Pharmacovigilance of the Covid19 therapeutic protocol: Experience of the Hassan II University Hospital of Fez, Morocco and analysis of national and international data

Faced with the pandemic related to the dissemination of the new Coronavirus and the health emergency, Morocco decided to treat patients with Covid-19 with Hydroxychloroquine (HCQ) or Chloroquine (CQ), associated with Azithromycin (AZM) according to a standardized therapeutic scheme, an off-label indication that required pharmacovigilance monitoring to ensure the safety of treated patients. Objective. To present the experience of the Hassan II University Hospital of Fez concerning the management of adverse events of the Covid19 therapeutic protocol. A notification form was made available to the nursing staff to be filled in for any adverse reaction (ADR) observed after the treatment was taken. A daily collection and in-depth analysis was performed. We present the results of the analysis of the data collected in our training between April 21 and August 22, 2020, discussing them with data from national and international databases. 102 ADR cases were collected out of 915 patients hospitalized at the UHC for Covid19 during this period with a prevalence of 11%. 23 patients had underlying defects. The incriminating protocol contained CQ in 55.8% and HCQ in 44.2%. The mean age of the patients was 40.83±17.1 years (18 to 86 years) with a M/F sex ratio of 0.92. The mean time to onset was 3 days (range 1-6 days). The most noted ADRs were digestive, cardiac and neurological. 14 cases were severe (one QT prolongation), 6 of which required transfer to an intensive care unit. The course of action adopted was the restoration of corrective treatment with 12 cases of treatment discontinuation and 8 cases of switching to 2nd line treatment

Children’s poisoning profile during the Covid-19 pandemic – Experience of Hassan II University Hospital in Fez, MOROCCO

Introduction. —The Covid-19 pandemic and the containment situation, has generated enormous risks for children. Indeed, with the closure of schools, children, forced to stay at home, found themselves in permanent contact with dangerous products (drugs, disinfectants, plants) exposing them to accidental poisoning. Objective. —To describe the epidemiological, clinical and evolutionary aspects of the cases of pediatric intoxications in the UHC during the period of Covid-19, in order to assess the repercussions of this pandemic on the profile of these intoxications, in terms of number and incriminated products. Material and method. — This is a retrospective descriptive comparative study of intoxication cases admitted to the pediatric emergency department of the University Hospital of Fez spread over 2 years; from March 1, 2019 to February 2021; comparing intoxications admitted during the period of Covid-19 with the previous year. Results. — The emergency department recorded 132 cases of intoxication during the Covid-19 period (compared to 104 cases in 2019). Fez was always the most concerned city (66.21% against 69.02% in 2019). The cases emanated from the urban environment in (58.78%). The accidental circumstance was the most frequent, with an increase from 77.88% in 2019 to 82.02%. The rate of cases of envenomation that consulted was almost similar; children are more exposed to scorpion stings (73.52%) than snake bites. The analysis of incriminated products was marked by the increase of Caustics (20.38% in 2019 to 24.24% in 2020), and the decrease of pesticides (19.41% in 2019 to 13.63%). The symptomatology was dominated by neurological signs in 25.75% of cases, followed by respiratory disorders (18.18%). The evolution was favorable in 95.46%, and death occurred in 4.54% of cases compared to 3.84% in2019. The Covid-19 pandemic has changed the use of antidotes