Abstract Introduction The determination of the groups at risk of death at admission in patients with bacterial infection in the ICU is important. Several prognostic factors have already been identified, however the neutrophil/lymphocyte ratio (NLR) has the advantage of being common and inexpensive. Objective To determine the threshold value of NLR to determine the group at risk of 15-day mortality and the overall survival of patients according to this threshold. Methods This was a retrospective cohort conducted in the intensive care unit of the Ibn Rochd University Hospital in Casablanca over a period of 2 years (January 2019 - January 2021), among hospitalized patients with bacterial infection, acquired or nosocomial. The sample size was calculated a priori and multivariate statistical analyses (multiple logistic regression, Youden index and Kaplan Meier survival estimation and Log Rank) were performed using Rstudio software. The significance level was less than 5%. Results A total of 200 patients were included in the study, 136 patients were alive at 15 days, there were no differences in age between the two groups. Factors associated with patient mortality at 15 days were: gender, use of vasoactive drugs, use of mechanical ventilation, type of sepsis, site of infection, SOFA score (p < 0.000), Apache score (p = 0.009) and NLR at admission (p = 0.001). The cut-off value for NLR was 15.07 with a mean discriminant value of 64.1%. The difference in median overall survival of patients in the two groups according to the threshold value was statistically significant 22 +/- 1.9 days and 11 +/-1.12 days (p = 0.042). Conclusions The NLR appears to be a prognostic factor for 15-day mortality. The knowledge of prognostic factors and threshold values of these indicators allow the prediction of at-risk groups in order to best adapt their management. Key messages The use of common and inexpensive biological prognostic markers are a reliable alternative to identify at-risk patients to optimize their management in developing countries. The RNL is a good biological prognostic markers of mortality of patients infected in ICU.

1. Abstract Besides respiratory symptoms, coronavirus disease 2019 (COVID-19), like the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), has neurological signs. Symptoms like myalgia, headaches, dizziness, anosmia, ageusia and disorder of consciousness confirms that the nervous system is involved in COVID-19 infection. Guillain barre syndrome (GBS) is a neurological disorder that usually follows a viral infection, it is possible that COVID-19 infection and GBS are closely related. In this case report, we try to elucidate the relation between SARS-CoV-2 and GBS. 2. Introduction The first unexplained pneumonia cases occurred in Wuhan, China, and quickly spread to other countries [1], It was later revealed that these unexplained pneumonia cases had been caused by a new coronavirus. It has been stated that the symptoms of this new coronavirus infection are very similar to those of SARS-CoV which spread in 2003 [2]. COVID-19 patients have such clinical symptoms as headache, vomiting, nausea, dizziness, myalgia, anosmia, ageusia, and disorder of consciousness. These symptoms confirm that the nervous system is involved in the COVID-19 infection. We present a case of a 72-year-old man who was initially diagnosed with COVID-19 pneumonia due to symptoms of fever and cough. 12 days later, he developed symmetric ascending quadriparesis and paresthesia. The diagnosis of Guillain barre syndrome (GBS) was made through cerebrospinal fluid analysis and he was successfully treated with intravenous immunoglobulin administration. 3. Case report A 72-year-old man, without any history of medical pathologies, was admitted in the emergency unit for respiratory distress: symptoms were myalgia, cough, headaches and fever. His vitals showed a respiratory rate at 25cycles per minute and blood saturation was 92% on room air, under the current epidemiological situation a chest CT scan showed ground glass opacities compatible with SARS-CoV-19 (Figure1) infection which was confirmed with nasopharyngeal secretions PCR. The patient was then transferred to our unit for further care. Medical interview of the patient revealed Influenza illness and extreme asthenia 12 days before his admission without any digestive signs, medical examination showed a patient with no loss of consciousness or changes in mental status a Glasgow coma score of 15/15, systolic blood pressure= 112mmhg, diastolic blood pressure= 78mmhg, heart rate= 79bpm, Oxygen saturation= 95% with 5l of oxygen and a respiratory rate= 26cycles per minute. Neurological examination showed: abolished tendon reflexes in the four limbs, swallowing disturbance, diffuse areflexia, medical research council (MRC) strength evaluation was 1/5 in the legs, 2/5 in the arms, 3/5 in the forearms and 4/5 in the hands, Sensation to light touch and pinprick was decreased distally in addition of a decreased vibration sense in the lower limbs.

The COVID-19 pandemic has had a great impact on chronic diseases, including epilepsy. The imbalance of antiepileptic drugs in case of intercurrent infection with COVID-19 leads to worsening seizures. A 71-year-old man, followed for post-traumatic epilepsy for 30 years, was stabilized with phenobarbital and topiramate. He presented generalized tonic-clonic epileptic seizures without meningitis. He improved well on midazolam combined with the usual treatment before the diagnosis and worsening of the covid-19. The severity of the lung damage led to hypoxia, recurrence of seizures, and poor prognosis. The association between covid-19 and epilepsy remains pejorative despite management. An epileptic seizure should always be considered as a possible manifestation of COVID-19. The article aimed to establish the relationship between covid-19 and the risk of worsening seizures and to demonstrate the severity of the association between covid-19 and epilepsy in elderly patients.

The COVID-19 pandemic and its impact on health systems had a significant effect on the management of inflammatory diseases in the long term and myopathies could be signs of COVID-19, making it difficult to diagnose the cause and effect relationship. An unvaccinated 62-year-old female patient followed for polymyositis was tested positive for COVID-19 on polymerase chain reaction (PCR) of nasopharyngeal swab revealed by dyspnea and rhinorrhea with fever and pulmonary involvement of 75%. She had an enlarged left ventricle with complete left branch block, inaugural diabetes mellitus with ketosis, kidney dysfunction, and inflammatory syndrome. Despite the early initiation of invasive ventilation in combination with the national protocol against covid-19, the patient died on day 4 of care. The best management should anticipate comorbidities and the evolutionary profile would guide the continuation of the treatment. Polymyositis like other rheumatic diseases was associated with a very high risk of developing a severe form of COVID-19. The combination of elder age and comorbidities led to a severe form of COVID-19 and therefore to a poor prognosis. The article aimed to show the severity of the association of covid-19 with polymyositis at the comorbid stage.

Pneumonia due to SARS-CoV-2 has caused considerable morbidity and mortalityworldwide particularly amongst those with comorbidities. The most frequent comorbidities are hypertension, diabetes and cardiovascular disease. until now, few associations between obstructive sleep apnea syndrome (OSAS) and COVID-19 have been reported. So, through the column of this article, Given the limited number of clinical cases reported about obstructive sleep apnea and COVID-19, we would like to report a case and share some experiences. Keywords: Obstructive Sleep Apnea; Obesity; COVID-19; Intensive care unit