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. 2020 Nov;2020(526):40-47.
doi: 10.1016/S1773-035X(20)30312-9. Epub 2020 Oct 31.

[Covid-19: clinical aspects and management]

[Article in French]
Édouard Desvaux  1 , Jean-François Faucher  2
Affiliations

[Covid-19: clinical aspects and management]

[Article in French]
Édouard Desvaux et al. Rev Francoph Lab. 2020 Nov.

Abstract
in English, French

Asymptomatic infections are not rare and most patients complain with fever and respiratory signs. Clinical signs are polymorphic and aspecific. Chest CT scan is commonly used as a diagnostic and triage tool in patients admitted to hospitalization. The 2 main complications are respiratory distress related to worsening pneumonia with an associated cytokine storm occurring mostly 7 to 10 days after disease onset, and thromboembolic disease. The fatality rate is around 2%. In-hospital management includes oxygen supply when needed and prevention of thromboembolic disease. Associated bacterial infections seem to be rare. Remdesivir might reduce the time to recovery in hospitalized patients needing an oxygen supply. Dexamethasone might reduce the fatality rate in patients requiring mechanical ventilation. The development of many candidate vaccines gives hope to fight the pandemic.

Les infections asymptomatiques ne sont pas rares ; les signes cliniques associent le plus souvent des signes généraux et des signes respiratoires ; ils sont polymorphes et non spécifiques. La tomodensitométrie thoracique est un outil important d’aide au diagnostic et de triage pour les patients dont l’état justifie une hospitalisation. Les deux complications principales de la maladie sont d’une part la détresse respiratoire par aggravation de la pneumonie, qui survient le plus souvent après sept à dix jours d’évolution dans le cadre d’un orage cytokinique, et la maladie thromboembolique d’autre part. Le taux de létalité est de l’ordre de 2 %. La prise en charge en milieu hospitalier comporte l’oxygénation le plus souvent et toujours la prévention de la maladie thromboembolique. Les surinfections bactériennes sont rares. Le remdésivir permettrait de raccourcir la durée des signes cliniques chez des patients hospitalisés et sous oxygénothérapie. La dexaméthasone permettrait de réduire la létalité chez les patients dont l’état justifie une ventilation mécanique. Le développement de nombreux candidats vaccins suscite beaucoup d’espoir pour accélérer la sortie de pandémie.

Keywords: Covid-19; chest CT-scan; clinical signs; management; vaccine.

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Figures

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©Pascal Bachelet / BSIP
Figure 1.
Figure 1.
Tomodensitométrie thoracique d’une pneumonie à Sars-CoV-2. © Service de radiologie et imagerie médicale, CHU Limoges.
See this image and copyright information in PMC

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