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Introduction Diabetes is the most common of comorbidity in patients with SARS-COV-2 pneumonia. Coagulation abnormalities with D-dimer levels are increased in this disease. Objectifs We aimed to compare the levels of D-dimer in diabetic and non-diabetic patients with COVID 19. A link between D-dimer and mortality has also been established. Materials A retrospective study was carried out at the University Hospital Center of Oujda (Morocco) from November 01st to December 01st, 2020. Our study population was divided into two groups: a diabetic group and a second group without diabetes to compare clinical and biological characteristics between the two groups. In addition, the receiver operator characteristic curve was used to assess the optimal D-dimer cut-off point for predicting mortality in diabetics. Results 201 confirmed-COVID-19-patients were included in the final analysis. The median age was 64 (IQR 56-73), and 56% were male. Our study found that D-dimer levels were statistically higher in diabetic patients compared to non-diabetic patients. (1745 vs 845 respectively, P = 0001). D-dimer level > 2885 ng/mL was a significant predictor of mortality in diabetic patients with a sensitivity of 71,4% and a specificity of 70,7%. Conclusion Our study found that diabetics with COVID-19 are likely to develop hypercoagulation with a poor prognosis.

Importance Proinflammatory and hypercoagulable states with marked elevation seen in D-Dimer levels have been accurately described in patients infected by the SARS- Cov2 even without pulmonary embolism (PE). Objectives To compare D-dimers values in patients infected by the novel Coronavirus 2019 (COVID-19) with and without PE and to establish an optimal D-dimer cut-off to predict the occurrence of PE, which guides pulmonary computed tomography angiography (CTPA) indication. Methods We retrospectively enrolled all COVID-19-patients admitted between October first and November 22th, 2020, at the University Hospital Center of Mohammed VI, Oujda (Morocco), suspected to have PE and underwent a CTPA. Demographic characteristics and blood test results were compared between PE-positive and PE-negative. The receiver operating characteristics (ROC) curve was constructed to establish an optimal D-Dimer cut-off to predict the occurrence of PE. Results The study population consisted of 84 confirmed COVID-19-patients. The mean age was 64.93 years (SD 14.19). PE was diagnosed on CTPA in 31 (36.9%) patients. Clinical symptoms and in-hospital outcomes were similar in both groups except that more men had PE (p = .025). The median value of D-dimers in the group of patients with PE was significantly higher (14 680[IQR 33620-3450]ng/mL compared to the group of patients without PE 2980[IQR 6870-1600]ng/mL [P < .001]. A D-dimer at 2600 ng/mL was the optimal cut-off for predicting PE with a sensitivity of 90.3%, and AUC was .773[CI 95%, .667 −.876). Conclusion A D-dimer cut-off value of 2600 ng/mL is a significant predictor of PE in COVID-19-patients with a sensitivity of 90.3%.

Background Cardiac injury has been linked to a poor prognosis during COVID-19 disease. Nevertheless, the risk factors associated are yet to be thoroughly investigated. Objectives We sought to compare demographical characteristics and in-hospital outcomes in patients infected by the SARS-CoV-2 with and without cardiac injury, to further investigate the prevalence of acute cardiac injury as well as its impact on their outcomes in COVID-19-patients. Methods We included in a retrospective analysis, all COVID-19 patients admitted between October first and December first, 2020, at the University Hospital Center of Oujda (Morocco) who underwent a troponin assay which was systematically measured on admission. The study population was divided into two groups: cardiac-injured patients and those without cardiac injury. Clinical, biological data and in-hospital outcomes were compared between the two groups. Results 298 confirmed COVID-19 cases were included. Our study found that compared to non-cardiac-injured, cardiac-injured patients are older, with higher possibilities of existing comorbidities including hypertension (68 [42.2%] vs 40 [29.2%], P = 0.02), diabetes (81 [50.3%] vs 53 [38.7%] P = 0.044), the need for mechanical ventilation, ICU admission and mortality. A Cox proportional hazards regression analysis shows a significantly increased risk of death among cardiac-injured COVID-19-patients as compared to non-cardiac injured. (HR, 1.620 [CI 95%: 2.562-1.024]) Conclusion Our retrospective cohort found that old age, comorbidities, a previous history of CAD, were significantly associated with acute cardiac injury. COVID-19 patients with acute cardiac injury are at a higher risk of ICU admission, and death.

Objective The aim of this study is to assess the impact of psychoeducation on patients with schizophrenia, focusing on clinical symptoms, insight, self-esteem, treatment adherence, and social autonomy. Methods This prospective study evaluates the effects of a 6-month psychoeducation program, the P.A.C.T. (Psychosis Aider Comprendre Traiter) program, on stabilized outpatients with schizophrenia, without the use of a control group. The program is designed to help patients understand their illness and treatment, improving adherence to care. Topics covered include the symptoms of schizophrenia, available treatment options, and coping strategies. The program also emphasizes peer support and individualized care, addressing challenges such as cognitive deficits and low motivation. Data were collected both prior to and following the psychoeducation program using a standardized questionnaire and assessment scales to evaluate the following: clinical symptoms (Positive and Negative Syndrome Scale, PANSS), therapeutic adherence (Medication Adherence Report Scale, MARS), insight (Birchwood Insight Scale), self-esteem (Rosenberg Self-Esteem Scale), and social autonomy (Social Autonomy Scale, SAS). Results A total of 100 patients participated in the psychoeducational sessions, with a mean age of 37.73 ± 10.51 years and a male predominance. Following the psychoeducation program, significant improvements were observed across all assessment scales: - PANSS: Clinical symptoms improved markedly, with the mean score decreasing from 83.17 ± 23.09 before psychoeducation to 43.67 ± 16.11 after psychoeducation (p < 0.0001). - MARS-5: The rate of good adherence to treatment increased from 9% to 63.7%, with a significant change (p < 0.0001). - Birchwood Insight Scale and Rosenberg Self-Esteem Scale: Insight and self-esteem scores improved significantly (p < 0.0001). - SAS: Social autonomy showed substantial improvement, with the mean SAS score decreasing from 58.81 to 20.21 (p < 0.0001). Conclusion The P.A.C.T. psychoeducation program has been shown to significantly improve clinical outcomes, treatment adherence, insight, self-esteem, and social autonomy in patients with schizophrenia. However, the absence of a control group prevents the generalization of these data. Subsequent comparative studies would be desirable to demonstrate the positive effect of psychoeducation in the early stages of the disease within the framework of a comprehensive approach to recovery.

The COVID-19 pandemic continues to be rampant with considerable morbidity and mortality worldwide since its emergence in December 2019. Several studies have focused on identifying different predictive factors of poor prognosis, including biological markers, such as C Reactive Protein among others. The objective of our work was to determine whether the CRP levels on admission to the intensive care unit are predictive of an unfavorable evolution of patients with COVID-19 through the experience of the Anesthesia and Intensive Care Unit of the University Hospital of Oujda and to compare our results with those reported in the literature. We conducted a retrospective, monocentric, descriptive and analytical study in the Department of Anesthesia and Intensive Care of the Mohammed VI University Hospital of Oujda, Morocco, between March 2020 and October 2021, including all critically ill patients admitted to the department during this period and meeting the inclusion criteria. The baseline admission CRP value was arbitrarily set at 100mg/d, thus conditioning the division of our patients into two groups (group 1: CRP < 100mg/L, group 2: CRP ≥ 100mg/L). Among our 1035 included patients, 291 patients with had a CRP<100mlg/L (group 1) and 744 presented a CRP level equal or superior to 100mg/L (group 2). Lung parenchymal involvement was more severe or even critical (CT involvement > 75%) in group 2 (60.8%) compared to group 1 (39.2%). In group 2, 79.8% of patients were mechanically ventilated, compared to 20.2% of patients in group 1. Finally, the mortality rate in patients with a CRP ≥ 100mg/l was 77.4%, compared with 22.6% for patients with a CRP < 100mg/l. These findings are all statistically highly significant (p<0.001). Given the high contagiousness of the virus and the emergence of several variants, the management of the COVID-19 pandemic has focused more on prevention through vaccination against the virus, but also on an early identification of patients likely to evolve unfavorably for a personalized management.

Introduction: schizophrenic relapse constitutes a formidable challenge in the realm of psychiatric care, often precipitating a cascade of deteriorating symptoms and functional impairment. Addressing this issue necessitates a comprehensive understanding of the factors that contribute to relapse occurrence. Methods: this cross-sectional study, conducted at the Hospital of Mental Health and Psychiatric Diseases in Oujda, sought to explore the intricate interplay between stress, coping mechanisms, and the incidence of relapse among individuals diagnosed with schizophrenia. Over six months, data were collected from three hundred schizophrenia patients, encompassing demographic, clinical, stress, and coping-related variables. Results: analysis of the findings unveiled compelling associations between stress intensity, coping efficacy, and relapse vulnerability. Notably, heightened stress intensity emerged as a significant predictor of relapse occurrence, surpassing the mere exposure to stressors. Furthermore, inadequate coping strategies were found to significantly elevate the risk of relapse, underscoring the pivotal role of adaptive coping skills in mitigating relapse susceptibility. In addition to these associations, the study revealed intriguing insights into the demographic and clinical characteristics of the patient population. Predominantly male and urban-dwelling, the patients exhibited varying levels of education and employment status. A substantial proportion reported a history of substance abuse and psychiatric family history, indicating potential predisposing factors for relapse vulnerability. These findings underscore the imperative of integrating stress management interventions and fostering adaptive coping mechanisms within schizophrenia treatment paradigms. Early identification and targeted interventions aimed at ameliorating stress reactivity and enhancing coping proficiency. Also, it held promise for the reduction of relapse rates and the increase of long-term outcomes for individuals grappling with schizophrenia. Conclusion: by elucidating the nuanced dynamics of stress and coping in relation to relapse, this study contributes valuable insights to the development of tailored interventions and therapeutic strategies in schizophrenia management.