 19 pneumonia can lead to an inappropriate inflammatory response, and can be complicated by acute respiratory distress syndrome, multivisceral failure with a high mortality rate. Objective: To observe the effect of therapeutic plasma exchange on the excessive inflammatory response. Materials and methods: In this study, we included 7 confirmed cases of COVID-19 in the intensive care unit (ICU) department of the university hospital of Oujda. COVID-19 cases were confirmed by RT PCR (reverse transcription-polymerase chain) and CT (computerized tomography) imaging according to WHO guidelines. Therapeutic plasma exchange was performed decrease cytokine storm-induced ARDS (Acute respiratory distress syndrome). Inflammation marker assays were performed before and after therapeutic plasma exchange to assess its efficacy. Results: Levels of inflammatory cytokines (IL-6) and acute phase response proteins, including ferritin and CRP, were elevated before therapeutic plasma exchange. After therapeutic plasma exchange, levels of acute phase reactants, inflammatory mediators, were significantly reduced (p < 0.05). Conclusion: Our data suggest that therapeutic plasma exchange reduces the inflammatory response in patients with severe COVID-19 not undergoing mechanical ventilation. Further studies are needed to explore the efficacy of therapeutic plasma exchange in patients with COVID-19.

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It has been observed that mental disorder is associated with an aggravation of COVID 19 disease. A 44-year-old male patient, with no medical history, admitted to the emergency room for dyspnea, the exploration revealed SARS-COV-2 pneumonia. The patient was stable until he was aware of the death of his sister by COVID 19, he was admitted into the intensive care unit 24hours later in a serious condition after worsening of the inflammatory balance and pulmonary lesions. COVID 19 requires appropriate mental health management to help improve the prognosis of this disease.

Introduction Acute pancreatitis (AP) is considered one of the potentially rare complications of severe hypertriglyceridemia (HTG). Multiple treatment modalities have been suggested for patients with HTG-AP, such as permanent removal of TG by plasmapheresis, the use of insulin and heparin to enhance lipoprotein lipase activity and fibrate therapy, but the data remains limited. Case management we reported a case of 33-year-old women admitted for HTG-induced PA (HTG-AP). The patient had hypertriglyceridemia for 7 years under fibrate therapy as a medical history. On admission to our intensive care unit, his triglyceride level was 1060 mg/dl and the lipase level was 298 IU/L. An abdominal CT scan revealed stage E AP. The patient was treated with a low dose insulin infusion (0.05 unit/kg/h) with heparin and 5-day course of plasmapheresis, Fibrate therapy was maintained. His triglycerides went down to 130.9 mg/dl and she was discharged. Conclusion Early recognition of severe HTG can prevent progression to multiples diseases such as acute pancreatitis, can facilitate appropriate or even aggressive treatment to minimize complications of this.

Introduction COVID19 infection is most often reveled by pulmonary symptoms, however cardiovascular manifestations has been observed revealing this infection with absence of respiratory symptoms. Clinical case A 62 year old female patient, with no medical history, admitted to the emergency room for epigastric pain, with no respiratory signs, the exploration revealed myocardial infarction with COVID 19 infection. Conclusion COVID19 infection manifest mainly with respiratory symptoms but it can also be revealed by cardiac manifestations with absence of respiratory symptoms. Physicians must be aware of these atypical manifestations and act accordingly to isolate patients to limit the spread of this disease.

Introduction SARS-CoV-2 viral infection can manifested by respiratory symptoms, or other symptoms, such as the cardiovascular manifestations including acute coronary syndrome, pericardial effusion, and heart failure. Clinical case A 51-year-old patient admitted to the emergency room for epigastric pain with no respiratory signs and with an ST-segment elevation inelectrocardiogram that ultimately revealed myocarditis and SARS CoV-2 2 infection. Conclusion The clinical manifestations of SARS CoV-2 might be atypical, and the diagnosis might be considered in this pandemic area