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Cohen LE, Hansen CL, Andrew MK, McNeil SA, Vanhems P, Kyncl J, Domingo JD, Zhang T, Dbaibo G, Laguna-Torres VA, Draganescu A, Baumeister E, Gomez D, Raboni SM, Giamberardino HIG, Nunes MC, Burtseva E, Sominina A, Medić S, Coulibaly D, Salah AB, Otieno NA, Koul PA, Unal S, Tanriover MD, Mazur M, Bresee J, Viboud C, Chaves SS. Predictors of Severity of Influenza-Related Hospitalizations: Results From the Global Influenza Hospital Surveillance Network (GIHSN). J Infect Dis 2024; 229:999-1009. [PMID: 37527470 PMCID: PMC11011157 DOI: 10.1093/infdis/jiad303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 07/13/2023] [Accepted: 07/26/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND The Global Influenza Hospital Surveillance Network (GIHSN) has since 2012 provided patient-level data on severe influenza-like-illnesses from >100 participating clinical sites worldwide based on a core protocol and consistent case definitions. METHODS We used multivariable logistic regression to assess the risk of intensive care unit admission, mechanical ventilation, and in-hospital death among hospitalized patients with influenza and explored the role of patient-level covariates and country income level. RESULTS The data set included 73 121 patients hospitalized with respiratory illness in 22 countries, including 15 660 with laboratory-confirmed influenza. After adjusting for patient-level covariates we found a 7-fold increase in the risk of influenza-related intensive care unit admission in lower middle-income countries (LMICs), compared with high-income countries (P = .01). The risk of mechanical ventilation and in-hospital death also increased by 4-fold in LMICs, though these differences were not statistically significant. We also find that influenza mortality increased significantly with older age and number of comorbid conditions. Across all severity outcomes studied and after controlling for patient characteristics, infection with influenza A/H1N1pdm09 was more severe than with A/H3N2. CONCLUSIONS Our study provides new information on influenza severity in underresourced populations, particularly those in LMICs.
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Affiliation(s)
- Lily E Cohen
- Ready2Respond p/o The Task Force for Global Health, Decatur, Georgia, USA
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Chelsea L Hansen
- Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA
- Brotman Baty Institute, University of Washington, Seattle, Washington, USA
- PandemiX Center, Department of Science & Environment, Roskilde University, Denmark
| | - Melissa K Andrew
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Shelly A McNeil
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Jan Kyncl
- Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czech Republic
- Department of Epidemiology and Biostatistics, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Javier Díez Domingo
- Fundación Para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO–Public Health), Valencia, Spain
| | - Tao Zhang
- School of Public Health, Fudan University, Shanghai, China
| | - Ghassan Dbaibo
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
| | | | - Anca Draganescu
- National Institute for Infectious Diseases “Prof Dr Matei Bals”, Bucharest, Romania
| | - Elsa Baumeister
- Respiratory Virus Laboratory, Virology Department, INEI-ANLIS, Buenos Aires, Argentina
| | - Doris Gomez
- Grupo de Investigación UNIMOL, Facultad de Medicina, Universidad de Cartagena, Cartagena de Indias, Colombia
| | - Sonia M Raboni
- Virology Laboratory, Infectious Diseases Division, Universidade Federal do Paraná, Hospital Pequeno Principe, Curitiba, Paraná, Brazil
| | - Heloisa I G Giamberardino
- Virology Laboratory, Infectious Diseases Division, Universidade Federal do Paraná, Hospital Pequeno Principe, Curitiba, Paraná, Brazil
| | - Marta C Nunes
- South African Medical Research Council, Vaccines and Infectious Diseases Analytics Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Science and Technology/National Research Foundation, South African Research Chair Initiative in Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Elena Burtseva
- Gamaleya Federal Research Center for Epidemiology and Microbiology, Ministry of Health of Russian Federation, Moscow, Russia
| | - Anna Sominina
- Smorodintsev Research Institute of Influenza, St Petersburg, Russia
| | - Snežana Medić
- Institute for Public Health of Vojvodina, Novi Sad, Serbia
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | | | - Afif Ben Salah
- Institut Pasteur de Tunis, Tunis, Tunisia
- Arabian Gulf University, Manama, Bahrain
| | - Nancy A Otieno
- Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Parvaiz A Koul
- Sheri Kashmir Institute of Medical Sciences, Srinagar, India
| | - Serhat Unal
- Department of Infectious Diseases and Clinical Microbiology, Hacettepe University School of Medicine, Ankara, Turkey
- Turkish Society of Internal Medicine, Ankara, Turkey
| | - Mine Durusu Tanriover
- Turkish Society of Internal Medicine, Ankara, Turkey
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Marie Mazur
- Ready2Respond p/o The Task Force for Global Health, Decatur, Georgia, USA
| | - Joseph Bresee
- Ready2Respond p/o The Task Force for Global Health, Decatur, Georgia, USA
| | - Cecile Viboud
- Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Sandra S Chaves
- Foundation for Influenza Epidemiology, Fondation de France, Paris, France
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Abifadel M, Ahmmed K, Banu S, Camara I, Chowdhury F, Coulibaly D, Dabar G, Dananché C, Daw R, Hassan Z, Hervé M, Islam A, Komurian-Pradel F, Kouamé JP, Kouriba B, Najjar-Pellet J, Rakotonaivo A, Ranaivo-Rabetokotany F, Rasamoelina M, Rasolofoarison T, Riachi M, Saadatian-Elahi M, Samison L, Sanchez Picot V, Savané S, Thera I, Touré A, Vanhems P. Characteristics of Hospitalized COVID-19 Patients at Admission and Factors Associated with Clinical Severity in Low- and Middle-Income Countries: An Observational Study. Am J Trop Med Hyg 2024; 110:741-748. [PMID: 38412531 PMCID: PMC10993839 DOI: 10.4269/ajtmh.23-0456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 10/02/2023] [Indexed: 02/29/2024] Open
Abstract
Despite the numerous articles published on the clinical characteristics and outcomes of COVID-19 with regard to high-income countries, little is known about patients in low- and middle-income countries (LMIC) in this context. The objective of this observational, prospective, hospital-based multicentric study was to describe clinical features and outcomes of laboratory-confirmed COVID-19 patients hospitalized in each of the participating centers in Bangladesh, Guinea, Ivory Coast, Lebanon, Madagascar, and Mali during the first year of the pandemic (March 5, 2020 to May 4, 2021). The study outcome was the clinical severity of COVID-19, defined as hospitalization in intensive care unit or death. Multivariate logistic regression models were performed to identify independent variables associated with disease severity. Overall, 1,096 patients were included. The median age was 49.0 years, ranging from 38.0 in Mali to 63.0 years in Guinea. The overall clinical severity of COVID-19 was 12.3%, ranging from 6.4% in Mali to 18.8% in Guinea. In both groups of patients <60 and ≥60 years old, cardiovascular diseases (adjusted odds ratio [aOR]: 1.99; 95% CI: 1.13-3.50, P = 0.02; aOR: 2.47; 95% CI: 1.33-4.57, P = 0.004) were independently associated with clinical severity, whereas in patients <60 years, diabetes (aOR: 2.13; 95% CI: 1.11-4.10, P = 0.02) was also associated with clinical severity. Our findings suggest that COVID-19-related severity and death in LMICs are mainly driven by older age. However, the presence of chronic diseases can also increase the risk of severity especially in younger patients.
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Affiliation(s)
- Marianne Abifadel
- Laboratoire Rodolphe Mérieux, Université Saint-Joseph, Beirut, Lebanon
| | - Kaousar Ahmmed
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sayera Banu
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Ibrahima Camara
- Health Emergencies Program, World Health Organization, Conakry, Guinea
| | - Fahmida Chowdhury
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Georges Dabar
- Hôpital Hôtel Dieu de France, Alfred Naccache Boulevard, Beirut, Lebanon
| | - Cédric Dananché
- Service Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, France
- Centre International de Recherche en Infectiologie, Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases Team, Institut National de la Santé et de la Recherche Médicale U1111, Centre National de la Recherche Scientifique Unité Mixte de Recherche 5308, École Nationale Supérieure de Lyon, Université Claude Bernard Lyon 1, France
| | | | - Zakiul Hassan
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Magali Hervé
- Hospices Civils de Lyon, Pôle Santé Publique, Bases Cliniques—Epidémiologiques, Service Hospitalo-Universitaire de Pharmacotoxicologie, Lyon, France
| | - Ariful Islam
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | | | | | | | | | | | | | | | - Moussa Riachi
- Hôpital Hôtel Dieu de France, Alfred Naccache Boulevard, Beirut, Lebanon
| | - Mitra Saadatian-Elahi
- Service Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, France
- Centre International de Recherche en Infectiologie, Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases Team, Institut National de la Santé et de la Recherche Médicale U1111, Centre National de la Recherche Scientifique Unité Mixte de Recherche 5308, École Nationale Supérieure de Lyon, Université Claude Bernard Lyon 1, France
| | - Luc Samison
- Centre d’Infectiologie Charles Mérieux, Ankatso, Antananarivo, Madagascar
| | | | - Sita Savané
- Institut National d’Hygiène Publique, Abidjan, Ivory Coast
| | - Ismaila Thera
- Centre International pour l’Excellence dans la Recherche (ICER), Bamako, Mali
| | - Abdoulaye Touré
- Institut National de Santé Publique, Ministère de la Santé, Conakry, Guinea
| | - Philippe Vanhems
- Service Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, France
- Centre International de Recherche en Infectiologie, Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases Team, Institut National de la Santé et de la Recherche Médicale U1111, Centre National de la Recherche Scientifique Unité Mixte de Recherche 5308, École Nationale Supérieure de Lyon, Université Claude Bernard Lyon 1, France
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Khanafer NL, Fitzpatrick F, Barbut F, Krutova M, Davies K, Guery B, Vanhems P. Heterogeneity in practices to reduce the risk of transmission of Clostridioides difficile in healthcare settings: a survey of ESCMID Study Group for Clostridioides difficile (ESGCD) members. Eur J Clin Microbiol Infect Dis 2024; 43:785-789. [PMID: 38332395 DOI: 10.1007/s10096-024-04767-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/23/2024] [Indexed: 02/10/2024]
Abstract
Clostridioides difficile is a leading cause of healthcare-associated infections. The main objective was to assess the current landscape of CDI infection prevention and control (IPC) practices. An anonymous survey of IPC practices for CDI was conducted between July 25 and October 31, 2022. Precautions for symptomatic patients were applicable for 75.9% and were discontinued 48 h minimum after the resolution of diarrhea for 40.7% of respondents. Daily cleaning of CDI patients' rooms was reported by 23 (42.6%). There was unexpected heterogeneity in IPC practices regarding the hospital management of CDI.
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Affiliation(s)
- Nagham Léa Khanafer
- Infection Control Unit, Hôpital Edouard Herriot, Hospices Civils de Lyon (HCL), Lyon, France.
- PHE3ID team, Centre International de Recherche en Infectiologie, Inserm U1111, CNRS UMR5308, ENS de Lyon, Lyon 1 University, Lyon, France.
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Clostridioides difficile - ESGCD, Basel, Switzerland.
| | - Fidelma Fitzpatrick
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Clostridioides difficile - ESGCD, Basel, Switzerland
- Department of Microbiology, Beaumont Hospital, Dublin, Ireland
- Department of Clinical Microbiology, The Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
| | - Frédéric Barbut
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Clostridioides difficile - ESGCD, Basel, Switzerland
- Infection Control Unit, Assistance Publique - Hôpitaux de Paris, Paris, France
- National reference Laboratory for Clostridioides difficile, Paris, France
| | - Marcela Krutova
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Clostridioides difficile - ESGCD, Basel, Switzerland
- 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Kerrie Davies
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Clostridioides difficile - ESGCD, Basel, Switzerland
- Healthcare Associated Infections Research Group, Leeds Teaching Hospitals, Leeds, UK
| | - Benoit Guery
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Clostridioides difficile - ESGCD, Basel, Switzerland
- Service of Infectious Diseases, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Philippe Vanhems
- Infection Control Unit, Hôpital Edouard Herriot, Hospices Civils de Lyon (HCL), Lyon, France
- PHE3ID team, Centre International de Recherche en Infectiologie, Inserm U1111, CNRS UMR5308, ENS de Lyon, Lyon 1 University, Lyon, France
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4
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Elias C, Raad M, Rasoanandrasana S, Raherinandrasana AH, Andriananja V, Raberahona M, Moore CE, Randria M, Raskine L, Vanhems P, Babin FX. Implementation of an antibiotic resistance surveillance tool in Madagascar, the TSARA project: a prospective, observational, multicentre, hospital-based study protocol. BMJ Open 2024; 14:e078504. [PMID: 38508637 PMCID: PMC10953040 DOI: 10.1136/bmjopen-2023-078504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 03/08/2024] [Indexed: 03/22/2024] Open
Abstract
INTRODUCTION Antimicrobial resistance (AMR) has become a significant public health threat. Without any interventions, it has been modelled that AMR will account for an estimated 10 million deaths annually by 2050, this mainly affects low/middle-income countries. AMR has a systemic negative perspective affecting the overall healthcare system down to the patient's personal outcome. In response to this issue, the WHO urged countries to provide antimicrobial stewardship programmes (ASPs). ASPs in hospitals are a vital component of national action plans for AMR, and have been shown to significantly reduce AMR, in particular in low-income countries such as Madagascar.As part of an ASP, AMR surveillance provides essential information needed to guide medical practice. We developed an AMR surveillance tool-Technique de Surveillance Actualisée de la Résistance aux Antimicrobiens (TSARA)-with the support of the Mérieux Foundation. TSARA combines bacteriological and clinical information to provide a better understanding of the scope and the effects of AMR in Madagascar, where no such surveillance tool exists. METHODS AND ANALYSIS A prospective, observational, hospital-based study was carried out for data collection using a standardised data collection tool, called TSARA deployed in 2023 in 10 hospitals in Madagascar participating in the national Malagasy laboratory network (Réseau des Laboratoires à Madagascar (RESAMAD)). Any hospitalised patient where the clinician decided to take a bacterial sample is included. As a prospective study, individual isolate-level data and antimicrobial susceptibility information on pathogens were collected routinely from the bacteriology laboratory and compiled with clinical information retrieved from face-to-face interviews with the patient and completed using medical records where necessary. Analysis of the local ecology, resistance rates and antibiotic prescription patterns were collected. ETHICS AND DISSEMINATION This protocol obtained ethical approval from the Malagasy Ethical Committee n°07-MSANP/SG/AGMED/CNPV/CERBM on 24 January 2023. Findings generated were shared with national health stakeholders, microbiologists, members of the RESAMAD network and the Malagasy academic society of infectious diseases.
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Affiliation(s)
- Christelle Elias
- Service Hygiène et Epidémiologie, Hospices Civils de Lyon, Lyon, France
- Public Health, Epidemiology & Evolutionary Ecology of Infectious Diseases (PHE3ID) team, Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Mathieu Raad
- Direction des Opérations Internationales, Fondation Mérieux, Lyon, France
| | | | | | | | - Mihaja Raberahona
- Service des Maladies Infectieuses, Hôpital Befelatanana, Antananarivo, Madagascar
| | - Catrin E Moore
- Centre for Neonatal and Paediatric Infection, St. George's, University of London, London, UK
| | - Mamy Randria
- Service de Biologie, Hôpital Befelatanana, Antananarivo, Madagascar
| | - Laurent Raskine
- Direction des Opérations Internationales, Fondation Mérieux, Lyon, France
| | - Philippe Vanhems
- Service Hygiène et Epidémiologie, Hospices Civils de Lyon, Lyon, France
- Public Health, Epidemiology & Evolutionary Ecology of Infectious Diseases (PHE3ID) team, Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, Université Claude Bernard Lyon 1, Lyon, France
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5
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Shirreff G, Huynh BT, Duval A, Pereira LC, Annane D, Dinh A, Lambotte O, Bulifon S, Guichardon M, Beaune S, Toubiana J, Kermorvant-Duchemin E, Chéron G, Cordel H, Argaud L, Douplat M, Abraham P, Tazarourte K, Martin-Gaujard G, Vanhems P, Hilliquin D, Nguyen D, Chelius G, Fraboulet A, Temime L, Opatowski L, Guillemot D. Assessing respiratory epidemic potential in French hospitals through collection of close contact data (April-June 2020). Sci Rep 2024; 14:3702. [PMID: 38355640 PMCID: PMC10866902 DOI: 10.1038/s41598-023-50228-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 12/17/2023] [Indexed: 02/16/2024] Open
Abstract
The transmission risk of SARS-CoV-2 within hospitals can exceed that in the general community because of more frequent close proximity interactions (CPIs). However, epidemic risk across wards is still poorly described. We measured CPIs directly using wearable sensors given to all present in a clinical ward over a 36-h period, across 15 wards in three hospitals in April-June 2020. Data were collected from 2114 participants and combined with a simple transmission model describing the arrival of a single index case to the ward to estimate the risk of an outbreak. Estimated epidemic risk ranged four-fold, from 0.12 secondary infections per day in an adult emergency to 0.49 per day in general paediatrics. The risk presented by an index case in a patient varied 20-fold across wards. Using simulation, we assessed the potential impact on outbreak risk of targeting the most connected individuals for prevention. We found that targeting those with the highest cumulative contact hours was most impactful (20% reduction for 5% of the population targeted), and on average resources were better spent targeting patients. This study reveals patterns of interactions between individuals in hospital during a pandemic and opens new routes for research into airborne nosocomial risk.
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Affiliation(s)
- George Shirreff
- Institut Pasteur, Epidemiology and Modelling of Antibiotic Evasion, Université Paris Cité, Paris, France
- UVSQ, Inserm, CESP, Anti-Infective Evasion and Pharmacoepidemiology Team, Université Paris-Saclay, Montigny-Le-Bretonneux, France
- Modélisation, Épidémiologie Et Surveillance Des Risques Sanitaires (MESuRS), Conservatoire National Des Arts Et Métiers, Paris, France
| | - Bich-Tram Huynh
- Institut Pasteur, Epidemiology and Modelling of Antibiotic Evasion, Université Paris Cité, Paris, France
- UVSQ, Inserm, CESP, Anti-Infective Evasion and Pharmacoepidemiology Team, Université Paris-Saclay, Montigny-Le-Bretonneux, France
| | - Audrey Duval
- Institut Pasteur, Epidemiology and Modelling of Antibiotic Evasion, Université Paris Cité, Paris, France
| | - Lara Cristina Pereira
- Institut Pasteur, Epidemiology and Modelling of Antibiotic Evasion, Université Paris Cité, Paris, France
| | - Djillali Annane
- IHU PROMETHEUS, Raymond Poincaré Hospital (APHP), INSERM, Université Paris Saclay Campus Versailles, Paris, France
| | - Aurélien Dinh
- Service de Maladies Infectieuses Et Tropicales, AP-HP. Paris Saclay, Hôpital Raymond Poincaré, Garches, France
| | - Olivier Lambotte
- Service de Médecine Interne Et Immunologie Clinique, AP-HP. Paris Saclay, Hôpital de Bicêtre, Le Kremlin Bicêtre, France
- UMR1184, IMVA-HB, Inserm, CEA, Université Paris Saclay, Le Kremlin Bicêtre, France
| | - Sophie Bulifon
- Service de Pneumologie, AP-HP. Paris Saclay, Hôpital de Bicêtre, Le Kremlin Bicêtre, France
| | - Magali Guichardon
- Service de Gériatrie, AP-HP. Paris Saclay, Hôpital Paul Brousse, Villejuif, France
| | - Sebastien Beaune
- Service Des Urgences Adultes, AP-HP. Paris Saclay, Hôpital Ambroise Paré, Boulogne-Billancourt, France
| | - Julie Toubiana
- Service de Pédiatrie Générale, AP-HP. Centre - Université Paris Cité, Hôpital Necker-Enfants Malades, Paris, France
| | - Elsa Kermorvant-Duchemin
- Service de Réanimation Néonatale, AP-HP. Centre - Université Paris Cité, Hôpital Necker-Enfants Malades, Paris, France
| | - Gerard Chéron
- Service Des Urgences Pédiatriques, AP-HP. Centre - Université Paris Cité, Hôpital Necker-Enfants Malades, Paris, France
| | - Hugues Cordel
- Service de Maladies Infectieuses Et Tropicales, AP-HP. Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Bobigny, France
| | - Laurent Argaud
- Service de Réanimation Adulte, Hospices Civils de Lyon - Université Claude Bernard, Hôpital Edouard Herriot, Lyon, France
| | - Marion Douplat
- Service Des Urgences Adultes, Hospices Civils de Lyon - Université Claude Bernard, Hôpital Lyon Sud, Pierre-Bénite, France
| | - Paul Abraham
- Service d'Anesthésie-Réanimation, Hospices Civils de Lyon - Université Claude Bernard, Hôpital Edouard Herriot, Lyon, France
| | - Karim Tazarourte
- Service Des Urgences Adultes, Hospices Civils de Lyon - Université Claude Bernard, Hôpital Edouard Herriot, Lyon, France
| | - Géraldine Martin-Gaujard
- Service de Gériatrie, Hospices Civils de Lyon - Université Claude Bernard, Hôpital Edouard Herriot, Lyon, France
| | - Philippe Vanhems
- Service Hygiène, Épidémiologie, Infectiovigilance Et Prévention, Hospices Civils de Lyon - Université Claude Bernard, Lyon, France
- Centre International de Recherche en Infectiologie, Team Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID), Univ Lyon, Inserm, U1111, CNRS, UMR5308, ENS de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Delphine Hilliquin
- Service Hygiène, Épidémiologie, Infectiovigilance Et Prévention, Hospices Civils de Lyon - Université Claude Bernard, Lyon, France
| | - Duc Nguyen
- Service Des Maladies Infectieuses Et Tropicales, CHU de Bordeaux, Hôpital Pellegrin, Bordeaux, France
| | | | | | - Laura Temime
- Modélisation, Épidémiologie Et Surveillance Des Risques Sanitaires (MESuRS), Conservatoire National Des Arts Et Métiers, Paris, France
- PACRI Unit, Conservatoire National Des Arts Et Métiers, Institut Pasteur, Paris, France
| | - Lulla Opatowski
- Institut Pasteur, Epidemiology and Modelling of Antibiotic Evasion, Université Paris Cité, Paris, France
- UVSQ, Inserm, CESP, Anti-Infective Evasion and Pharmacoepidemiology Team, Université Paris-Saclay, Montigny-Le-Bretonneux, France
| | - Didier Guillemot
- Institut Pasteur, Epidemiology and Modelling of Antibiotic Evasion, Université Paris Cité, Paris, France.
- UVSQ, Inserm, CESP, Anti-Infective Evasion and Pharmacoepidemiology Team, Université Paris-Saclay, Montigny-Le-Bretonneux, France.
- Department of Public Health, Medical Information, Clinical Research, AP-HP. Paris Saclay, Paris, France.
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Bangoura ST, Diallo BD, Diaby M, Camara A, Hounmenou CG, Magassouba AS, Kadio KJJO, Vanhems P, Touré A, Khanafer N. Predictors of Death in Rifampicin Resistant Tuberculosis Patients Treated with the Short Course in Conakry, Guinea. Am J Trop Med Hyg 2024; 110:117-122. [PMID: 37956449 DOI: 10.4269/ajtmh.23-0190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 09/17/2023] [Indexed: 11/15/2023] Open
Abstract
The emergence of rifampicin-resistant tuberculosis (RR-TB) is a major issue for TB control programs due to high risk of treatment failure and death. The objective of this study was to describe survival and to determine predictors of death in RR-TB patients treated with the short regimen (9-11 months) in the Conakry TB treatment centers. Sociodemographic, clinical, and survival data were collected prospectively between 2016 and 2021 on RR-TB patients in the Department of Pneumo-Phtisiology, the Carrière and the Tombolia TB centers. The Kaplan-Meier method was used to estimate the cumulative incidence of death of patients. The Cox regression model was used to identify the predictors independently associated with death. Of 869 patients, 164 (18.9%) patients died during treatment, 126 of them within 120 days of treatment initiation. The factors associated with death during treatment were as follows: patients treated in the Carrière TB center (adjusted hazard ratio [aHR] = 1.65; 95% CI: 1.06-2.59) and in the Department of Pneumo-Phtisiology (aHR = 3.26; 95% CI: 2.10-5.07), patients ≥ 55 years old (aHR = 4.80; 95% CI: 2.81-8.19), patients with no history of first-line TB treatment (aHR = 1.51; 95% CI: 1.05-2.16), and patients living with HIV (aHR = 2.81; 95% CI: 1.94-4.07). The results of this study can help the national TB control program to reconsider its therapeutic strategy to improve patient care in case of RR-TB. Large prospective clinical studies should be conducted to provide evidence of the impact of such factors like previous history of TB treatment and HIV infection on survival of RR-TB patients.
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Affiliation(s)
- Salifou Talassone Bangoura
- Centre de Recherche et de Formation en Infectiologie de Guinée, Gamal Abdel Nasser University, Conakry, Republic of Guinea
- Département de Santé Publique, Gamal Abdel Nasser University, Conakry, Republic of Guinea
- Département des Sciences Pharmaceutiques et Biologiques, Gamal Abdel Nasser University, Conakry, Republic of Guinea
| | - Boubacar Djelo Diallo
- Programme National de Lutte Antituberculeuse, Conakry, Republic of Guinea
- Service de Pneumo-Phtisiologie, Hôpital National Ignace Deen, Conakry, Republic of Guinea
| | - Maladho Diaby
- Centre de Recherche et de Formation en Infectiologie de Guinée, Gamal Abdel Nasser University, Conakry, Republic of Guinea
| | - Alioune Camara
- Centre de Recherche et de Formation en Infectiologie de Guinée, Gamal Abdel Nasser University, Conakry, Republic of Guinea
- Département de Santé Publique, Gamal Abdel Nasser University, Conakry, Republic of Guinea
| | - Castro Gbêmêmali Hounmenou
- Centre de Recherche et de Formation en Infectiologie de Guinée, Gamal Abdel Nasser University, Conakry, Republic of Guinea
| | | | - Kadio Jean-Jacques Olivier Kadio
- Centre de Recherche et de Formation en Infectiologie de Guinée, Gamal Abdel Nasser University, Conakry, Republic of Guinea
- Département de Santé Publique, Gamal Abdel Nasser University, Conakry, Republic of Guinea
- Département des Sciences Pharmaceutiques et Biologiques, Gamal Abdel Nasser University, Conakry, Republic of Guinea
| | - Philippe Vanhems
- Santé Publique, Epidémiologie et Ecologie Evolutive des Maladies Infectieuses, Centre international de recherche en infectiologie, INSERM-U1111-UCBL Lyon 1-ENS Lyon, France
- Service d'Hygiène, Épidémiologie, Infectiovigilance et Prévention, Edouard Herriot Hospital, Hospices Civils de Lyon, France
| | - Abdoulaye Touré
- Centre de Recherche et de Formation en Infectiologie de Guinée, Gamal Abdel Nasser University, Conakry, Republic of Guinea
- Département de Santé Publique, Gamal Abdel Nasser University, Conakry, Republic of Guinea
- Département des Sciences Pharmaceutiques et Biologiques, Gamal Abdel Nasser University, Conakry, Republic of Guinea
| | - Nagham Khanafer
- Santé Publique, Epidémiologie et Ecologie Evolutive des Maladies Infectieuses, Centre international de recherche en infectiologie, INSERM-U1111-UCBL Lyon 1-ENS Lyon, France
- Service d'Hygiène, Épidémiologie, Infectiovigilance et Prévention, Edouard Herriot Hospital, Hospices Civils de Lyon, France
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Diarra YM, Wimba PM, Katchunga PB, Bengehya J, Miganda B, Oyimangirwe M, Tshilolo L, Ahuka SM, Iwaz J, Étard JF, Écochard R, Vanhems P, Rabilloud M. Estimating the number of probable new SARS-CoV-2 infections among tested subjects from the number of confirmed cases. BMC Med Res Methodol 2023; 23:272. [PMID: 37978439 PMCID: PMC10655282 DOI: 10.1186/s12874-023-02077-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 10/20/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVES In most African countries, confirmed COVID-19 case counts underestimate the number of new SARS-CoV-2 infection cases. We propose a multiplying factor to approximate the number of biologically probable new infections from the number of confirmed cases. METHODS Each of the first thousand suspect (or alert) cases recorded in South Kivu (DRC) between 29 March and 29 November 2020 underwent a RT-PCR test and an IgM and IgG serology. A latent class model and a Bayesian inference method were used to estimate (i) the incidence proportion of SARS-CoV-2 infection using RT-PCR and IgM test results, (ii) the prevalence using RT-PCR, IgM and IgG test results; and, (iii) the multiplying factor (ratio of the incidence proportion on the proportion of confirmed -RT-PCR+- cases). RESULTS Among 933 alert cases with complete data, 218 (23%) were RT-PCR+; 434 (47%) IgM+; 464 (~ 50%) RT-PCR+, IgM+, or both; and 647 (69%) either IgG + or IgM+. The incidence proportion of SARS-CoV-2 infection was estimated at 58% (95% credibility interval: 51.8-64), its prevalence at 72.83% (65.68-77.89), and the multiplying factor at 2.42 (1.95-3.01). CONCLUSIONS In monitoring the pandemic dynamics, the number of biologically probable cases is also useful. The multiplying factor helps approximating it.
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Affiliation(s)
- Y M Diarra
- Université de Lyon, Lyon, France.
- Université Claude Bernard Lyon 1, Villeurbanne, France.
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.
- Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, CNRS UMR 5558, Villeurbanne, France.
| | - P M Wimba
- Université de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
- Université Officielle de Bukavu, Democratic Republic of the Congo, Bukavu, Congo
- Cliniques Universitaires de Bukavu, Democratic Republic of the Congo, Bukavu, Congo
- Centre International de Recherche en Infectiologie (CIRI), INSERM U1111-CNRS UMR 5308, Lyon, France
| | - P B Katchunga
- Université Officielle de Bukavu, Democratic Republic of the Congo, Bukavu, Congo
- Cliniques Universitaires de Bukavu, Democratic Republic of the Congo, Bukavu, Congo
| | - J Bengehya
- Université Officielle de Mbujimayi (UOM), Mbuji-Mayi, Democratic Republic of the Congo
| | - B Miganda
- Bureau Information Sanitaire, Division provinciale de la Santé Sud-Kivu, Democratic Republic of the Congo, Bukavu, Congo
| | - M Oyimangirwe
- Université Officielle de Bukavu, Democratic Republic of the Congo, Bukavu, Congo
| | - L Tshilolo
- Université Officielle de Mbujimayi (UOM), Mbuji-Mayi, Democratic Republic of the Congo
| | - S M Ahuka
- Department of Virology, National Institute for Biomedical Research (INRB), Democratic Republic of the Congo, Kinshasa, Congo
- Service of Microbiology, Department of Medical Biology, Kinshasa teaching School of Medecine, Faculty of Medecine, University of Kinshasa, Democratic Republic of the Congo, Kinshasa, Congo
| | - J Iwaz
- Université de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, CNRS UMR 5558, Villeurbanne, France
| | - J F Étard
- IRD UMI 233, INSERM U1175, Université de Montpellier, Unité TransVIHMI, Montpellier, France
- EpiGreen, Paris, France
| | - R Écochard
- Université de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, CNRS UMR 5558, Villeurbanne, France
| | - P Vanhems
- Université de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
- Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, CNRS UMR 5558, Villeurbanne, France
- Centre International de Recherche en Infectiologie (CIRI), INSERM U1111-CNRS UMR 5308, Lyon, France
- Service d'Hygiène Hospitalière, Infectiovigilance et Prévention, Hospices Civils de Lyon, Épidémiologie, Lyon, France
| | - M Rabilloud
- Université de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, CNRS UMR 5558, Villeurbanne, France
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8
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Khanafer N, Henaff L, Bennia S, Termoz A, Chapurlat R, Escuret V, Proriol M, Duvert F, Mena C, Planckaert C, Trehet-Mandez N, Saadatian-Elahi M, Vanhems P. Factors Associated with Long COVID-19 in a French Multicentric Prospective Cohort Study. Int J Environ Res Public Health 2023; 20:6678. [PMID: 37681818 PMCID: PMC10488030 DOI: 10.3390/ijerph20176678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/16/2023] [Accepted: 08/24/2023] [Indexed: 09/09/2023]
Abstract
(1) Background: A substantial proportion of COVID-19 patients continue to experience long-lasting effects that hamper their quality of life. The objectives of this study were (1) to report the prevalence of persistent clinical symptoms 6-12 months after the onset of COVID-19 and (2) to identify potential factors at admission associated with the occurrence of long COVID. (2) Methods: A prospective study was conducted among COVID-19 adult patients, hospitalized in four French university hospitals. Patients were invited to two ambulatory follow-up medical visits, 6-8 months (visit #1) and one year (visit #2) after the onset of their COVID-19. A multivariate logistic regression was performed to assess factors associated with long COVID. (3) Results: In total, 189 patients participated in this study (mean age of 63.4 years). BMI > 30 kg/m2 (aOR 3.52), AST levels between 31 and 42 U/L (aOR 8.68), and AST levels > 42 U/L (aOR 3.69) were associated with persistent clinical symptoms at visit #1. Anosmia (aOR 13.34), AST levels between 31 and 42 U/L (aOR 10.27), stay in ICU (aOR 5.43), pain (aOR 4.31), and longer time before hospitalization (aOR 1.14) were significantly associated with persistent clinical symptoms at visit #2. Patients with ageusia (aOR 0.17) had a lower risk of long COVID. (4) Conclusions: This study showed that some patients experienced persistent clinical symptoms one year after COVID-19 onset that were associated with some determinants at the acute phase/stage.
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Affiliation(s)
- Nagham Khanafer
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, Lyon 1 University, CEDEX 07, 69364 Lyon, France; (L.H.); (M.S.-E.); (P.V.)
- Department of Hygiene, Epidemiology, and Prevention, Edouard Herriot Hospital, Hospices Civils de Lyon, 69003 Lyon, France;
| | - Laetitia Henaff
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, Lyon 1 University, CEDEX 07, 69364 Lyon, France; (L.H.); (M.S.-E.); (P.V.)
| | - Sabrina Bennia
- Department of Hygiene, Epidemiology, and Prevention, Edouard Herriot Hospital, Hospices Civils de Lyon, 69003 Lyon, France;
| | - Anne Termoz
- Service Recherche et Epidémiologie Cliniques, Hospices Civils de Lyon, Pôle Santé Publique, 69003 Lyon, France;
| | - Roland Chapurlat
- Department of Rheumatology, Edouard Herriot University Hospital, Hospices Civils de Lyon, 69003 Lyon, France; (R.C.); (M.P.)
- INSERM UMR 1033, University of Lyon, 69003 Lyon, France; (F.D.); (C.M.); (C.P.); (N.T.-M.)
- Prévention des Maladies Osseuses, Edouard Herriot Hospital, Hospices Civils de Lyon, 69003 Lyon, France
| | - Vanessa Escuret
- Institut des Agents Infectieux, Hospices Civils de Lyon, 69317 Lyon, France;
| | - Mathilde Proriol
- Department of Rheumatology, Edouard Herriot University Hospital, Hospices Civils de Lyon, 69003 Lyon, France; (R.C.); (M.P.)
| | - Florence Duvert
- INSERM UMR 1033, University of Lyon, 69003 Lyon, France; (F.D.); (C.M.); (C.P.); (N.T.-M.)
- Prévention des Maladies Osseuses, Edouard Herriot Hospital, Hospices Civils de Lyon, 69003 Lyon, France
| | - Camille Mena
- INSERM UMR 1033, University of Lyon, 69003 Lyon, France; (F.D.); (C.M.); (C.P.); (N.T.-M.)
- Prévention des Maladies Osseuses, Edouard Herriot Hospital, Hospices Civils de Lyon, 69003 Lyon, France
| | - Catherine Planckaert
- INSERM UMR 1033, University of Lyon, 69003 Lyon, France; (F.D.); (C.M.); (C.P.); (N.T.-M.)
- Prévention des Maladies Osseuses, Edouard Herriot Hospital, Hospices Civils de Lyon, 69003 Lyon, France
| | - Nadège Trehet-Mandez
- INSERM UMR 1033, University of Lyon, 69003 Lyon, France; (F.D.); (C.M.); (C.P.); (N.T.-M.)
- Prévention des Maladies Osseuses, Edouard Herriot Hospital, Hospices Civils de Lyon, 69003 Lyon, France
| | - Mitra Saadatian-Elahi
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, Lyon 1 University, CEDEX 07, 69364 Lyon, France; (L.H.); (M.S.-E.); (P.V.)
| | - Philippe Vanhems
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, Lyon 1 University, CEDEX 07, 69364 Lyon, France; (L.H.); (M.S.-E.); (P.V.)
- Department of Hygiene, Epidemiology, and Prevention, Edouard Herriot Hospital, Hospices Civils de Lyon, 69003 Lyon, France;
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Conrad A, Valour F, Vanhems P. Burden of influenza in the elderly: a narrative review. Curr Opin Infect Dis 2023; 36:296-302. [PMID: 37431557 DOI: 10.1097/qco.0000000000000931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
PURPOSE OF REVIEW This review provides an update on specificities of influenza in older adults (≥65-year-old), including epidemiology, burden in terms of hospitalization and mortality, extra-respiratory complications and specific challenges of prevention. RECENT FINDINGS In the past 2 years, influenza activity was drastically reduced by barrier measures implemented during the COVID-19 pandemic. A recent French epidemiological study covering 2010-2018 epidemic seasons estimated that 75% of costs induced by influenza-associated hospitalizations and complications were attributable to older adults, a population bearing more than 90% of influenza-associated excess mortality.In addition to their age, comorbidities and reduced vaccine response, long-term facility residents are at risk for nosocomial outbreaks. Beyond respiratory complications, influenza triggers acute myocardial infarction and ischemic stroke. Influenza might drive significant functional loss in frail older adults, which can lead to "catastrophic" or severe disability in up to 10% of patients. Vaccination remains the cornerstone of prevention, with enhanced immunization strategies (i.e., high-dose or adjuvanted formulations) to be largely implemented in older adults. Efforts to increase influenza vaccination uptake during the COVID-19 pandemic should be consolidated. SUMMARY Burden of influenza in the elderly is largely under-recognized, especially the cardiovascular complications and the impact on functional status, justifying more effective preventive strategies.
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Affiliation(s)
- Anne Conrad
- Service des maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon
- CIRI - Centre International de Recherche en Infectiologie, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon
| | - Florent Valour
- Service des maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon
- CIRI - Centre International de Recherche en Infectiologie, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon
| | - Philippe Vanhems
- CIRI - Centre International de Recherche en Infectiologie, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon
- Service d'Hygiène, Épidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France
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10
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Saadatian-Elahi M, Henaff L, Elias C, Nunes MC, Hot A, Martin-Gaujard G, Escuret V, Amour S, Vanhems P. Patient influenza vaccination reduces the risk of hospital-acquired influenza: An incident test negative-case control study in Lyon university hospital, France (2004-2020). Vaccine 2023; 41:4341-4346. [PMID: 37321894 DOI: 10.1016/j.vaccine.2023.05.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 05/02/2023] [Accepted: 05/26/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Literature is limited on the impact of patient vaccination on the risk of hospital-acquired influenza (HAI). This test negative case-control study nested in a surveillance program aimed at evaluating the effectiveness of influenza vaccination in reducing the risk of HAI in hospitalized patients during 15 influenza seasons (2004-05 to 2019-20). METHODS HAI cases were those who developed influenza like illness (ILI) symptoms at least 72 h after hospitalization and had a positive reverse transcriptase-polymerase chain reaction (RT-PCR). Controls were those with ILI symptoms and a negative RT-PCR test. A nasal swab as well as socio-demographic, clinical data and information on influenza vaccination were collected. RESULTS Of the 296 patients included, 67 were confirmed HAI cases. Influenza vaccine coverage was significantly higher among controls compared to HAI cases (p = 0.002). The risk of HAI was reduced by almost 60 % in vaccinated patients. CONCLUSIONS A better control of HAI can be achieved by vaccinating hospitalized patients.
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Affiliation(s)
- Mitra Saadatian-Elahi
- Service Hygiène, Epidémiologie et Prévention, Centre Hospitalier Hôpital Eduard Herriot, Hospices Civils de Lyon, 69437 Lyon Cedex, France; CIRI, Centre International de Recherche en Infectiologie, (Team Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID)), Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007 Lyon, France
| | - Laetitia Henaff
- Service Hygiène, Epidémiologie et Prévention, Centre Hospitalier Hôpital Eduard Herriot, Hospices Civils de Lyon, 69437 Lyon Cedex, France; CIRI, Centre International de Recherche en Infectiologie, (Team Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID)), Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007 Lyon, France
| | - Christelle Elias
- Service Hygiène, Epidémiologie et Prévention, Centre Hospitalier Hôpital Eduard Herriot, Hospices Civils de Lyon, 69437 Lyon Cedex, France; CIRI, Centre International de Recherche en Infectiologie, (Team Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID)), Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007 Lyon, France
| | - Marta C Nunes
- CIRI, Centre International de Recherche en Infectiologie, (Team Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID)), Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007 Lyon, France; Centre for Excellence in Respiratory Pathogens, Hospices Civils de Lyon, Lyon, France; South African Medical Research Council, Vaccines & Infectious Diseases Analytics Research Unit, and Department of Science and Technology/National Research Foundation, South African Research Chair Initiative in Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Arnaud Hot
- Internal Medicine, University Hospital Edouard Herriot, Hospices Civils de Lyon, France
| | | | - Vanessa Escuret
- Laboratoire de Virologie, Institut des Agents Infectieux, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France; Virpath - Grippe, de l'émergence au contrôle, Centre International de Recherche en Infectiologie (CIRI), Inserm U111, CNRS 5308, ENS, UCBL1, Faculté de Médecine RTH Laënnec, Lyon, France
| | - Selilah Amour
- Service Hygiène, Epidémiologie et Prévention, Centre Hospitalier Hôpital Eduard Herriot, Hospices Civils de Lyon, 69437 Lyon Cedex, France; CIRI, Centre International de Recherche en Infectiologie, (Team Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID)), Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007 Lyon, France
| | - Philippe Vanhems
- Service Hygiène, Epidémiologie et Prévention, Centre Hospitalier Hôpital Eduard Herriot, Hospices Civils de Lyon, 69437 Lyon Cedex, France; CIRI, Centre International de Recherche en Infectiologie, (Team Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID)), Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007 Lyon, France.
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11
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Gustin MP, Pujo-Menjouet L, Vanhems P. Influenza transmissibility among patients and health-care professionals in a geriatric short-stay unit using individual contact data. Sci Rep 2023; 13:10547. [PMID: 37386032 PMCID: PMC10310843 DOI: 10.1038/s41598-023-36908-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 06/12/2023] [Indexed: 07/01/2023] Open
Abstract
Detailed information are lacking on influenza transmissibility in hospital although clusters are regularly reported. In this pilot study, our goal was to estimate the transmission rate of H3N2 2012-influenza, among patients and health care professionals in a short-term Acute Care for the Elderly Unit by using a stochastic approach and a simple susceptible-exposed-infectious-removed model. Transmission parameters were derived from documented individual contact data collected by Radio Frequency IDentification technology at the epidemic peak. From our model, nurses appeared to transmit infection to a patient more frequently with a transmission rate of 1.04 per day on average compared to 0.38 from medical doctors. This transmission rate was 0.34 between nurses. These results, even obtained in this specific context, might give a relevant insight of the influenza dynamics in hospitals and will help to improve and to target control measures for preventing nosocomial transmission of influenza. The investigation of nosocomial transmission of SARS-COV-2 might gain from similar approaches.
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Affiliation(s)
- Marie-Paule Gustin
- Department of Public Health, Institute of Pharmacy, CIRI-Centre International de Recherche en Infectiologie, Inserm, U1111, CNRS, UMR 5308, ENS Lyon, Equipe PHIE3D, University Lyon, University Claude Bernard Lyon 1, 7 Rue Guillaume Paradin, 69372, Lyon, France
| | - Laurent Pujo-Menjouet
- University of Lyon, University Claude Bernard Lyon 1, CNRS UMR5208, Inria, Dracula Team, Institut Camille Jordan, 69622, Villeurbanne, France.
| | - Philippe Vanhems
- Hospices Civils de Lyon, Service Hygiène, CIRI-Centre International de Recherche en Infectiologie, Université Lyon, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Lyon, France
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12
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Andrew MK, Pott H, Staadegaard L, Paget J, Chaves SS, Ortiz JR, McCauley J, Bresee J, Nunes MC, Baumeister E, Raboni SM, Giamberardino HIG, McNeil SA, Gomez D, Zhang T, Vanhems P, Koul PA, Coulibaly D, Otieno NA, Dbaibo G, Almeida MLG, Laguna-Torres VA, Drăgănescu AC, Burtseva E, Sominina A, Danilenko D, Medić S, Diez-Domingo J, Lina B. Age Differences in Comorbidities, Presenting Symptoms, and Outcomes of Influenza Illness Requiring Hospitalization: A Worldwide Perspective From the Global Influenza Hospital Surveillance Network. Open Forum Infect Dis 2023; 10:ofad244. [PMID: 37383245 PMCID: PMC10296081 DOI: 10.1093/ofid/ofad244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/26/2023] [Indexed: 06/30/2023] Open
Abstract
Background The Global Influenza Hospital Surveillance Network (GIHSN) was established in 2012 to conduct coordinated worldwide influenza surveillance. In this study, we describe underlying comorbidities, symptoms, and outcomes in patients hospitalized with influenza. Methods Between November 2018 and October 2019, GIHSN included 19 sites in 18 countries using a standardized surveillance protocol. Influenza infection was laboratory-confirmed with reverse-transcription polymerase chain reaction. A multivariate logistic regression model was utilized to analyze the extent to which various risk factors predict severe outcomes. Results Of 16 022 enrolled patients, 21.9% had laboratory-confirmed influenza; 49.2% of influenza cases were A/H1N1pdm09. Fever and cough were the most common symptoms, although they decreased with age (P < .001). Shortness of breath was uncommon among those <50 years but increased with age (P < .001). Middle and older age and history of underlying diabetes or chronic obstructive pulmonary disease were associated with increased odds of death and intensive care unit (ICU) admission, and male sex and influenza vaccination were associated with lower odds. The ICU admissions and mortality occurred across the age spectrum. Conclusions Both virus and host factors contributed to influenza burden. We identified age differences in comorbidities, presenting symptoms, and adverse clinical outcomes among those hospitalized with influenza and benefit from influenza vaccination in protecting against adverse clinical outcomes. The GIHSN provides an ongoing platform for global understanding of hospitalized influenza illness.
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Affiliation(s)
- Melissa K Andrew
- Correspondence: Melissa K. Andrew, MD, PhD, Department of Medicine (Geriatrics), Dalhousie University, 5955 Veterans Memorial Lane, Halifax, NS B3H 2E1, Canada (); Bruno Lina, Laboratoire de Virologie, Institut des Agents Infectieux (IAI), Hospices Civils de Lyon, 103 Grande Rue de la Croix-Rousse, Lyon, 69317 CEDEX 04, France ()
| | - Henrique Pott
- Dalhousie University and Canadian Center for Vaccinology, Halifax, Canada
- Department of Medicine, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Lisa Staadegaard
- Netherlands Institute for Health Care Research (Nivel), Utrecht, Netherlands
| | - John Paget
- Netherlands Institute for Health Care Research (Nivel), Utrecht, Netherlands
| | - Sandra S Chaves
- Foundation for Influenza Epidemiology, Fondation de France, Paris, France
| | - Justin R Ortiz
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - John McCauley
- WHO Collaborating Centre for Reference and Research on Influenza, Crick Institute, London, United Kingdom
| | - Joseph Bresee
- Centre for Vaccine Equity, Task Force for Global Health, Atlanta, Georgia, USA
| | - Marta C Nunes
- South African Medical Research Council, Vaccines & Infectious Diseases Analytics (VIDA) Research Unit, and Department of Science and Technology/National Research Foundation, South African Research Chair Initiative in Vaccine Preventable Diseases, Faculty of Health Sciences University of the Witwatersrand, Johannesburg, South Africa
| | - Elsa Baumeister
- National Reference Laboratory for Viral Respiratory Diseases, Virology Department, INEI-ANLIS, Buenos Aires, Argentina
| | - Sonia Mara Raboni
- Molecular Biology/Microbiology Research Laboratory, Universidade Federal do Paraná, Curitiba, Brazil
| | - Heloisa I G Giamberardino
- Epidemiology, Immunization and Infection Control Department—Hospital Pequeno Principe, Curitiba, Paraná, Brazil
| | - Shelly A McNeil
- Dalhousie University and Canadian Center for Vaccinology, Halifax, Canada
| | - Doris Gomez
- Grupo de Investigación UNIMOL, Facultad de Medicina, Universidad de Cartagena, Cartagena de Indias, Colombia
| | - Tao Zhang
- School of Public Health, Fudan University, Shanghai, China
| | | | | | - Daouda Coulibaly
- Institut National d'Hygiène Publique (INHP), Abidjan, Côte d’Ivoire
| | - Nancy A Otieno
- Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Ghassan Dbaibo
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
| | | | | | | | - Elena Burtseva
- FSBI “N.F. Gamaleya NRCEM” Ministry of Health of the Russian Federation (Federal Research Budgetary Institute “National Research Center of Epidemiology and Microbiology named after honorary academician N.F. Gamaleya), Moscow, Russia
| | - Anna Sominina
- Smorodintsev Research Institute of Influenza, St. Petersburg, Russia
| | - Daria Danilenko
- Smorodintsev Research Institute of Influenza, St. Petersburg, Russia
| | - Snežana Medić
- Institute of Public Health of Vojvodina, Novi Sad, Serbia
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | | | - Bruno Lina
- Correspondence: Melissa K. Andrew, MD, PhD, Department of Medicine (Geriatrics), Dalhousie University, 5955 Veterans Memorial Lane, Halifax, NS B3H 2E1, Canada (); Bruno Lina, Laboratoire de Virologie, Institut des Agents Infectieux (IAI), Hospices Civils de Lyon, 103 Grande Rue de la Croix-Rousse, Lyon, 69317 CEDEX 04, France ()
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13
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Tresson P, Quiquandon S, Rivoire E, Boibieux A, Vanhems P, Bordet M, Long A. American Society of Anesthesiologists-Physical Status Classification As An Independent Risk Factor of Surgical Site Infection After Infra-Inguinal Arterial Bypass. Ann Surg 2023; 277:e1157-e1163. [PMID: 35417113 DOI: 10.1097/sla.0000000000005182] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The present study aimed to assess whether high-risk American Society of Anesthesiologists (ASA)-Physical Status was an independent risk factor for the development of surgical site infection (SSI) after infra-inguinal lower extremity bypass (LEB). SUMMARY OF BACKGROUND DATA The ASA-Physical Status Classification System assesses the overall physical status preoperatively. ASA-Physical Status is associated with postoperative morbidity and mortality. However, limited data are available on how ASA-Physical Status Class affects the development of SSI after infra-inguinal LEB. METHODS Patients who had undergone infra-inguinal LEB from January 1, 2015 to December 31, 2018, for obliterative arteriopathy or popliteal aneurysm at our university hospital were included. SSI risk factors were identified using multivariable logistic regression. The length of hospital stay, major limb events (MALE), major adverse cardiovascular events (MACE), and all-cause mortality were compared for patients with SSI versus those without SSI 3 months and 1- year of follow-up after the index surgery. RESULTS Among the 267 patients included, 30 (11.2%) developed SSI during the 3-month period and 32 (12%) at 1 year. ASA-Physical Status ≥3 [odds ratio (OR): 3.7, 95% confidence interval CI) 1.5-11.1], emergency surgery (OR: 2.7, 95% CI 1.2-6.0), general anesthesia (OR: 2.8, 95% CI 1.3-6.1), and procedure performed by a junior surgeon (OR: 2.7, 95% CI 1.3-6.0) were independently associated with SSI. At 3 months and 1 year, SSI was significantly associated with MALE (including surgical wound debridement, subsequent thrombectomy, major amputation), length of hospital stay, and all-cause mortality. CONCLUSION The ASA-Physical Status should be considered in medical management when an infra-inguinal LEB is considered in frail patients, to prevent surgical complications.
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Affiliation(s)
- Philippe Tresson
- Hospices Civils de Lyon, Hôpital Louis Pradel, Service de Chirurgie Vasculaire et Endovasculaire, Bron cedex, France
- Centre rHodANien d'isChemie intEStinale (CHANCES Network), Hospices Civils de Lyon, France
| | - Samuel Quiquandon
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de Médecine Interne et de Médecine Vasculaire, Lyon cedex, France
- Université de Lyon, University Claude Bernard Lyon 1, Lyon, France
| | - Emeraude Rivoire
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de Médecine Interne et de Médecine Vasculaire, Lyon cedex, France
- Université de Lyon, University Claude Bernard Lyon 1, Lyon, France
| | - André Boibieux
- Centre de Référence des Infections Vasculaire Complexes (CRIVasc Network), Lyon, France
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Service des Maladies Infectieuses Lyon cedex, France
| | - Philippe Vanhems
- Hospices Civils de Lyon, Hopital Edouard Herriot, Service d'Hygiéne, Epidémiologie et Prévention, Lyon cedex, France
- CIRI, Centre International de Recherche en Infectiologie, Laboratoire des Pathogénes Emergents-Fondation Mérieux, Université Lyon, Inserm, ENS de Lyon, France
| | - Marine Bordet
- Hospices Civils de Lyon, Hôpital Louis Pradel, Service de Chirurgie Vasculaire et Endovasculaire, Bron cedex, France
- Université de Lyon, University Claude Bernard Lyon 1, Lyon, France
| | - Anne Long
- Centre rHodANien d'isChemie intEStinale (CHANCES Network), Hospices Civils de Lyon, France
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de Médecine Interne et de Médecine Vasculaire, Lyon cedex, France
- Université de Lyon, University Claude Bernard Lyon 1, Lyon, France
- Univ Lyon, University Lyon 1, Interuniversity Laboratory of Human Movement Biology EA7424, Team Atherosclerosis, Thrombosis and Physical Activity, Lyon, France
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14
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Rabilloud M, Elsensohn MH, Riche B, Voirin N, Bénet T, Porcu C, Iwaz J, Étard JF, Vanhems P, Écochard R. Stronger Impact of COVID-19 in Nursing Homes of a French Region During the Second Pandemic Wave. J Am Med Dir Assoc 2023:S1525-8610(23)00378-X. [PMID: 37156472 PMCID: PMC10121131 DOI: 10.1016/j.jamda.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 03/13/2023] [Accepted: 04/04/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVES Quantify the effects of characteristics of nursing homes and their surroundings on the spread of COVID-19 outbreaks and assess the changes in resident protection between the first 2 waves (March 1 to July 31 and August 1 to December 31, 2020). DESIGN An observational study was carried out on data on COVID-19 outbreaks extracted from a database that monitored the spread of the virus in nursing homes. SETTING AND PARTICIPANTS The study concerned all 937 nursing homes with >10 beds in Auvergne-Rhône-Alpes region, France. METHODS The rate of nursing homes with at least 1 outbreak and the cumulative number of deaths were modeled for each wave. RESULTS During the second (vs the first wave), the proportion of nursing homes that reported at least 1 outbreak was higher (70% vs 56%) and the cumulative number of deaths more than twofold (3348 vs 1590). The outbreak rate was significantly lower in public hospital-associated nursing homes than in private for-profit ones. During the second wave, it was lower in public and private not-for-profit nursing homes than in private for-profit ones. During the first wave, the probability of outbreak and the mean number of deaths increased with the number of beds (P < .001). During the second wave, the probability of outbreak remained stable in >80-bed institutions and, under proportionality assumption, the mean number of deaths was less than expected in >100-bed institutions. The outbreak rate and the cumulative number of deaths increased significantly with the increase in the incidence of hospitalization for COVID-19 in the surrounding populations. CONCLUSIONS AND IMPLICATIONS The outbreak in the nursing homes was stronger during the second than the first wave despite better preparedness and higher availabilities of tests and protective equipment. Solutions for insufficient staffing, inadequate rooming, and suboptimal functioning should be found before future epidemics.
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Affiliation(s)
- Muriel Rabilloud
- Université de Lyon, Lyon, France; Université Lyon 1, Lyon, France; Équipe Biostatistique-Santé, Laboratoire de Biométrie et Biologie Évolutive, CNRS UMR 5558, Villeurbanne, France; Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.
| | - Mad-Hélénie Elsensohn
- Université de Lyon, Lyon, France; Université Lyon 1, Lyon, France; Équipe Biostatistique-Santé, Laboratoire de Biométrie et Biologie Évolutive, CNRS UMR 5558, Villeurbanne, France; Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
| | - Benjamin Riche
- Université de Lyon, Lyon, France; Université Lyon 1, Lyon, France; Équipe Biostatistique-Santé, Laboratoire de Biométrie et Biologie Évolutive, CNRS UMR 5558, Villeurbanne, France; Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
| | - Nicolas Voirin
- Epidemiology and Modelling in Infectious Diseases (EPIMOD), Dompierre-sur-Veyle, France
| | - Thomas Bénet
- Santé Publique France, Auvergne-Rhône-Alpes Regional Office, Lyon, France
| | - Catherine Porcu
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
| | - Jean Iwaz
- Université de Lyon, Lyon, France; Université Lyon 1, Lyon, France; Équipe Biostatistique-Santé, Laboratoire de Biométrie et Biologie Évolutive, CNRS UMR 5558, Villeurbanne, France; Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
| | - Jean-François Étard
- TransVIHMI (Institut de Recherche pour le Développement, IRD, Institut National de la Santé et de la Recherche Médicale, INSERM, Université de Montpellier), Montpellier, France; EpiGreen, Paris, France
| | - Philippe Vanhems
- Service d'Hygiène Hospitalière, Épidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France; CIRI - Centre International de Recherche en Infectiologie, Univ Lyon, Université Claude Bernard Lyon1, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Lyon, France
| | - René Écochard
- Université de Lyon, Lyon, France; Université Lyon 1, Lyon, France; Équipe Biostatistique-Santé, Laboratoire de Biométrie et Biologie Évolutive, CNRS UMR 5558, Villeurbanne, France; Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
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15
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Hooli S, King C, McCollum ED, Colbourn T, Lufesi N, Mwansambo C, Gregory CJ, Thamthitiwat S, Cutland C, Madhi SA, Nunes MC, Gessner BD, Hazir T, Mathew JL, Addo-Yobo E, Chisaka N, Hassan M, Hibberd PL, Jeena P, Lozano JM, MacLeod WB, Patel A, Thea DM, Nguyen NTV, Zaman SM, Ruvinsky RO, Lucero M, Kartasasmita CB, Turner C, Asghar R, Banajeh S, Iqbal I, Maulen-Radovan I, Mino-Leon G, Saha SK, Santosham M, Singhi S, Awasthi S, Bavdekar A, Chou M, Nymadawa P, Pape JW, Paranhos-Baccala G, Picot VS, Rakoto-Andrianarivelo M, Rouzier V, Russomando G, Sylla M, Vanhems P, Wang J, Basnet S, Strand TA, Neuman MI, Arroyo LM, Echavarria M, Bhatnagar S, Wadhwa N, Lodha R, Aneja S, Gentile A, Chadha M, Hirve S, O'Grady KAF, Clara AW, Rees CA, Campbell H, Nair H, Falconer J, Williams LJ, Horne M, Qazi SA, Nisar YB. In-hospital mortality risk stratification in children aged under 5 years with pneumonia with or without pulse oximetry: A secondary analysis of the Pneumonia REsearch Partnership to Assess WHO REcommendations (PREPARE) dataset. Int J Infect Dis 2023; 129:240-250. [PMID: 36805325 PMCID: PMC10017350 DOI: 10.1016/j.ijid.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 02/01/2023] [Accepted: 02/05/2023] [Indexed: 02/17/2023] Open
Abstract
OBJECTIVES We determined the pulse oximetry benefit in pediatric pneumonia mortality risk stratification and chest-indrawing pneumonia in-hospital mortality risk factors. METHODS We report the characteristics and in-hospital pneumonia-related mortality of children aged 2-59 months who were included in the Pneumonia Research Partnership to Assess WHO Recommendations dataset. We developed multivariable logistic regression models of chest-indrawing pneumonia to identify mortality risk factors. RESULTS Among 285,839 children, 164,244 (57.5%) from hospital-based studies were included. Pneumonia case fatality risk (CFR) without pulse oximetry measurement was higher than with measurement (5.8%, 95% confidence interval [CI] 5.6-5.9% vs 2.1%, 95% CI 1.9-2.4%). One in five children with chest-indrawing pneumonia was hypoxemic (19.7%, 95% CI 19.0-20.4%), and the hypoxemic CFR was 10.3% (95% CI 9.1-11.5%). Other mortality risk factors were younger age (either 2-5 months [adjusted odds ratio (aOR) 9.94, 95% CI 6.67-14.84] or 6-11 months [aOR 2.67, 95% CI 1.71-4.16]), moderate malnutrition (aOR 2.41, 95% CI 1.87-3.09), and female sex (aOR 1.82, 95% CI 1.43-2.32). CONCLUSION Children with a pulse oximetry measurement had a lower CFR. Many children hospitalized with chest-indrawing pneumonia were hypoxemic and one in 10 died. Young age and moderate malnutrition were risk factors for in-hospital chest-indrawing pneumonia-related mortality. Pulse oximetry should be integrated in pneumonia hospital care for children under 5 years.
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Affiliation(s)
- Shubhada Hooli
- Division of Pediatric Emergency Medicine, Texas Children's Hospital/Baylor College of Medicine, Houston, United States of America
| | - Carina King
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden and Institute for Global Health, University College London, London, United Kingdom
| | - Eric D McCollum
- Global Program in Respiratory Sciences, Eudowood Division of Pediatric Respiratory Sciences, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, United States of America and Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America
| | - Tim Colbourn
- Institute for Global Health, University College London, London, United Kingdom
| | | | | | - Christopher J Gregory
- Division of Vector-Borne Diseases, US Centers for Disease Control and Prevention, Fort Collins, United States of America
| | - Somsak Thamthitiwat
- Division of Global Health Protection, Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Clare Cutland
- African Leadership in Vaccinology Expertise (Alive), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shabir Ahmed Madhi
- South African Medical Research Council: Vaccines and Infectious Diseases Analytics Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Marta C Nunes
- South African Medical Research Council: Vaccines and Infectious Diseases Analytics Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases Unit, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Tabish Hazir
- The Children's Hospital, (Retired), Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan (deceased)
| | - Joseph L Mathew
- Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Emmanuel Addo-Yobo
- Kwame Nkrumah University of Science & Technology/Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Noel Chisaka
- World Bank, Washington DC, United States of America
| | - Mumtaz Hassan
- The Children's Hospital, Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan (deceased)
| | - Patricia L Hibberd
- Department of Global Health, Boston University School of Public Health, Boston, United States of America
| | | | - Juan M Lozano
- Florida International University, Miami, United States of America
| | - William B MacLeod
- Department of Global Health, Boston University School of Public Health, Boston, United States of America
| | - Archana Patel
- Lata Medical Research Foundation, Nagpur and Datta Meghe Institute of Medical Sciences, Sawangi, India
| | - Donald M Thea
- Department of Global Health, Boston University School of Public Health, Boston, United States of America
| | | | - Syed Ma Zaman
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Raul O Ruvinsky
- Dirección de Control de Enfermedades Inmunoprevenibles, Ministerio de Salud de la Nación, Buenos Aires, Argentina
| | - Marilla Lucero
- Research Institute for Tropical Medicine, Manila, Philippines
| | - Cissy B Kartasasmita
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | | | - Rai Asghar
- Rawalpindi Medical College, Rawalpindi, Pakistan
| | | | - Imran Iqbal
- Combined Military Hospital Institute of Medical Sciences, Multan, Pakistan
| | - Irene Maulen-Radovan
- Instituto Nacional de Pediatria Division de Investigacion Insurgentes, Mexico City, Mexico
| | - Greta Mino-Leon
- Children's Hospital Dr Francisco de Ycaza Bustamante, Head of Department, Infectious diseases, Guayaquil, Ecuador
| | - Samir K Saha
- Child Health Research Foundation and Dhaka Shishu Hospital, Dhaka, Bangladesh
| | - Mathuram Santosham
- International Vaccine Access Center (IVAC), Department of International Health, Johns Hopkins University, Baltimore, United States of America
| | | | - Shally Awasthi
- King George's Medical University, Department of Pediatrics, Lucknow, India
| | | | - Monidarin Chou
- University of Health Sciences, Rodolph Mérieux Laboratory & Ministry of Environment, Phom Phen, Cambodia
| | - Pagbajabyn Nymadawa
- Mongolian Academy of Sciences, Academy of Medical Sciences, Ulaanbaatar, Mongolia
| | | | | | | | | | | | - Graciela Russomando
- Universidad Nacional de Asuncion, Departamento de Biología Molecular y Genética, Instituto de Investigaciones en Ciencias de la Salud, Asuncion, Paraguay
| | - Mariam Sylla
- Gabriel Touré Hospital, Department of Pediatrics, Bamako, Mali
| | - Philippe Vanhems
- Unité d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France and Centre International de Recherche en Infectiologie, Institut National de la Santé et de la Recherche Médicale U1111, CNRS Unité Mixte de Recherche 5308, École Nationale Supérieure de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Jianwei Wang
- Chinese Academy of Medical Sciences & Peking Union, Medical College Institute of Pathogen Biology, MOH Key Laboratory of Systems Biology of Pathogens and Dr Christophe Mérieux Laboratory, Beijing, China
| | - Sudha Basnet
- Center for Intervention Science in Maternal and Child Health, University of Bergen, Norway and Department of Pediatrics, Tribhuvan University Institute of Medicine, Nepal
| | - Tor A Strand
- Research Department, Innlandet Hospital Trust, Lillehammer, Norway
| | - Mark I Neuman
- Division of Emergency Medicine, Boston Children's Hospital, Harvard Medical School, Boston, United States of America
| | | | - Marcela Echavarria
- Clinical Virology Unit, Centro de Educación Médica e Investigaciones Clínicas, Mar del Plata, Argentina
| | | | - Nitya Wadhwa
- Translational Health Science and Technology Institute, Faridabad, India
| | - Rakesh Lodha
- All India Institute of Medical Sciences, New Delhi, India
| | - Satinder Aneja
- School of Medical Sciences & Research, Sharda University, Greater Noida, India
| | - Angela Gentile
- Department of Epidemiology, "R. Gutiérrez" Children's Hospital, Buenos Aires, Argentina
| | - Mandeep Chadha
- Former Scientist G, ICMR National Institute of Virology, Pune, India
| | | | - Kerry-Ann F O'Grady
- Australian Centre for Health Services Innovation, Queensland University of Technology, Kelvin Grove, Australia
| | - Alexey W Clara
- Centers for Disease Control, Central American Region, Guatemala City, Guatemala
| | - Chris A Rees
- Division of Pediatric Emergency Medicine, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, United States of America
| | - Harry Campbell
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, Scotland
| | - Harish Nair
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, Scotland
| | - Jennifer Falconer
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, Scotland
| | - Linda J Williams
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, Scotland
| | - Margaret Horne
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, Scotland
| | - Shamim A Qazi
- Department of Maternal, Newborn, Child, and Adolescent Health (Retired), World Health Organization, Geneva, Switzerland
| | - Yasir Bin Nisar
- Department of Maternal, Newborn, Child, and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland.
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Guibert N, Trepat K, Pozzetto B, Josset L, Fassier JB, Allatif O, Saker K, Brengel-Pesce K, Walzer T, Vanhems P, Trouillet-Assant S. A third vaccine dose equalises the levels of effectiveness and immunogenicity of heterologous or homologous COVID-19 vaccine regimens, Lyon, France, December 2021 to March 2022. Euro Surveill 2023; 28. [PMID: 37052679 PMCID: PMC10103547 DOI: 10.2807/1560-7917.es.2023.28.15.2200746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
BackgroundTo cope with the persistence of the COVID-19 epidemic and the decrease in antibody levels following vaccination, a third dose of vaccine has been recommended in the general population. However, several vaccine regimens had been used initially for the primary vaccination course, and the heterologous Vaxzevria/Comirnaty regimen had shown better efficacy and immunogenicity than the homologous Comirnaty/Comirnaty regimen.AimWe wanted to determine if this benefit was retained after a third dose of an mRNA vaccine.MethodsWe combined an observational epidemiological study of SARS-CoV-2 infections among vaccinated healthcare workers at the University Hospital of Lyon, France, with a prospective cohort study to analyse immunological parameters before and after the third mRNA vaccine dose.ResultsFollowing the second vaccine dose, heterologous vaccination regimens were more protective against infection than homologous regimens (adjusted hazard ratio (HR) = 1.88; 95% confidence interval (CI): 1.18-3.00; p = 0.008), but this was no longer the case after the third dose (adjusted HR = 0.86; 95% CI: 0.72-1.02; p = 0.082). Receptor-binding domain-specific IgG levels and serum neutralisation capacity against different SARS-CoV-2 variants were higher after the third dose than after the second dose in the homologous regimen group, but not in the heterologous group.ConclusionThe advantage conferred by heterologous vaccination was lost after the third dose in terms of both protection and immunogenicity. Immunological measurements 1 month after vaccination suggest that heterologous vaccination induces maximal immunity after the second dose, whereas the third dose is required to reach the same level in individuals with a homologous regimen.
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Affiliation(s)
- Nicolas Guibert
- Occupational Health and Medicine Department, Hospices Civils de Lyon, Université Claude Bernard Lyon1, Université Gustave Eiffel-IFSTTAR, UMRESTTE, UMR T_9405, Lyon University, Lyon, France
| | - Kylian Trepat
- Joint Research Unit Civils Hospices of Lyon-bioMérieux, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France
- CIRI - Centre International de Recherche en Infectiologie, Université de Lyon, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Jean Monnet de Saint-Etienne, Lyon, France
| | - Bruno Pozzetto
- Laboratoire des Agents infectieux et d'Hygiène, University Hospital of Saint-Etienne, Saint-Etienne, France
- CIRI - Centre International de Recherche en Infectiologie, Université de Lyon, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Jean Monnet de Saint-Etienne, Lyon, France
| | - Laurence Josset
- GenEPII sequencing platform, Institute of Infectious Agents, Hospices Civils de Lyon, Lyon, France
- Virology Laboratory, Institute of Infectious Agents, Laboratory Associated with the National Reference Centre for Respiratory Viruses, Hospices Civils de Lyon, Lyon, France
- CIRI - Centre International de Recherche en Infectiologie, Université de Lyon, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Jean Monnet de Saint-Etienne, Lyon, France
| | - Jean-Baptiste Fassier
- Occupational Health and Medicine Department, Hospices Civils de Lyon, Université Claude Bernard Lyon1, Université Gustave Eiffel-IFSTTAR, UMRESTTE, UMR T_9405, Lyon University, Lyon, France
| | - Omran Allatif
- CIRI - Centre International de Recherche en Infectiologie, Université de Lyon, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Jean Monnet de Saint-Etienne, Lyon, France
| | - Kahina Saker
- Joint Research Unit Civils Hospices of Lyon-bioMérieux, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France
| | - Karen Brengel-Pesce
- Joint Research Unit Civils Hospices of Lyon-bioMérieux, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France
| | - Thierry Walzer
- These authors contributed equally and share last authorship
- CIRI - Centre International de Recherche en Infectiologie, Université de Lyon, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Jean Monnet de Saint-Etienne, Lyon, France
| | - Philippe Vanhems
- These authors contributed equally and share last authorship
- Service D'Hygiène, Épidémiologie, Infectiovigilance et Prévention, Hôpital Édouard Herriot, Hospices Civils de Lyon, Lyon, France
- CIRI - Centre International de Recherche en Infectiologie, Université de Lyon, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Jean Monnet de Saint-Etienne, Lyon, France
| | - Sophie Trouillet-Assant
- These authors contributed equally and share last authorship
- Joint Research Unit Civils Hospices of Lyon-bioMérieux, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France
- CIRI - Centre International de Recherche en Infectiologie, Université de Lyon, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Jean Monnet de Saint-Etienne, Lyon, France
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17
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Lahaye C, Parant F, Haesebaert J, Goldet K, Bendim'red L, Henaff L, Saadatian-Elahi M, Vanhems P, Cuerq C, Gilbert T, Blond E, Bost M, Bonnefoy M. Minerals and Antioxidant Micronutrients Levels and Clinical Outcome in Older Patients Hospitalized for COVID-19 during the First Wave of the Pandemic. Nutrients 2023; 15:nu15061516. [PMID: 36986247 PMCID: PMC10056386 DOI: 10.3390/nu15061516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/17/2023] [Accepted: 03/18/2023] [Indexed: 03/30/2023] Open
Abstract
Excessive inflammatory response has been implicated in severe respiratory forms of coronavirus disease 2019 (COVID-19). Trace elements such as zinc, selenium, and copper are known to modulate inflammation and immunity. This study aimed to assess the relationships between antioxidant vitamins and mineral trace elements levels as well as COVID-19 severity in older adults hospitalized. In this observational retrospective cohort study, the levels of zinc, selenium, copper, vitamin A, β-carotene, and vitamin E were measured in 94 patients within the first 15 days of hospitalization. The outcomes were in-hospital mortality secondary to COVID-19 or severe COVID-19. A logistic regression analysis was conducted to test whether the levels of vitamins and minerals were independently associated with severity. In this cohort (average age of 78 years), severe forms (46%) were associated with lower zinc (p = 0.012) and β-carotene (p < 0.001) concentrations, and in-hospital mortality (15%) was associated with lower zinc (p = 0.009), selenium (p = 0.014), vitamin A (p = 0.001), and β-carotene (p = 0.002) concentrations. In regression analysis, severe forms remained independently associated with lower zinc (aOR 2.13, p = 0.018) concentrations, and death was associated with lower vitamin A (aOR = 0.165, p = 0.021) concentrations. Low plasma concentrations of zinc and vitamin A were associated with poor prognosis in older people hospitalized with COVID-19.
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Affiliation(s)
- Clément Lahaye
- Department of Geriatric Medicine, Hôpital Gabriel Montpied, 63000 Clermont-Ferrand, France
- Unité de Nutrition Humaine, Université Clermont Auvergne, INRAE, 63000 Clermont-Ferrand, France
| | - François Parant
- Biology Center South, Hôpital Lyon Sud, 69310 Pierre-Bénite, France
| | - Julie Haesebaert
- Public Health Unit, Department of Clinical Research and Epidemiology, Groupement Hospitalier Est, 69002 Lyon, France
- RESHAPE Research on Healthcare Performance Inserm U1290, Université Lyon 1, 69008 Lyon, France
| | - Karine Goldet
- Clinical Research Centre, Ageing, Brain, Fragility-Hôpital des Charpennes, 69100 Villeurbanne, France
| | - Lamia Bendim'red
- Clinical Research Centre, Ageing, Brain, Fragility-Hôpital des Charpennes, 69100 Villeurbanne, France
| | - Laetitia Henaff
- Department of Hygiene, Epidemiology and Prevention, Hôpital Édouard Herriot, Hospices Civils de Lyon, 69003 Lyon, France
- ICIR-International Center for Infectiology Research (Team PHE3ID), Claude Bernard Lyon 1 University, Inserm, U1111, CNRS, UMR5308, ENS Lyon, 46 Allée d'Italie, 69007 Lyon, France
| | - Mitra Saadatian-Elahi
- Department of Hygiene, Epidemiology and Prevention, Hôpital Édouard Herriot, Hospices Civils de Lyon, 69003 Lyon, France
- ICIR-International Center for Infectiology Research (Team PHE3ID), Claude Bernard Lyon 1 University, Inserm, U1111, CNRS, UMR5308, ENS Lyon, 46 Allée d'Italie, 69007 Lyon, France
| | - Philippe Vanhems
- Department of Hygiene, Epidemiology and Prevention, Hôpital Édouard Herriot, Hospices Civils de Lyon, 69003 Lyon, France
- ICIR-International Center for Infectiology Research (Team PHE3ID), Claude Bernard Lyon 1 University, Inserm, U1111, CNRS, UMR5308, ENS Lyon, 46 Allée d'Italie, 69007 Lyon, France
| | - Charlotte Cuerq
- Biology Center South, Hôpital Lyon Sud, 69310 Pierre-Bénite, France
| | - Thomas Gilbert
- RESHAPE Research on Healthcare Performance Inserm U1290, Université Lyon 1, 69008 Lyon, France
- Department of Geriatric Medicine, Groupement Hospitalier Sud, CHU de Lyon, 69495 Pierre-Bénite, France
| | - Emilie Blond
- Biology Center South, Hôpital Lyon Sud, 69310 Pierre-Bénite, France
| | - Muriel Bost
- Biology Center South, Hôpital Lyon Sud, 69310 Pierre-Bénite, France
| | - Marc Bonnefoy
- Department of Geriatric Medicine, Groupement Hospitalier Sud, CHU de Lyon, 69495 Pierre-Bénite, France
- INSERM, 1060 CaRMeN 165 Chemin du Grand Revoyet, 69310 Pierre-Bénite, France
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18
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Barateau V, Peyrot L, Saade C, Pozzetto B, Brengel-Pesce K, Elsensohn MH, Allatif O, Guibert N, Compagnon C, Mariano N, Chaix J, Djebali S, Fassier JB, Lina B, Lefsihane K, Espi M, Thaunat O, Marvel J, Rosa-Calatrava M, Pizzorno A, Maucort-Boulch D, Henaff L, Saadatian-Elahi M, Vanhems P, Paul S, Walzer T, Trouillet-Assant S, Defrance T. Prior SARS-CoV-2 infection enhances and reshapes spike protein-specific memory induced by vaccination. Sci Transl Med 2023; 15:eade0550. [PMID: 36921035 DOI: 10.1126/scitranslmed.ade0550] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
The diversity of vaccination modalities and infection history are both variables that have an impact on the immune memory of individuals vaccinated against SARS-CoV-2. To gain more accurate knowledge of how these parameters imprint on immune memory, we conducted a long-term follow-up of SARS-CoV-2 spike protein-specific immune memory in unvaccinated and vaccinated COVID-19 convalescent individuals as well as in infection-naïve vaccinated individuals. Here, we report that individuals from the convalescent vaccinated (hybrid immunity) group have the highest concentrations of spike protein-specific antibodies at 6 months after vaccination. As compared with infection-naïve vaccinated individuals, they also display increased frequencies of an atypical mucosa-targeted memory B cell subset. These individuals also exhibited enhanced TH1 polarization of their SARS-CoV-2 spike protein-specific follicular T helper cell pool. Together, our data suggest that prior SARS-CoV-2 infection increases the titers of SARS-CoV-2 spike protein-specific antibody responses elicited by subsequent vaccination and induces modifications in the composition of the spike protein-specific memory B cell pool that are compatible with enhanced functional protection at mucosal sites.
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Affiliation(s)
- Véronique Barateau
- CIRI-Centre International de Recherche en Infectiologie, Univ Lyon, Université Claude Bernard Lyon 1 Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Jean Monnet de Saint-Etienne, Lyon 69007, France
| | - Loïc Peyrot
- CIRI-Centre International de Recherche en Infectiologie, Univ Lyon, Université Claude Bernard Lyon 1 Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Jean Monnet de Saint-Etienne, Lyon 69007, France
| | - Carla Saade
- CIRI-Centre International de Recherche en Infectiologie, Univ Lyon, Université Claude Bernard Lyon 1 Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Jean Monnet de Saint-Etienne, Lyon 69007, France
| | - Bruno Pozzetto
- CIRI-Centre International de Recherche en Infectiologie, Univ Lyon, Université Claude Bernard Lyon 1 Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Jean Monnet de Saint-Etienne, Lyon 69007, France.,Immunology laboratory, CIC1408, CHU Saint Etienne, Saint Etienne 42055, France
| | - Karen Brengel-Pesce
- Laboratoire Commun de Recherche Hospices Civils de Lyon-bioMérieux, Hospices Civils de Lyon, Hopital Lyon Sud, Pierre-Bénite 69495, France
| | - Mad-Hélénie Elsensohn
- Hospices Civils de Lyon, Pôle Santé Publique, Service de Biostatistique et Bioinformatique, Lyon 69003, France.,CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, Villeurbanne 69100, France
| | - Omran Allatif
- CIRI-Centre International de Recherche en Infectiologie, Univ Lyon, Université Claude Bernard Lyon 1 Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Jean Monnet de Saint-Etienne, Lyon 69007, France
| | - Nicolas Guibert
- Occupational Health and Medicine Department, Hospices Civils de Lyon, Université Claude Bernard Lyon1, Ifsttar, UMRESTTE, UMR T_9405, Lyon University, Avenue Rockefeller, Lyon 69008, France
| | - Christelle Compagnon
- Laboratoire Commun de Recherche Hospices Civils de Lyon-bioMérieux, Hospices Civils de Lyon, Hopital Lyon Sud, Pierre-Bénite 69495, France
| | | | - Julie Chaix
- BIOASTER, 40 Avenue Tony Garnier, Lyon 69007, France
| | - Sophia Djebali
- CIRI-Centre International de Recherche en Infectiologie, Univ Lyon, Université Claude Bernard Lyon 1 Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Jean Monnet de Saint-Etienne, Lyon 69007, France
| | - Jean-Baptiste Fassier
- Occupational Health and Medicine Department, Hospices Civils de Lyon, Université Claude Bernard Lyon1, Ifsttar, UMRESTTE, UMR T_9405, Lyon University, Avenue Rockefeller, Lyon 69008, France
| | - Bruno Lina
- CIRI-Centre International de Recherche en Infectiologie, Univ Lyon, Université Claude Bernard Lyon 1 Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Jean Monnet de Saint-Etienne, Lyon 69007, France.,Virology laboratory, Institute of Infectious Agents, National Reference Centre for Respiratory Viruses, Hospices Civils de Lyon, Lyon 69317, France
| | - Katia Lefsihane
- CIRI-Centre International de Recherche en Infectiologie, Univ Lyon, Université Claude Bernard Lyon 1 Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Jean Monnet de Saint-Etienne, Lyon 69007, France
| | - Maxime Espi
- CIRI-Centre International de Recherche en Infectiologie, Univ Lyon, Université Claude Bernard Lyon 1 Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Jean Monnet de Saint-Etienne, Lyon 69007, France
| | - Olivier Thaunat
- CIRI-Centre International de Recherche en Infectiologie, Univ Lyon, Université Claude Bernard Lyon 1 Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Jean Monnet de Saint-Etienne, Lyon 69007, France
| | - Jacqueline Marvel
- CIRI-Centre International de Recherche en Infectiologie, Univ Lyon, Université Claude Bernard Lyon 1 Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Jean Monnet de Saint-Etienne, Lyon 69007, France
| | - Manuel Rosa-Calatrava
- CIRI-Centre International de Recherche en Infectiologie, Univ Lyon, Université Claude Bernard Lyon 1 Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Jean Monnet de Saint-Etienne, Lyon 69007, France
| | - Andres Pizzorno
- CIRI-Centre International de Recherche en Infectiologie, Univ Lyon, Université Claude Bernard Lyon 1 Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Jean Monnet de Saint-Etienne, Lyon 69007, France
| | - Delphine Maucort-Boulch
- Hospices Civils de Lyon, Pôle Santé Publique, Service de Biostatistique et Bioinformatique, Lyon 69003, France.,CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, Villeurbanne 69100, France
| | - Laetitia Henaff
- CIRI-Centre International de Recherche en Infectiologie, Univ Lyon, Université Claude Bernard Lyon 1 Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Jean Monnet de Saint-Etienne, Lyon 69007, France.,Service D'Hygiène, Épidémiologie, Infectiovigilance et Prévention, Hôpital Édouard Herriot, Hospices Civils de Lyon, Lyon 69008, France
| | - Mitra Saadatian-Elahi
- CIRI-Centre International de Recherche en Infectiologie, Univ Lyon, Université Claude Bernard Lyon 1 Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Jean Monnet de Saint-Etienne, Lyon 69007, France.,Service D'Hygiène, Épidémiologie, Infectiovigilance et Prévention, Hôpital Édouard Herriot, Hospices Civils de Lyon, Lyon 69008, France
| | - Philippe Vanhems
- CIRI-Centre International de Recherche en Infectiologie, Univ Lyon, Université Claude Bernard Lyon 1 Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Jean Monnet de Saint-Etienne, Lyon 69007, France.,Service D'Hygiène, Épidémiologie, Infectiovigilance et Prévention, Hôpital Édouard Herriot, Hospices Civils de Lyon, Lyon 69008, France
| | - Stéphane Paul
- CIRI-Centre International de Recherche en Infectiologie, Univ Lyon, Université Claude Bernard Lyon 1 Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Jean Monnet de Saint-Etienne, Lyon 69007, France.,Immunology laboratory, CIC1408, CHU Saint Etienne, Saint Etienne 42055, France
| | - Thierry Walzer
- CIRI-Centre International de Recherche en Infectiologie, Univ Lyon, Université Claude Bernard Lyon 1 Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Jean Monnet de Saint-Etienne, Lyon 69007, France
| | - Sophie Trouillet-Assant
- CIRI-Centre International de Recherche en Infectiologie, Univ Lyon, Université Claude Bernard Lyon 1 Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Jean Monnet de Saint-Etienne, Lyon 69007, France.,Laboratoire Commun de Recherche Hospices Civils de Lyon-bioMérieux, Hospices Civils de Lyon, Hopital Lyon Sud, Pierre-Bénite 69495, France
| | - Thierry Defrance
- CIRI-Centre International de Recherche en Infectiologie, Univ Lyon, Université Claude Bernard Lyon 1 Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Jean Monnet de Saint-Etienne, Lyon 69007, France
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19
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Loubet P, Wittkop L, Ninove L, Chalouni M, Barrou B, Blay JY, Hourmant M, Thouvenot E, Laville M, Laviolle B, Lelievre JD, Morel J, Quoc SN, Spano JP, Terrier B, Thiebaut A, Viallard JF, Vrtovsnik F, Circosta S, Esterle L, Levier A, Vanhems P, Tartour E, Parfait B, de Lamballerie X, Launay O. One-month humoral response following two or three doses of messenger RNA coronavirus disease 2019 vaccines as primary vaccination in specific populations in France: first results from the Agence Nationale Recherche contre le Sida (ANRS)0001S COV-POPART cohort. Clin Microbiol Infect 2023; 29:388.e1-388.e8. [PMID: 36252789 PMCID: PMC9562615 DOI: 10.1016/j.cmi.2022.10.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 10/05/2022] [Accepted: 10/06/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVES We aimed to investigate the 1-month humoral response to two or three doses of a messenger RNA coronavirus disease 2019 (COVID-19) vaccine as a primary vaccination regimen in specific populations compared with that in healthy adults. METHODS Agence Nationale Recherche contre le Sida (ANRS)0001S-COV-POPART (NCT04824651) is a French nation-wide, multi-centre, prospective, observational cohort study assessing the immune response to COVID-19 vaccines routinely administered to 11 sub-groups of patients with chronic conditions and two control groups. Patients and controls who received at least two vaccine doses and whose results 1 month after the second dose were available were included. The humoral response was assessed 1 month after the first, second and third doses (if applicable) based on the percentage of responders (positive for anti-Spike severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] IgG antibodies), geometric means of anti-Spike SARS-CoV-2 IgG antibodies (enzyme-linked immunosorbent assay) and proportion of participants with anti-SARS-CoV-2-specific neutralizing antibodies (in vitro neutralization assay for the original SARS-CoV-2 strain). All analyses were centralized. RESULTS We included 4091 participants in this analysis: 2979 participants from specific sub-populations and 1112 controls. Only 522 (17.5%) participants from the specific populations received three doses as a primary vaccination regimen. Patients living with human immunodeficiency virus, cancer and diabetes had high percentages of responders after two doses, whereas patients with solid organ transplants, allogeneic hematopoietic stem cell transplants and hypogammaglobulinaemia had the lowest percentage of responders (35.9% [95% CI, 29.2-43.0], 57.4% [95% CI, 48.1-66.3] and 77.1% [95% CI, 65.6-86.3], respectively). In those who received the third dose, the percentage of responders reached 54.2% (95% CI, 42.9-65.2) (vs. 32.3% [95% CI, 16.7-51.4] after 2 doses) among those with solid organ transplants and 73.9% (95% CI, 58.9-85.7) (vs. 56.1% [95% CI, 46.2-65.7] after 2 doses) among those with hematopoietic stem cell transplants. Similar results were found with anti-SARS-CoV-2-specific neutralizing antibodies. CONCLUSIONS A lower humoral response to COVID-19 vaccines was observed in the specific populations compared with that in the controls. The third dose of this vaccine in the primary regimen had a positive effect on the percentages of patients who developed anti-Spike IgG antibodies and specific neutralizing antibodies.
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Affiliation(s)
- Paul Loubet
- INSERM, F-CRIN, Reseau Innovative Clinical Research in Vaccinology (IREIVAC), Paris, France; Service des Maladies infectieuses et Tropicales, CHU de Nîmes, Nîmes, France; INSERM U1047 - Université de Montpellier, Nîmes, France.
| | - Linda Wittkop
- Université de Bordeaux, ISPED, INSERM, Bordeaux Population Health Research Center, U1219, CIC-EC 1401, Bordeaux, France,Inria équipe SISTM, Talence, France,CHU de Bordeaux, Service d'information médicale, INSERM, Institut Bergonié, CIC-EC 1401, Bordeaux, France
| | - Laetitia Ninove
- Unite des Virus Emergents, Aix-Marseille Université, Institut de Recherche pour le Développement 190, Inserm 1207, Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France
| | - Mathieu Chalouni
- Université de Bordeaux, ISPED, INSERM, Bordeaux Population Health Research Center, U1219, CIC-EC 1401, Bordeaux, France
| | - Benoit Barrou
- Service de Transplantation Rénale, Pitié Salpêtrière, APHP, Sorbonne Université, Paris, France
| | - Jean-Yves Blay
- Centre Léon-Bérard, Département de cancérologie médicale, Lyon, France,Université Claude Bernard Lyon, Unicancer, Lyon, France
| | | | | | - Martine Laville
- INSERM U1191/UMR 5203, Université de Montpellier, Montpellier, France,CHU de Lyon, Université de Lyon, Association Française d’Etudes et de Recherche de l’Obésité, INSERM, F-CRIN –French Obesity Research Centre of Excellence (FORCE) Network, Lyon, France
| | - Bruno Laviolle
- Université de Rennes, CHU Rennes, INSERM, CIC 1414, Rennes, France
| | | | - Jacques Morel
- Département de Rhumatologie, CHU et Université de Montpellier, Montpellier, France
| | - Stéphanie Nguyen Quoc
- APHP–Sorbonne Université, INSERM U1135, CNRS ERL 8255, Centre d’Immunologie et des Maladies Infectieuses–Paris, Paris, France
| | - Jean-Philippe Spano
- Sorbonne université, INSERM, institut Pierre-Louis d'épidémiologie et de santé publique (IPLESP), équipe TheraVir, AP–HP, Sorbonne université, hôpital universitaire Pitié-Salpêtrière, Oncologie médicale, CLIP2 Galilée, Paris, France
| | - Benjamin Terrier
- Service de Médecine Interne, Hôpital Cochin, APHP, Paris, France
| | - Anne Thiebaut
- Département d’Hématologie, CHU Grenoble Alpes, Grenoble, France
| | | | - François Vrtovsnik
- Service de Néphrologie, Hôpital Bichat-Claude Bernard, APHP, Département Hospitalo-Universitaire Fire, Université de Paris, Paris, France
| | - Sophie Circosta
- INSERM, SC10-US019 Essais thérapeutiques et Maladies Infectieuses, Paris, France
| | - Laure Esterle
- Université de Bordeaux, ISPED, INSERM, Bordeaux Population Health Research Center, U1219, CIC-EC 1401, Bordeaux, France
| | | | - Philippe Vanhems
- Service d'Hygiène, Epidémiologie et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon, Equipe Epidémiologie et Santé Publique, Université de Lyon, Université Lyon 1, Lyon, France
| | - Eric Tartour
- Service d'Immunologie biologique, Hôpital européen Georges Pompidou/APHP, Paris, France
| | - Beatrice Parfait
- Centre de ressources Biologiques, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Xavier de Lamballerie
- Unite des Virus Emergents, Aix-Marseille Université, Institut de Recherche pour le Développement 190, Inserm 1207, Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France
| | - Odile Launay
- INSERM, F-CRIN, Reseau Innovative Clinical Research in Vaccinology (IREIVAC), Paris, France,Centre d'Investigation Clinique Cochin Pasteur, Hôpital Cochin/APHP, INSERM CIC 1417, Paris, France,Université de Paris, Paris, France
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20
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Colosi E, Bassignana G, Barrat A, Lina B, Vanhems P, Bielicki J, Colizza V. Minimising school disruption under high incidence conditions due to the Omicron variant in France, Switzerland, Italy, in January 2022. Euro Surveill 2023; 28:2200192. [PMID: 36729116 PMCID: PMC9896604 DOI: 10.2807/1560-7917.es.2023.28.5.2200192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BackgroundAs record cases of Omicron variant were registered in Europe in early 2022, schools remained a vulnerable setting undergoing large disruption.AimThrough mathematical modelling, we compared school protocols of reactive screening, regular screening, and reactive class closure implemented in France, in Baselland (Switzerland), and in Italy, respectively, and assessed them in terms of case prevention, testing resource demand, and schooldays lost.MethodsWe used a stochastic agent-based model of SARS-CoV-2 transmission in schools accounting for within- and across-class contacts from empirical contact data. We parameterised it to the Omicron BA.1 variant to reproduce the French Omicron wave in January 2022. We simulated the three protocols to assess their costs and effectiveness for varying peak incidence rates in the range experienced by European countries.ResultsWe estimated that at the high incidence rates registered in France during the Omicron BA.1 wave in January 2022, the reactive screening protocol applied in France required higher test resources compared with the weekly screening applied in Baselland (0.50 vs 0.45 tests per student-week), but achieved considerably lower control (8% vs 21% reduction of peak incidence). The reactive class closure implemented in Italy was predicted to be very costly, leading to > 20% student-days lost.ConclusionsAt high incidence conditions, reactive screening protocols generate a large and unplanned demand in testing resources, for marginal control of school transmissions. Comparable or lower resources could be more efficiently used through weekly screening. Our findings can help define incidence levels triggering school protocols and optimise their cost-effectiveness.
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Affiliation(s)
- Elisabetta Colosi
- Sorbonne Université, INSERM, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Giulia Bassignana
- Sorbonne Université, INSERM, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Alain Barrat
- Aix Marseille Univ, Université de Toulon, CNRS, CPT, Turing Center for Living Systems, Marseille, France
| | - Bruno Lina
- National Reference Center for Respiratory Viruses, Department of Virology, Infective Agents Institute, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France,Centre International de Recherche en Infectiologie (CIRI), Virpath Laboratory, INSERM U1111, CNRS—UMR 5308, École Normale Supérieure de Lyon, Université Claude Bernard Lyon, Lyon University, Lyon, France
| | - Philippe Vanhems
- Service d'Hygiène, Épidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France,Centre International de Recherche en Infectiologie (CIRI), Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID) – Inserm - U1111 - UCBL Lyon 1 - CNRS –UMR5308 - ENS de Lyon, Lyon, France
| | - Julia Bielicki
- Paediatric Infectious Diseases, University of Basel Children's Hospital, Basel, Switzerland
| | - Vittoria Colizza
- Sorbonne Université, INSERM, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
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21
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Martin H, Falconer J, Addo-Yobo E, Aneja S, Arroyo LM, Asghar R, Awasthi S, Banajeh S, Bari A, Basnet S, Bavdekar A, Bhandari N, Bhatnagar S, Bhutta ZA, Brooks A, Chadha M, Chisaka N, Chou M, Clara AW, Colbourn T, Cutland C, D'Acremont V, Echavarria M, Gentile A, Gessner B, Gregory CJ, Hazir T, Hibberd PL, Hirve S, Hooli S, Iqbal I, Jeena P, Kartasasmita CB, King C, Libster R, Lodha R, Lozano JM, Lucero M, Lufesi N, MacLeod WB, Madhi SA, Mathew JL, Maulen-Radovan I, McCollum ED, Mino G, Mwansambo C, Neuman MI, Nguyen NTV, Nunes MC, Nymadawa P, O'Grady KAF, Pape JW, Paranhos-Baccala G, Patel A, Picot VS, Rakoto-Andrianarivelo M, Rasmussen Z, Rouzier V, Russomando G, Ruvinsky RO, Sadruddin S, Saha SK, Santosham M, Singhi S, Soofi S, Strand TA, Sylla M, Thamthitiwat S, Thea DM, Turner C, Vanhems P, Wadhwa N, Wang J, Zaman SMA, Campbell H, Nair H, Qazi SA, Nisar YB. Assembling a global database of child pneumonia studies to inform WHO pneumonia management algorithm: Methodology and applications. J Glob Health 2022; 12:04075. [PMID: 36579417 PMCID: PMC9798037 DOI: 10.7189/jogh.12.04075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background The existing World Health Organization (WHO) pneumonia case management guidelines rely on clinical symptoms and signs for identifying, classifying, and treating pneumonia in children up to 5 years old. We aimed to collate an individual patient-level data set from large, high-quality pre-existing studies on pneumonia in children to identify a set of signs and symptoms with greater validity in the diagnosis, prognosis, and possible treatment of childhood pneumonia for the improvement of current pneumonia case management guidelines. Methods Using data from a published systematic review and expert knowledge, we identified studies meeting our eligibility criteria and invited investigators to share individual-level patient data. We collected data on demographic information, general medical history, and current illness episode, including history, clinical presentation, chest radiograph findings when available, treatment, and outcome. Data were gathered separately from hospital-based and community-based cases. We performed a narrative synthesis to describe the final data set. Results Forty-one separate data sets were included in the Pneumonia Research Partnership to Assess WHO Recommendations (PREPARE) database, 26 of which were hospital-based and 15 were community-based. The PREPARE database includes 285 839 children with pneumonia (244 323 in the hospital and 41 516 in the community), with detailed descriptions of clinical presentation, clinical progression, and outcome. Of 9185 pneumonia-related deaths, 6836 (74%) occurred in children <1 year of age and 1317 (14%) in children aged 1-2 years. Of the 285 839 episodes, 280 998 occurred in children 0-59 months old, of which 129 584 (46%) were 2-11 months of age and 152 730 (54%) were males. Conclusions This data set could identify an improved specific, sensitive set of criteria for diagnosing clinical pneumonia and help identify sick children in need of referral to a higher level of care or a change of therapy. Field studies could be designed based on insights from PREPARE analyses to validate a potential revised pneumonia algorithm. The PREPARE methodology can also act as a model for disease database assembly.
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Affiliation(s)
- Helena Martin
- Centre for Global Health, Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom
| | - Jennifer Falconer
- Centre for Global Health, Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom
| | - Emmanuel Addo-Yobo
- Kwame Nkrumah University of Science and Technology/Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Satinder Aneja
- School of Medical Sciences and Research, Sharda University, Greater Noida, India
| | | | - Rai Asghar
- Rawalpindi Medical College, Rawalpindi, Pakistan
| | - Shally Awasthi
- King George’s Medical University, Department of Pediatrics, Lucknow, India
| | - Salem Banajeh
- Department of Paediatrics and Child Health, University of Sana’a, Sana’a, Yemen
| | - Abdul Bari
- Independent newborn and child health consultant, Islamabad, Pakistan
| | - Sudha Basnet
- Center for Intervention Science in Maternal and Child Health, University of Bergen, Norway,Department of Pediatrics, Tribhuvan University Institute of Medicine, Nepal
| | - Ashish Bavdekar
- King Edward Memorial (KEM) Hospital Pune, Department of Pediatrics, Pune, India
| | - Nita Bhandari
- Center for Health Research and Development, Society for Applied Studies, India
| | | | - Zulfiqar A Bhutta
- Institute for Global Health and Development, Aga Khan University, Pakistan
| | - Abdullah Brooks
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Mandeep Chadha
- Former Scientist, Indian Council of Medical Research (ICMR), National Institute of Virology, Pune, India
| | | | - Monidarin Chou
- University of Health Sciences, Rodolphe Mérieux Laboratory, Phom Phen, Cambodia,Ministry of Environment, Phom Phen, Cambodia
| | - Alexey W Clara
- Centers for Disease Control, Central American Region, Guatemala City, Guatemala
| | - Tim Colbourn
- Institute for Global Health, University College London, London, United Kingdom
| | - Clare Cutland
- South African Medical Research Council, Vaccines and Infectious Diseases Analytics Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa,Department of Science and Technology/National Research Foundation, South African Research Chair Initiative in Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Marcela Echavarria
- Clinical Virology Unit, Centro de Educación Médica e Investigaciones Clínicas, Argentina
| | - Angela Gentile
- Department of Epidemiology, “R. Gutiérrez” Children's Hospital, Buenos Aires, Argentina
| | - Brad Gessner
- Pfizer Vaccines, Collegeville, Pennsylvania, USA
| | - Christopher J. Gregory
- Division of Vector-borne Diseases, US Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Tabish Hazir
- Retired from Children Hospital, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - Patricia L. Hibberd
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | | | - Shubhada Hooli
- Section of Pediatric Emergency Medicine, Texas Children’s Hospital, Baylor College of Medicine, Houston, Texas, USA
| | - Imran Iqbal
- Department of Paediatrics, Combined Military Hospital Institute of Medical Sciences, Multan, Pakistan
| | | | - Cissy B Kartasasmita
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Carina King
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden,Institute for Global Health, University College London, London, United Kingdom
| | | | - Rakesh Lodha
- All India Institute of Medical Sciences, New Delhi, India
| | | | - Marilla Lucero
- Research Institute for Tropical Medicine, Manila, Philippines
| | | | - William B MacLeod
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Shabir Ahmed Madhi
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg
| | - Joseph L Mathew
- Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Irene Maulen-Radovan
- Instituto Nactional de Pediatria Division de Investigacion Insurgentes, Mexico City, Mexico
| | - Eric D McCollum
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA,Global Program in Respiratory Sciences, Eudowood Division of Pediatric Respiratory Sciences, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, USA
| | - Greta Mino
- Department of Infectious diseases, Guayaquil, Ecuador
| | | | - Mark I Neuman
- Division of Emergency Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Marta C Nunes
- South African Medical Research Council, Vaccines and Infectious Diseases Analytics Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa,Department of Science and Technology/National Research Foundation, South African Research Chair Initiative in Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Pagbajabyn Nymadawa
- Mongolian Academy of Sciences, Academy of Medical Sciences, Ulaanbaatar, Mongolia
| | - Kerry-Ann F O'Grady
- Australian Centre for Health Services Innovation, Queensland University of Technology, Kelvin Grove, Australia
| | | | | | - Archana Patel
- Lata Medical Research Foundation, Nagpur and Datta Meghe Institute of Medical Sciences, Sawangi, India
| | | | | | - Zeba Rasmussen
- Division of International Epidemiology and Population Studies (DIEPS), Fogarty International Center (FIC), National Institute of Health (NIH), USA
| | | | - Graciela Russomando
- Universidad Nacional de Asuncion, Departamento de Biología Molecular y Genética, Instituto de Investigaciones en Ciencias de la Salud, Asuncion, Paraguay
| | - Raul O Ruvinsky
- Dirección de Control de Enfermedades Inmunoprevenibles, Ministerio de Salud de la Nación, Buenos Aires, Argentina
| | - Salim Sadruddin
- Consultant/Retired World Health Organization (WHO) Staff, Geneva, Switzerland
| | - Samir K. Saha
- Child Health Research Foundation, Dhaka, Bangladesh,Dhaka Shishu Hospital, Dhaka, Bangladesh
| | - Mathuram Santosham
- International Vaccine Access Center (IVAC), Department of International Health, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Sajid Soofi
- Department of Pediatrics and Child Health, Aga Khan University, Pakistan
| | - Tor A Strand
- Research Department, Innlandet Hospital Trust, Lillehammer, Norway
| | - Mariam Sylla
- Gabriel Touré Hospital, Department of Pediatrics, Bamako, Mali
| | - Somsak Thamthitiwat
- Division of Global Health Protection, Thailand Ministry of Public Health – US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Donald M Thea
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | | | - Philippe Vanhems
- Unité d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France,Centre International de Recherche en Infectiologie, École Nationale Supérieure de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Nitya Wadhwa
- Translational Health Science and Technology Institute, Faridabad, India
| | - Jianwei Wang
- Chinese Academy of Medical Sciences & Peking Union, Medical College Institute of Pathogen Biology, MOH Key Laboratory of Systems Biology of Pathogens and Dr Christophe Mérieux Laboratory, Beijing, China
| | - Syed MA Zaman
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Harry Campbell
- Centre for Global Health, Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom
| | - Harish Nair
- Centre for Global Health, Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom
| | - Shamim Ahmad Qazi
- Consultant/Retired World Health Organization (WHO) Staff, Geneva, Switzerland
| | - Yasir Bin Nisar
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization (WHO), Geneva, Switzerland
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22
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Bangoura ST, Rabilloud M, Camara A, Campoy S, Condé M, Vanhems P, Kadio KJJO, Touré A, Khanafer N. Factors associated with the nutritional status of children under 5 years of age in Guinea between 2005 and 2018. Public Health Nutr 2022; 26:1-10. [PMID: 36539345 PMCID: PMC9989713 DOI: 10.1017/s1368980022002622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 11/11/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To determine the factors associated with the nutritional status of children under 5 years of age in Guinea between 2005 and 2018. DESIGN Data from the 2005, 2012 and 2018 Guinea Demographic and Health Surveys (DHS) were used for this study. Three anthropometric indicators (stunting, underweight and wasting) were assessed according to the 2006 WHO Child Growth Standards and analysed according to the year, the characteristics of the household, the child and the mother using multivariate logistic regression. SETTING Data were collected in the capital Conakry and in the seven administrative regions of Guinea. PARTICIPANTS The study included children under 5 years of age for whom height and weight were available: 2765 (DHS-2005), 3220 (DHS-2012) and 3551 (DHS-2018). RESULTS Analysis of the data from the three surveys showed that children living in rural areas were more likely to be stunted than children living in urban areas (OR = 1·32, 95 % CI (1·08, 1·62)). Similarly, the children from middle, poor and the poorest households were more likely to be stunted and underweight than children from richest households. The chance to stunting increased with age in the first 3 years. However, the chance to wasting decreased with age. Children in all age groups were more likely of being underweight. Children of thin mothers were more likely to be both wasted (OR = 2·0, 95 % CI (1·5, 2·6)) and underweight (OR = 1·9, 95 % CI (1·5, 2·3)). CONCLUSION The implementation of targeted interventions adapted to the observed disparities could considerably improve the nutritional status of children and mothers.
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Affiliation(s)
- Salifou Talassone Bangoura
- Centre de Recherche et de Formation en Infectiologie de Guinée (CERFIG), Campus Universitaire Hadja Mafory Bangoura, Donka, Conakry, BP: 6629P, Guinée
- Chaire de Santé Publique, Université Gamal Abdel Nasser de Conakry, Conakry, Guinée
- Département des Sciences Pharmaceutiques et Biologiques, Université Gamal Abdel Nasser de Conakry, Conakry, Guinée
| | - Muriel Rabilloud
- Université Lyon 1, CNRS, UMR5558, Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, Villeurbanne, France
- Hospices Civils de Lyon, Pôle Santé Publique, Service de Biostatistique et Bioinformatique, Lyon, France
| | - Alioune Camara
- Centre de Recherche et de Formation en Infectiologie de Guinée (CERFIG), Campus Universitaire Hadja Mafory Bangoura, Donka, Conakry, BP: 6629P, Guinée
- Chaire de Santé Publique, Université Gamal Abdel Nasser de Conakry, Conakry, Guinée
| | - Séphora Campoy
- Hospices Civils de Lyon, Pôle Santé Publique, Service de Biostatistique et Bioinformatique, Lyon, France
| | - Mamoudou Condé
- Chaire de Santé Publique, Université Gamal Abdel Nasser de Conakry, Conakry, Guinée
| | - Philippe Vanhems
- Santé publique, Epidémiologie et Ecologie Evolutive des Maladies Infectieuses, Centre International de Recherche en Infectiologie (CIRI), INSERM U1111-UCBL 1-ENS, Lyon, France
- Department of Hygiene, Epidemiology, and Prevention, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Kadio Jean-Jacques Olivier Kadio
- Centre de Recherche et de Formation en Infectiologie de Guinée (CERFIG), Campus Universitaire Hadja Mafory Bangoura, Donka, Conakry, BP: 6629P, Guinée
- Chaire de Santé Publique, Université Gamal Abdel Nasser de Conakry, Conakry, Guinée
- Département des Sciences Pharmaceutiques et Biologiques, Université Gamal Abdel Nasser de Conakry, Conakry, Guinée
| | - Abdoulaye Touré
- Centre de Recherche et de Formation en Infectiologie de Guinée (CERFIG), Campus Universitaire Hadja Mafory Bangoura, Donka, Conakry, BP: 6629P, Guinée
- Chaire de Santé Publique, Université Gamal Abdel Nasser de Conakry, Conakry, Guinée
- Département des Sciences Pharmaceutiques et Biologiques, Université Gamal Abdel Nasser de Conakry, Conakry, Guinée
| | - Nagham Khanafer
- Santé publique, Epidémiologie et Ecologie Evolutive des Maladies Infectieuses, Centre International de Recherche en Infectiologie (CIRI), INSERM U1111-UCBL 1-ENS, Lyon, France
- Department of Hygiene, Epidemiology, and Prevention, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
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23
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Vanhems P, Nunes MC. Further Cautions When Modeling the Public Health Impact of Infectious Diseases. Am J Public Health 2022; 112:e1-e2. [DOI: 10.2105/ajph.2022.307086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Philippe Vanhems
- Philippe Vanhems is with the Service d’Hygiène, Epidémiologie et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France, and the Centre International de Recherche en Infectiologie (CIRI) Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France. Marta C. Nunes is with the Hospices Civils de Lyon, Lyon, France, and the South African Medical Research Council, Vaccines and Infectious Diseases Analytics (VIDA) Research Unit, and the Department of Science and Technology/National
| | - Marta C. Nunes
- Philippe Vanhems is with the Service d’Hygiène, Epidémiologie et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France, and the Centre International de Recherche en Infectiologie (CIRI) Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France. Marta C. Nunes is with the Hospices Civils de Lyon, Lyon, France, and the South African Medical Research Council, Vaccines and Infectious Diseases Analytics (VIDA) Research Unit, and the Department of Science and Technology/National
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24
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Khanafer N, Oudot S, Planckaert C, Paquin N, Mena C, Mandel NT, Chapurlat R, Lombard C, Martin-Gaujard G, Juillard L, Elias C, Janoly-Dumenil A, Jolivot A, Benazzouz M, Maligeay M, Ayala MP, Ismail D, Vanhems P. Using ELEFIGHT® QR Codes for Quick Access to Information on Influenza Burden and Prevention: A Pilot Study in Lyon University Hospital. Vaccines (Basel) 2022; 10:vaccines10101591. [PMID: 36298457 PMCID: PMC9610108 DOI: 10.3390/vaccines10101591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/09/2022] [Accepted: 09/19/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: The Vaccine Coverage Rate of influenza remains low and omnichannel efforts are required to improve it. The objective was to evaluate the feasibility and outcomes of a QR Code nudging system in outpatient departments. (2) Methods: The study was performed in 6 departments ensuring ambulatory activities in a French university Hospital between November and December 2021. By scanning QR codes, users accessed anonymously to the ELEFIGHT® web app, which provides medical information on influenza and invites them to initiate a discussion about influenza prevention with their physicians during the consultation. (3) Results: 351 people made 529 scans with an average reading time of 1 min and 4 s and a conversion rate of 32%, i.e., people willing to engage in a discussion. (4) Conclusions: The study suggests that direct access to medical information through QR codes in hospitals might help nudge people to raise their awareness and trigger their action on influenza prevention.
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Affiliation(s)
- Nagham Khanafer
- Unité D’hygiène, Epidémiologie et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon (HCL), 69003 Lyon, France
- Equipe PHE3ID, Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, Université de Lyon1, 69007 Lyon, France
- Correspondence: ; Tel.: +33-4-27-85-80-63; Fax: +33-4-72-11-07-26
| | | | | | - Nathalie Paquin
- Hôpital Edouard Herriot, Hospices Civils de Lyon (HCL), 69437 Lyon, France
| | - Camille Mena
- Hôpital Edouard Herriot, Hospices Civils de Lyon (HCL), 69437 Lyon, France
| | | | - Roland Chapurlat
- Hôpital Edouard Herriot, Hospices Civils de Lyon (HCL), 69437 Lyon, France
| | - Catherine Lombard
- Hôpital Edouard Herriot, Hospices Civils de Lyon (HCL), 69437 Lyon, France
| | | | - Laurent Juillard
- Hôpital Edouard Herriot, Hospices Civils de Lyon (HCL), 69437 Lyon, France
| | - Christelle Elias
- Unité D’hygiène, Epidémiologie et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon (HCL), 69003 Lyon, France
- Equipe PHE3ID, Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, Université de Lyon1, 69007 Lyon, France
| | | | - Anne Jolivot
- Hôpital Edouard Herriot, Hospices Civils de Lyon (HCL), 69437 Lyon, France
| | | | | | | | | | - Philippe Vanhems
- Unité D’hygiène, Epidémiologie et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon (HCL), 69003 Lyon, France
- Equipe PHE3ID, Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, Université de Lyon1, 69007 Lyon, France
- Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), 75679 Paris, France
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25
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Fneich A, Poinsot P, Elias C, Restier L, Vanhems P, Wallet F, Caussy C, Duclos A, Peretti N. Undernourished patients do not have increased risk of severe COVID-19 outcomes. Clin Nutr Open Sci 2022; 44:9-14. [PMID: 35378830 PMCID: PMC8968129 DOI: 10.1016/j.nutos.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/23/2022] [Indexed: 01/25/2023] Open
Abstract
Background Undernutrition has been previously identified as a deleterious factor in acute infections. In covid-19 infection, obesity is a risk-factor of severe evolution, but initial undernutrition has not been evaluated yet. Methods We retrospectively analyzed correlation between nutritional status at admission and severe outcomes (intensive care unit admission, invasive mechanical ventilation requirement and death) of patients hospitalized for confirmed covid-19 infection. Results Risk of intensive care unit admission and invasive mechanical ventilation requirement was not significantly different between undernutrition and normoweight sub-groups, but increased in excessive weight sub-group (ODDR (IC 95%) 1.048 (1.011-1.086), p = 0.011). Risk of death was the same in all sub-groups. Conclusion Undernutrition didn't appear as a factor of severe outcomes in covid-19 infection.
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Affiliation(s)
- Ahmad Fneich
- Univ Lyon, Hospices Civil de Lyon, Gastro-enterology and Pediatric Nutrition, Hôpital Femme Mère Enfant, F-69500, Bron, France
| | - Pierre Poinsot
- Univ Lyon, Hospices Civil de Lyon, Gastro-enterology and Pediatric Nutrition, Hôpital Femme Mère Enfant, F-69500, Bron, France,Univ Lyon, CarMeN Laboratory, INRAE, UMR1397, INSERM, UMR1060, F-69310, Pierre-Bénite, France,Corresponding author. Univ Lyon, CarMeN Laboratory, INRAE, UMR1397, INSERM, UMR1060, F-69310, Pierre-Bénite, France
| | - Christelle Elias
- Emerging Pathogens Laboratory- Fondation Mérieux, Lyon, France,Univ Lyon, Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, CNRS, UMR 5308, ENS Lyon, F-69008 Lyon, France,Univ Lyon, Hospices Civil de Lyon, Infection Control and Epidemiology Unit, Hôpital Croix Rousse, F-69004 Lyon, France
| | - Lioara Restier
- Univ Lyon, Hospices Civil de Lyon, Gastro-enterology and Pediatric Nutrition, Hôpital Femme Mère Enfant, F-69500, Bron, France
| | - Philippe Vanhems
- Emerging Pathogens Laboratory- Fondation Mérieux, Lyon, France,Univ Lyon, Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, CNRS, UMR 5308, ENS Lyon, F-69008 Lyon, France,Univ Lyon, Hospices Civil de Lyon, Infection Control and Epidemiology Unit, Hôpital Croix Rousse, F-69004 Lyon, France
| | - Florent Wallet
- Univ Lyon, Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, CNRS, UMR 5308, ENS Lyon, F-69008 Lyon, France,Univ Lyon, Hospices Civils de Lyon, Medical Intensive Care Unit, Lyon-Sud Hospital, F69310, Pierre Bénite, France
| | - Cyrielle Caussy
- Univ Lyon, CarMeN Laboratory, INRAE, UMR1397, INSERM, UMR1060, F-69310, Pierre-Bénite, France,Univ Lyon, Hospices Civils de Lyon, Département Endocrinologie, Diabète et Nutrition, Hôpital Lyon Sud, F-69495, Pierre-Bénite, France
| | - Antoine Duclos
- Univ Lyon, Hospices Civils de Lyon, Health Data Department, Health Services and Performance Research Lab (HeSPeR, EA 7425), Lyon, France
| | - Noël Peretti
- Univ Lyon, Hospices Civil de Lyon, Gastro-enterology and Pediatric Nutrition, Hôpital Femme Mère Enfant, F-69500, Bron, France,Univ Lyon, CarMeN Laboratory, INRAE, UMR1397, INSERM, UMR1060, F-69310, Pierre-Bénite, France
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26
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Kuczewski E, Henaff L, Regard A, Argaud L, Lukaszewicz AC, Rimmelé T, Cassier P, Fredenucci I, Loeffert-Frémiot S, Khanafer N, Vanhems P. Bacterial Cross-Transmission between Inanimate Surfaces and Patients in Intensive Care Units under Real-World Conditions: A Repeated Cross-Sectional Study. Int J Environ Res Public Health 2022; 19:9401. [PMID: 35954765 PMCID: PMC9367990 DOI: 10.3390/ijerph19159401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/22/2022] [Accepted: 07/28/2022] [Indexed: 02/01/2023]
Abstract
Background/Objectives: Contaminated surfaces play an important role in the nosocomial infection of patients in intensive care units (ICUs). This study, conducted in two ICUs at Edouard Herriot Hospital (Lyon, France), aimed to describe rooms' microbial ecology and explore the potential link between environmental contamination and patients' colonization and/or infection. Methods: Environmental samples were realized once monthly from January 2020 to December 2021 on surfaces close to the patient (bedrails, bedside table, and dedicated stethoscope) and healthcare workers' high-touch surfaces, which were distant from the patient (computer, worktop/nurse cart, washbasin, and hydro-alcoholic solution/soap dispenser). Environmental bacteria were compared to the cultures of the patients hospitalized in the sampled room over a period of ± 10 days from the environmental sampling. Results: Overall, 137 samples were collected: 90.7% of the samples close to patients, and 87.9% of the distant ones were positives. Overall, 223 bacteria were isolated, mainly: Enterococcus faecalis (15.7%), Pantoea agglomerans (8.1%), Enterobacter cloacae/asburiae (6.3%), Bacillus cereus and other Bacillus spp (6.3%), Enterococcusfaecium (5.8%), Stenotrophomonas maltophilia (5.4%), and Acinetobacter baumannii (4.9%). Throughout the study, 142 patients were included, of which, n = 67 (47.2%) were infected or colonized by at least one bacterium. In fourteen cases, the same bacterial species were found both in environment and patient samples, with the suspicion of a cross-contamination between the patient-environment (n = 10) and environment-patient (n = 4). Conclusions: In this work, we found a high level of bacterial contamination on ICU rooms' surfaces and described several cases of potential cross-contamination between environment and patients in real-world conditions.
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Affiliation(s)
- Elisabetta Kuczewski
- Unité d’Hygiène, Epidémiologie et Prévention, Hôpital Edouard Herriot, Groupement Hospitalier Centre, Hospices Civils de Lyon, 69003 Lyon, France; (A.R.); (N.K.); (P.V.)
| | - Laetitia Henaff
- Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID), Centre International de Recherche en Infectiologie (CIRI), Inserm, U1111,Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, 69007 Lyon, France;
| | - Anne Regard
- Unité d’Hygiène, Epidémiologie et Prévention, Hôpital Edouard Herriot, Groupement Hospitalier Centre, Hospices Civils de Lyon, 69003 Lyon, France; (A.R.); (N.K.); (P.V.)
| | - Laurent Argaud
- Service de Médecine Intensive—Réanimation, Pavillon H, Hôpital Edouard Herriot, Hospices Civils de Lyon, 69003 Lyon, France;
| | - Anne-Claire Lukaszewicz
- Service de Réanimation, Pavillon P, Hôpital Edouard Herriot, Hospices Civils de Lyon, 69002 Lyon, France; (A.-C.L.); (T.R.)
| | - Thomas Rimmelé
- Service de Réanimation, Pavillon P, Hôpital Edouard Herriot, Hospices Civils de Lyon, 69002 Lyon, France; (A.-C.L.); (T.R.)
| | - Pierre Cassier
- Plateau de Microbiologie Environnementale et Hygiène Hospitalière, Laboratoire de Biologie et Sécurité de l’Environnement, Institut des Agents Infectieux, Hôpital de la Croix-Rousse, Groupement Hospitalier Nord, Hospices Civils de Lyon, 69004 Lyon, France; (P.C.); (I.F.)
| | - Isabelle Fredenucci
- Plateau de Microbiologie Environnementale et Hygiène Hospitalière, Laboratoire de Biologie et Sécurité de l’Environnement, Institut des Agents Infectieux, Hôpital de la Croix-Rousse, Groupement Hospitalier Nord, Hospices Civils de Lyon, 69004 Lyon, France; (P.C.); (I.F.)
| | | | - Nagham Khanafer
- Unité d’Hygiène, Epidémiologie et Prévention, Hôpital Edouard Herriot, Groupement Hospitalier Centre, Hospices Civils de Lyon, 69003 Lyon, France; (A.R.); (N.K.); (P.V.)
- Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID), Centre International de Recherche en Infectiologie (CIRI), Inserm, U1111,Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, 69007 Lyon, France;
| | - Philippe Vanhems
- Unité d’Hygiène, Epidémiologie et Prévention, Hôpital Edouard Herriot, Groupement Hospitalier Centre, Hospices Civils de Lyon, 69003 Lyon, France; (A.R.); (N.K.); (P.V.)
- Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID), Centre International de Recherche en Infectiologie (CIRI), Inserm, U1111,Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, 69007 Lyon, France;
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Vacheron CH, Lepape A, Savey A, Machut A, Timsit JF, Comparot S, Courno G, Vanhems P, Landel V, Lavigne T, Bailly S, Bettega F, Maucort-Boulch D, Friggeri A. Attributable Mortality of Ventilator-associated Pneumonia Among Patients with COVID-19. Am J Respir Crit Care Med 2022; 206:161-169. [PMID: 35537122 PMCID: PMC9887408 DOI: 10.1164/rccm.202202-0357oc] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Rationale: Patients with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are at higher risk of ventilator-associated pneumonia (VAP) and may have an increased attributable mortality (increased or decreased risk of death if VAP occurs in a patient) and attributable fraction (proportion of deaths that are attributable to an exposure) of VAP-related mortality compared with subjects without coronavirus disease (COVID-19). Objectives: Estimation of the attributable mortality of the VAP among patients with COVID-19. Methods: Using the REA-REZO surveillance network, three groups of adult medical ICU patients were computed: control group (patients admitted between 2016 and 2019; prepandemic patients), pandemic COVID-19 group (PandeCOV+), and pandemic non-COVID-19 group (PandeCOV-) admitted during 2020. The primary outcome was the estimation of attributable mortality and attributable fraction related to VAP in these patients. Using multistate modeling with causal inference, the outcomes related to VAP were also evaluated. Measurements and Main Results: A total of 64,816 patients were included in the control group, 7,442 in the PandeCOV- group, and 1,687 in the PandeCOV+ group. The incidence of VAP was 14.2 (95% confidence interval [CI], 13.9 to 14.6), 18.3 (95% CI, 17.3 to 19.4), and 31.9 (95% CI, 29.8 to 34.2) per 1,000 ventilation-days in each group, respectively. Attributable mortality at 90 days was 3.15% (95%, CI, 2.04% to 3.43%), 2.91% (95% CI, -0.21% to 5.02%), and 8.13% (95% CI, 3.54% to 12.24%), and attributable fraction of mortality at 90 days was 1.22% (95% CI, 0.83 to 1.63), 1.42% (95% CI, -0.11% to 2.61%), and 9.17% (95% CI, 3.54% to 12.24%) for the control, PandeCOV-, and PandeCOV+ groups, respectively. Except for the higher risk of developing VAP, the PandeCOV- group shared similar VAP characteristics with the control group. PandeCOV+ patients were at lower risk of death without VAP (hazard ratio, 0.62; 95% CI, 0.52 to 0.74) than the control group. Conclusions: VAP-attributable mortality was higher for patients with COVID-19, with more than 9% of the overall mortality related to VAP.
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Affiliation(s)
- Charles-Hervé Vacheron
- Département d'Anesthésie Réanimation, Centre Hospitalier Lyon Sud.,REA-REZO Infections et Antibiorésistance en Réanimation, Hôpital Henry Gabrielle.,CIRI-Centre International de Recherche en Infectiologie (Team PHE3ID), Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Alain Lepape
- Département d'Anesthésie Réanimation, Centre Hospitalier Lyon Sud.,REA-REZO Infections et Antibiorésistance en Réanimation, Hôpital Henry Gabrielle.,CIRI-Centre International de Recherche en Infectiologie (Team PHE3ID), Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Anne Savey
- REA-REZO Infections et Antibiorésistance en Réanimation, Hôpital Henry Gabrielle.,Centre Hospitalier Henry Gabrielle.,CIRI-Centre International de Recherche en Infectiologie (Team PHE3ID), Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Anaïs Machut
- REA-REZO Infections et Antibiorésistance en Réanimation, Hôpital Henry Gabrielle
| | - Jean Francois Timsit
- Médecine Intensive Réanimation Infectieuse, AP-HP Hôpital Bichat, Université de Paris, Paris, France
| | - Sylvie Comparot
- Service de Lutte Contre les Infections Nosocomiale CH, Avignon, France
| | - Gaelle Courno
- Réanimation Polyvalente CH de Toulon, Hôpital Sainte Musse, Toulon, France
| | - Philippe Vanhems
- Service Hygiène, Epidémiologie, Infectiovigilance et Prévention, Centre Hospitalier Edouard Herriot.,CIRI-Centre International de Recherche en Infectiologie (Team PHE3ID), Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | | | - Thierry Lavigne
- Hygiène Hospitalière, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Sebastien Bailly
- HP2 Laboratory, Grenoble Alpes University, INSERM U1300 and Grenoble Alpes University Hospital, Grenoble, France
| | - Francois Bettega
- HP2 Laboratory, Grenoble Alpes University, INSERM U1300 and Grenoble Alpes University Hospital, Grenoble, France
| | - Delphine Maucort-Boulch
- Pôle Santé Publique, Service de Biostatistique et Bioinformatique, Hospices Civils de Lyon, Lyon, France.,Université de Lyon, Lyon, France; and.,Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, Villeurbanne, France
| | - Arnaud Friggeri
- Département d'Anesthésie Réanimation, Centre Hospitalier Lyon Sud.,REA-REZO Infections et Antibiorésistance en Réanimation, Hôpital Henry Gabrielle.,CIRI-Centre International de Recherche en Infectiologie (Team PHE3ID), Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
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Elias C, Nail-Billaud S, Basset P, Laurent F, Dantony E, Fauvernier M, Roy P, Vanhems P. Protocol for a prospective quasi-experimental study on SARS-CoV-2 transmission during outdoor sports events in France: the COVID-ESO project. BMJ Open 2022; 12:e055927. [PMID: 35710259 PMCID: PMC9207572 DOI: 10.1136/bmjopen-2021-055927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The spread of SARS-CoV-2 and its variants in the community remains a major concern despite the application of control measures including the banning of mass sporting events. The circulation of SARS-CoV-2 within the general population, and potentially within the population practicing outdoor sports activities, suggests contexts conducive to the transmission of the virus. We hypothesise that outdoor sports events (OSEs) do not present a higher risk of SARS-CoV-2 contamination. The objective of the COVID-ESO project is to measure if individuals participating in OSE present a similar risk of SARS-CoV-2 transmission compared with individuals not participating in OSE, in France. METHODS AND ANALYSIS The COVID-ESO project is a prospective, quasi-experimental study to be conducted in volunteer individuals likely to participate in OSE. Six events are targeted across France to be included. Three sport trials will be eligible for the study: running, cycling and triathlon. Each individual participating in the OSE will choose one of his or her usual training partner to be eligible for the unexposed control group. Individuals will be matched (1:1) on age, sex and the district of residence. Individuals assigned to the exposed group will participate in the OSE, whereas individuals assigned to the unexposed group will not participate in the OSE. All individuals will be asked to perform saliva tests on the day of the event and 7 days after the event. A questionnaire including sociodemographic, clinical and exposure data to SARS-CoV-2 will be sent by email for both groups on the day before the event and 7 days after the event. Differences in SARS-CoV-2 infection rates between the exposed versus the unexposed group will be analysed by fitting a conditional logistic regression model, adjusted for potential confounders. As the sport events unfold, data will be analyzed by performing sequential meta-analyses. ETHICS AND DISSEMINATION This protocol has been approved by the ethical committee. Ethical approval has been obtained for the Clinical research and committee of South West of France, 10 June 2021. COMITE DE PROTECTION DES PERSONNES DU SUD-OUEST ET OUTRE-MER 4 under the reference number 21.03.23.71737/CPP2021-04-045 a COVID/2021-A00845-36. Findings generated from this study will be shared to national health and sport authorities.
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Affiliation(s)
- Christelle Elias
- Service d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France
- Équipe Santé Publique, Epidémiologie et Eco-évolution des Maladies Infectieuses (PHE3ID), Centre International de Recherche en Infectiologie, Lyon, France
| | - Sandrine Nail-Billaud
- Centre de Recherche en Cancérologie-Immunologie Nantes Angers (CRCINA), UMR 1232 Inserm-Equipe 7 « Immunité Innée et Immunothérapie », Université Angers Faculté des Sciences, Angers, France
- Institut de Biologie en Santé, CHU Angers, Angers, France
| | - Patrick Basset
- Fonds de dotation, Ultra Sports Science, Pierre-Bénite, France
| | - Frédéric Laurent
- Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | | | | | - Pascal Roy
- Service de Biostatistiques, Hospices Civils de Lyon, Lyon, France
| | - Philippe Vanhems
- Service d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France
- Équipe Santé Publique, Epidémiologie et Eco-évolution des Maladies Infectieuses (PHE3ID), Centre International de Recherche en Infectiologie, Lyon, France
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29
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de Fougerolles TR, Damm O, Ansaldi F, Chironna M, Crépey P, de Lusignan S, Gray I, Guillen JM, Kassianos G, Mosnier A, de Lejarazu RO, Pariani E, Puig-Barbera J, Schelling J, Trippi F, Vanhems P, Wahle K, Watkins J, Rasuli A, Vitoux O, Bricout H. National influenza surveillance systems in five European countries: a qualitative comparative framework based on WHO guidance. BMC Public Health 2022; 22:1151. [PMID: 35681199 PMCID: PMC9178537 DOI: 10.1186/s12889-022-13433-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 05/13/2022] [Indexed: 11/27/2022] Open
Abstract
Background Influenza surveillance systems vary widely between countries and there is no framework to evaluate national surveillance systems in terms of data generation and dissemination. This study aimed to develop and test a comparative framework for European influenza surveillance. Methods Surveillance systems were evaluated qualitatively in five European countries (France, Germany, Italy, Spain, and the United Kingdom) by a panel of influenza experts and researchers from each country. Seven surveillance sub-systems were defined: non-medically attended community surveillance, virological surveillance, community surveillance, outbreak surveillance, primary care surveillance, hospital surveillance, mortality surveillance). These covered a total of 19 comparable outcomes of increasing severity, ranging from non-medically attended cases to deaths, which were evaluated using 5 comparison criteria based on WHO guidance (granularity, timing, representativeness, sampling strategy, communication) to produce a framework to compare the five countries. Results France and the United Kingdom showed the widest range of surveillance sub-systems, particularly for hospital surveillance, followed by Germany, Spain, and Italy. In all countries, virological, primary care and hospital surveillance were well developed, but non-medically attended events, influenza cases in the community, outbreaks in closed settings and mortality estimates were not consistently reported or published. The framework also allowed the comparison of variations in data granularity, timing, representativeness, sampling strategy, and communication between countries. For data granularity, breakdown per risk condition were available in France and Spain, but not in the United Kingdom, Germany and Italy. For data communication, there were disparities in the timeliness and accessibility of surveillance data. Conclusions This new framework can be used to compare influenza surveillance systems qualitatively between countries to allow the identification of structural differences as well as to evaluate adherence to WHO guidance. The framework may be adapted for other infectious respiratory diseases. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13433-0.
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Affiliation(s)
| | - Oliver Damm
- Sanofi-Aventis Deutschland GmbH, Berlin, Germany
| | | | - Maria Chironna
- Department of Interdisciplinary Medicine - Hygiene Section, University of Bari, Bari, Italy
| | - Pascal Crépey
- Université de Rennes, EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS - U 1309, Rennes, France
| | - Simon de Lusignan
- University of Oxford, Oxford, UK.,Royal College of General Practitioners, London, UK
| | | | | | | | | | | | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | | | | | - Philippe Vanhems
- CIRI, Centre International de Recherche en Infectiologie, (Team (PHE3ID), Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007, Lyon, France.,Hospices Civils de Lyon and Hospices Civils de Lyon (HCL), Lyon, France
| | - Klaus Wahle
- Westfälische Wilhelms-Universität, Munich, Germany
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Loubet P, Wittkop L, Ninove L, Chalouni M, Lacombe K, Pourcher V, Galtier F, Laviolle B, Vanhems P, Launay O. Immunité humorale à la vaccination Covid-19 en populations particulières : résultats préliminaires de la cohorte ANRS0001 S COV-POPART. MÉDECINE ET MALADIES INFECTIEUSES FORMATION 2022. [PMCID: PMC9152496 DOI: 10.1016/j.mmifmc.2022.03.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Introduction L'efficacité de la vaccination Covid-19 est diminuée chez les personnes immunodéprimées. La réponse en anticorps anti-Spike est hétérogène dans ces populations mais la plupart des études publiées sont de taille limitée sans groupe contrôle. Matériels et méthodes COV-POPART est une cohorte nationale prospective multicentrique ayant inclus, entre le 25 mars et le 31 décembre 2021, des participants adultes dans 11 populations particulières (cancer solide, transplantés organe solide (TOS), greffés cellules souches hématopoïétiques (GCSH), insuffisants rénaux chroniques (IRC), maladies auto-immunes et systémiques (MAIS), rhumatismes inflammatoires chroniques (RIC), Sclérose En Plaques et maladies du spectre de la neuromyélite optique (SEP), hypogammaglobulinémie, diabète (1 et 2), obésité sans diabète, Personnes Vivant avec le VIH-1 (PVVIH)) et 2 groupes contrôles (18-74 ans et > 74 ans) indemnes des affections suscitées. Les participants ayant à l'inclusion des anticorps anti-nucléocapside (NCP) positifs ont été exclus. La proportion de participants avec des anticorps IgG anti-Spike (ELISA Euroimmun) (=répondeurs) et des anticorps neutralisants spécifiques (test de neutralisation in vitro sur la souche originale) a été évaluée de manière standardisée et centralisée un mois après la deuxième dose de vaccin. Résultats Parmi les 6612 participants de la cohorte, 3301 avaient des résultats disponibles au 17/02/2022 et 3127 des anticorps anti-NCP négatifs : 2271 participants de populations particulières (156 cancers solides, 135 TOS, 47 GCSH, 81 IRC, 124 MAI, 129 RIC, 321 SEP, 50 hypogammaglobulinémies, 320 diabétiques, 623 obèses non diabétiques et 777 VIH) et 856 contrôles (831 : 18-74 ans et 25 : >74 ans). La majorité des participants (86,7%) a reçu deux doses de BNT162b2. Dans le groupe contrôle, 99,9% (IC95% 99,3 ; 100,0) des personnes âgées de 18 à 74 ans et 96,0% (79.6 ; 99,9) des personnes âgées de plus de 75 ans ont développé des anticorps IgG anti-Spike. Chez les patients obèses et les PVVIH, les pourcentages de répondeurs étaient de 88,9 % (86,2 ; 91,3) et 97.3 % (95,9 ; 98,3). Les pourcentages de répondeurs étaient plus faibles chez les SEP (73,8 % [68,7 ; 78,6]), GCSH (61,7 % [46,4 ; 75,5]) ou TOS (31,1 % [23,4 ; 39,6]). La fréquence des anticorps neutralisants était similaire à celle des anticorps anti-Spike dans les groupes contrôles. Les obèses et PVVIH (85,8 % [82,8 ; 88,5] et 95,6 % [93,9 ; 96,9]) présentaient plus fréquemment des anticorps neutralisants contrairement aux participants SEP, GSCH et TOS (69,8 % [64,4 ; 74,8], 57,4 % [42,2 ; 71,7] et 27,4 % [20,1 ; 35,7]). Conclusion Les résultats préliminaires de la cohorte COV-POPART montrent, à 1 mois de la fin du schéma vaccinal standard de primo-vaccination Covid-19, une réponse humorale hétérogène dans les populations particulières. Cette réponse est plus faible chez les patients atteints de SEP, GSCH ou TOS. Aucun lien d'intérêt
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31
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Rees CA, Colbourn T, Hooli S, King C, Lufesi N, McCollum ED, Mwansambo C, Cutland C, Madhi SA, Nunes M, Matthew JL, Addo-Yobo E, Chisaka N, Hassan M, Hibberd PL, Jeena PM, Lozano JM, MacLeod WB, Patel A, Thea DM, Nguyen NTV, Kartasasmita CB, Lucero M, Awasthi S, Bavdekar A, Chou M, Nymadawa P, Pape JW, Paranhos-Baccala G, Picot VS, Rakoto-Andrianarivelo M, Rouzier V, Russomando G, Sylla M, Vanhems P, Wang J, Asghar R, Banajeh S, Iqbal I, Maulen-Radovan I, Mino-Leon G, Saha SK, Santosham M, Singhi S, Basnet S, Strand TA, Bhatnagar S, Wadhwa N, Lodha R, Aneja S, Clara AW, Campbell H, Nair H, Falconer J, Qazi SA, Nisar YB, Neuman MI. Derivation and validation of a novel risk assessment tool to identify children aged 2–59 months at risk of hospitalised pneumonia-related mortality in 20 countries. BMJ Glob Health 2022; 7:bmjgh-2021-008143. [PMID: 35428680 PMCID: PMC9014031 DOI: 10.1136/bmjgh-2021-008143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 03/20/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction Existing risk assessment tools to identify children at risk of hospitalised pneumonia-related mortality have shown suboptimal discriminatory value during external validation. Our objective was to derive and validate a novel risk assessment tool to identify children aged 2–59 months at risk of hospitalised pneumonia-related mortality across various settings. Methods We used primary, baseline, patient-level data from 11 studies, including children evaluated for pneumonia in 20 low-income and middle-income countries. Patients with complete data were included in a logistic regression model to assess the association of candidate variables with the outcome hospitalised pneumonia-related mortality. Adjusted log coefficients were calculated for each candidate variable and assigned weighted points to derive the Pneumonia Research Partnership to Assess WHO Recommendations (PREPARE) risk assessment tool. We used bootstrapped selection with 200 repetitions to internally validate the PREPARE risk assessment tool. Results A total of 27 388 children were included in the analysis (mean age 14.0 months, pneumonia-related case fatality ratio 3.1%). The PREPARE risk assessment tool included patient age, sex, weight-for-age z-score, body temperature, respiratory rate, unconsciousness or decreased level of consciousness, convulsions, cyanosis and hypoxaemia at baseline. The PREPARE risk assessment tool had good discriminatory value when internally validated (area under the curve 0.83, 95% CI 0.81 to 0.84). Conclusions The PREPARE risk assessment tool had good discriminatory ability for identifying children at risk of hospitalised pneumonia-related mortality in a large, geographically diverse dataset. After external validation, this tool may be implemented in various settings to identify children at risk of hospitalised pneumonia-related mortality.
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Affiliation(s)
- Chris A Rees
- Division of Pediatric Emergency Medicine, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Tim Colbourn
- Institute for Global Health, University College London, London, UK
| | - Shubhada Hooli
- Section of Pediatric Emergency Medicine, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA
| | - Carina King
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Norman Lufesi
- Acute Respiratory Illness Unit, Government of Malawi Ministry of Health, Lilongwe, Malawi
| | - Eric D McCollum
- Global Program in Respiratory Sciences, Eudowood Division of Pediatric Respiratory Sciences, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Charles Mwansambo
- Acute Respiratory Illness Unit, Government of Malawi Ministry of Health, Lilongwe, Malawi
| | - Clare Cutland
- South African Medical Research Council: Vaccines and Infectious Diseases Analytics Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg-Braamfontein, South Africa
| | - Shabir Ahmed Madhi
- South African Medical Research Council: Vaccines and Infectious Diseases Analytics Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg-Braamfontein, South Africa
| | - Marta Nunes
- South African Medical Research Council: Vaccines and Infectious Diseases Analytics Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg-Braamfontein, South Africa
| | - Joseph L Matthew
- Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Noel Chisaka
- World Bank, World Bank, Washington, District of Columbia, USA
| | - Mumtaz Hassan
- Department of Pediatrics, Children's Hospital, Islamabad, Pakistan
| | - Patricia L Hibberd
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Prakash M Jeena
- Department of Paediatrics and Child Health, University of KwaZulu-Natal Nelson R Mandela School of Medicine, Durban, South Africa
| | - Juan M Lozano
- Division of Medical and Population Health Science Education and Research, Florida International University, Miami, Florida, USA
| | - William B MacLeod
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Archana Patel
- Lata Medical Research Foundation, Nagpur and Datta Meghe Institute of Medical Sciences, Sawangi, India
| | - Donald M Thea
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | | | - Cissy B Kartasasmita
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Marilla Lucero
- Department of Pediatrics, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Shally Awasthi
- Department of Pediatrics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | | | - Monidarin Chou
- Rodolph Mérieux Laboratory, Faculty of Medicine, University of Health Sciences, Phnom Penh, Cambodia
| | - Pagbajabyn Nymadawa
- Department of Pediatrics, Mongolian Academy of Sciences, Ulaanbaatar, Mongolia
| | | | | | | | | | | | - Graciela Russomando
- Departamento de Biología Molecular y Genética, Instituto de Investigaciones en Ciencias de la Salud, Asuncion, Paraguay
| | - Mariam Sylla
- Department of Pediatrics, Gabriel Touré University Hospital Center, Bamako, Mali
| | - Philippe Vanhems
- Unité d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France
| | - Jianwei Wang
- MOH Key Laboratory of Systems Biology of Pathogens and Dr Christophe Mérieux Laboratory, Chinese Academy of Medical Sciences & Peking Union, Beijing, China
| | - Rai Asghar
- Department of Paediatrics, Rawalpindi Medical College, Rawalpindi, Pakistan
| | - Salem Banajeh
- Department of Pediatrics, Sana'a University, Sana'a, Yemen
| | - Imran Iqbal
- Department of Pediatrics, Nishtar Medical College, Multan, Pakistan
| | - Irene Maulen-Radovan
- Division de Investigacion Insurgentes, Instituto Nactional de Pediatria, Mexico City, Mexico
| | - Greta Mino-Leon
- Infectious Diseases, Children's Hospital Dr Francisco de Ycaza Bustamante, Guayaquil, Ecuador
| | - Samir K Saha
- Child Health Research Foundation, Dhaka Shishu Hosp, Dhaka, Bangladesh
| | - Mathuram Santosham
- International Vaccine Access Center (IVAC), Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Sunit Singhi
- Department of Pediatrics, Medanta, The Medicity, Gurgaon, India
| | - Sudha Basnet
- Department of Pediatrics, Tribhuvan University Institute of Medicine, Kathmandu, Nepal
| | - Tor A Strand
- Department of Research, Innlandet Hospital Trust, Lillehammer, Norway
| | - Shinjini Bhatnagar
- Department of Maternal and Child Health, Translational Health Science and Technology Institute, Faridabad, India
| | - Nitya Wadhwa
- Department of Maternal and Child Health, Translational Health Science and Technology Institute, Faridabad, India
| | - Rakesh Lodha
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Satinder Aneja
- Department of Pediatrics, Sharda University School of Medical Sciences and Research, Greater Noida, Uttar Pradesh, India
| | - Alexey W Clara
- Central American Region, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Harry Campbell
- Population Health Sciences and Informati, The University of Edinburgh, Edinburgh, UK
| | - Harish Nair
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, Scotland
| | - Jennifer Falconer
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, Scotland
| | - Shamim A Qazi
- Department of Maternal, Newborn, Child, and Adolescent Health (Retired), World Health Organization, Geneva, Switzerland
| | - Yasir B Nisar
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Mark I Neuman
- Division of Emergency Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Parant F, Bouloy J, Haesebaert J, Bendim’red L, Goldet K, Vanhems P, Henaff L, Gilbert T, Cuerq C, Blond E, Bost M, Bonnefoy M. Vitamin D and COVID-19 Severity in Hospitalized Older Patients: Potential Benefit of Prehospital Vitamin D Supplementation. Nutrients 2022; 14:nu14081641. [PMID: 35458203 PMCID: PMC9031320 DOI: 10.3390/nu14081641] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 02/06/2023] Open
Abstract
Studies involving the associations between vitamin D supplementation taken before the onset of COVID-19 infection and the clinical outcomes are still scarce and this issue remains controversial. This study aimed to assess the relationships between vitamin D (VitD) status and supplementation and coronavirus disease 2019 (COVID-19) severity in older adults (average age of 78 years) hospitalized for COVID-19. We conducted an observational retrospective cohort study with 228 older hospitalized patients during the first wave of the COVID-19 pandemic. The outcomes were in-hospital mortality secondary to COVID-19 or critically severe COVID-19. A logistic regression analysis was conducted to test whether pre-hospital VitD supplementation was independently associated with severity. In this study, 46% of patients developed a severe form and the overall in-hospital mortality was 15%. Sixty-six (29%) patients received a VitD supplement during the 3 months preceding the infection onset. Additionally, a VitD supplement was associated with fewer severe COVID-19 forms (OR = 0.426, p = 0.0135) and intensive care unit (ICU) admissions (OR = 0.341, p = 0.0076). As expected, age > 70 years, male gender and BMI ≥ 35 kg/m2 were independent risk factors for severe forms of COVID-19. No relationship between serum 25(OH)D levels and the severity of the COVID-19 was identified. VitD supplementation taken during the 3 months preceding the infection onset may have a protective effect on the development of severe COVID-19 forms in older adults. Randomized controlled trials and large-scale cohort studies are necessary to strengthen this observation.
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Affiliation(s)
- François Parant
- Biology Center South, Hôpital Lyon Sud, 69310 Pierre-Bénite, France; (F.P.); (C.C.); (E.B.); (M.B.)
| | - Justin Bouloy
- Department of Geriatric Medicine, Groupement Hospitalier Sud, CHU de Lyon, 69495 Pierre-Bénite, France; (T.G.); (M.B.)
- Correspondence: ; Tel.: +33-6-68-41-83-65
| | - Julie Haesebaert
- Department of Clinical Research and Epidemiology, Public Health Unit, Groupement Hospitalier Est, 69002 Lyon, France;
- RESHAPE Research on Healthcare Performance Inserm U1290, Université Lyon 1, 69008 Lyon, France
| | - Lamia Bendim’red
- Clinical Research Centre, Ageing, Brain, Fragility-Hôpital des Charpennes, 69100 Villeurbanne, France; (L.B.); (K.G.)
| | - Karine Goldet
- Clinical Research Centre, Ageing, Brain, Fragility-Hôpital des Charpennes, 69100 Villeurbanne, France; (L.B.); (K.G.)
| | - Philippe Vanhems
- Department of Hygiene, Epidemiology and Prevention, Hôpital Édouard Herriot, Hospices Civils de Lyon, 69003 Lyon, France; (P.V.); (L.H.)
- ICIR-International Center for Infectiology Research (Team PHE3ID), Claude Bernard Lyon 1 University, Inserm, U1111, CNRS, UMR5308, ENS Lyon, 46 Allée d’Italie, 69007 Lyon, France
| | - Laetitia Henaff
- Department of Hygiene, Epidemiology and Prevention, Hôpital Édouard Herriot, Hospices Civils de Lyon, 69003 Lyon, France; (P.V.); (L.H.)
- ICIR-International Center for Infectiology Research (Team PHE3ID), Claude Bernard Lyon 1 University, Inserm, U1111, CNRS, UMR5308, ENS Lyon, 46 Allée d’Italie, 69007 Lyon, France
| | - Thomas Gilbert
- Department of Geriatric Medicine, Groupement Hospitalier Sud, CHU de Lyon, 69495 Pierre-Bénite, France; (T.G.); (M.B.)
- RESHAPE Research on Healthcare Performance Inserm U1290, Université Lyon 1, 69008 Lyon, France
| | - Charlotte Cuerq
- Biology Center South, Hôpital Lyon Sud, 69310 Pierre-Bénite, France; (F.P.); (C.C.); (E.B.); (M.B.)
| | - Emilie Blond
- Biology Center South, Hôpital Lyon Sud, 69310 Pierre-Bénite, France; (F.P.); (C.C.); (E.B.); (M.B.)
| | - Muriel Bost
- Biology Center South, Hôpital Lyon Sud, 69310 Pierre-Bénite, France; (F.P.); (C.C.); (E.B.); (M.B.)
| | - Marc Bonnefoy
- Department of Geriatric Medicine, Groupement Hospitalier Sud, CHU de Lyon, 69495 Pierre-Bénite, France; (T.G.); (M.B.)
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Dananché C, Paranhos-Baccalà G, Messaoudi M, Sylla M, Awasthi S, Bavdekar A, Pape JW, Rouzier V, Wang J, Sanghavi S, Diallo S, Chou M, Eap T, Rakoto-Andrianarivelo M, Endtz H, Ren L, Dash-Yandag B, Guillen R, Nymadawa P, Russomando G, Komurian-Pradel F, Vanhems P, Picot VS. Nasopharyngeal Viral and Bacterial Co-Detection among Children from Low- and Middle-Income Countries with and without Pneumonia. Am J Trop Med Hyg 2022; 106:1086-1093. [PMID: 35130481 PMCID: PMC8991339 DOI: 10.4269/ajtmh.21-0980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/23/2021] [Indexed: 11/07/2022] Open
Abstract
The role of microbial coinfection in the pathogenesis of pneumonia in children is not well known. The aim of this work was to describe the prevalence of microorganism co-detection in nasopharyngeal samples (NPS) of pneumonia cases and control subjects and to study the potential association between nasopharyngeal microorganism co-detection and pneumonia. A case-control study was carried out from 2010 to 2014 in nine study sites located in low- or middle-income countries. The data from 888 children under 5 years of age with pneumonia (cases) and 870 children under 5 without pneumonia (controls) were analyzed. Nasopharyngeal samples were collected; reverse transcription polymerase chain reaction (RT-PCR) enabled the detection of five bacteria and 19 viruses. Multiple, mixed-effects logistic regression modeling was undertaken to evaluate the association between microorganism co-detection and pneumonia. A single Streptococcus pneumoniae colonization was observed in 15.2% of the controls and 10.1% of the cases (P = 0.001), whereas S. pneumoniae and a single virus co-detection was observed in 33.3% of the cases and in 14.6% of the controls (P < 0.001). Co-detections with rhinovirus, respiratory syncytial virus, parainfluenza virus, human metapneumovirus, and influenza virus were more frequent in the cases compared with the controls (P < 0.001) and were significantly associated with pneumonia in multiple regression analysis. The proportion of single virus detection without bacterial co-detection was not different between cases and controls (13.6% versus 11.3%, P = 0.13). This study suggests that coinfection of S. pneumoniae and certain viruses may play a role in the pathophysiology of pneumonia in children.
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Affiliation(s)
- Cédric Dananché
- CIRI, Centre International de Recherche en Infectiologie (team Public Health, Epidemiology and Evolutionnary Ecology of Infectious Diseases (PHE3ID)), Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007, Lyon, France
- Infection Control and Epidemiology Department, Hospices Civils de Lyon, Lyon, France
| | | | | | | | - Shally Awasthi
- Chatrapati Shahu Ji Maharaj Medical University, Lucknow, India
| | | | - Jean-William Pape
- Centres GHESKIO (Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes), Port-au-Prince, Haiti
| | - Vanessa Rouzier
- Centres GHESKIO (Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes), Port-au-Prince, Haiti
| | - Jianwei Wang
- MOH Key Laboratory of the Systems Biology of Pathogens and Dr. Christophe Mérieux Laboratory, Fondation Mérieux, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | | | | | - Monidarin Chou
- Faculty of Pharmacy, University of Health Sciences, Phnom Penh, Cambodia
| | - Tekchheng Eap
- Department of Pneumology, National Pediatric Hospital, Phnom Penh, Cambodia
| | | | - Hubert Endtz
- Mérieux Foundation, Lyon, France
- Department of Clinical Microbiology & Infectious Diseases, Erasmus MC, Rotterdam, The Netherlands
| | - Lili Ren
- MOH Key Laboratory of the Systems Biology of Pathogens and Dr. Christophe Mérieux Laboratory, Fondation Mérieux, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | | | - Rosa Guillen
- Instituto de Investigaciones en Ciencias de la Salud, National University of Asunción, Asunción, Paraguay
| | | | - Graciela Russomando
- Instituto de Investigaciones en Ciencias de la Salud, National University of Asunción, Asunción, Paraguay
| | | | - Philippe Vanhems
- CIRI, Centre International de Recherche en Infectiologie (team Public Health, Epidemiology and Evolutionnary Ecology of Infectious Diseases (PHE3ID)), Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007, Lyon, France
- Infection Control and Epidemiology Department, Hospices Civils de Lyon, Lyon, France
- Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Lyon center, France
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Venet F, Gossez M, Bidar F, Bodinier M, Coudereau R, Lukaszewicz AC, Tardiveau C, Brengel-Pesce K, Cheynet V, Cazalis MA, Pescarmona R, Garnier L, Ortillon M, Buisson M, Bouscambert-Duchamp M, Morfin-Sherpa F, Casalegno JS, Conti F, Rimmelé T, Argaud L, Cour M, Saadatian-Elahi M, Henaff L, Vanhems P, Monneret G. T cell response against SARS-CoV-2 persists after one year in patients surviving severe COVID-19. EBioMedicine 2022; 78:103967. [PMID: 35349827 PMCID: PMC8957405 DOI: 10.1016/j.ebiom.2022.103967] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 03/10/2022] [Accepted: 03/10/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND In critically ill COVID-19 patients, the initial response to SARS-CoV-2 infection is characterized by major immune dysfunctions. The capacity of these severe patients to mount a robust and persistent SARS-CoV-2 specific T cell response despite the presence of severe immune alterations during the ICU stay is unknown. METHODS Critically ill COVID-19 patients were sampled five times during the ICU stay and 9 and 13 months afterwards. Immune monitoring included counts of lymphocyte subpopulations, HLA-DR expression on monocytes, plasma IL-6 and IL-10 concentrations, anti-SARS-CoV-2 IgG levels and T cell proliferation in response to three SARS-CoV-2 antigens. FINDINGS Despite the presence of major lymphopenia and decreased monocyte HLA-DR expression during the ICU stay, convalescent critically ill COVID-19 patients consistently generated adaptive and humoral immune responses against SARS-CoV-2 maintained for more than one year after hospital discharge. Patients with long hospital stays presented with stronger anti-SARS-CoV-2 specific T cell response but no difference in anti-SARS-CoV2 IgG levels. INTERPRETATION Convalescent critically ill COVID-19 patients consistently generated a memory immune response against SARS-CoV-2 maintained for more than one year after hospital discharge. In recovered individuals, the intensity of SARS-CoV-2 specific T cell response was dependent on length of hospital stay. FUNDING This observational study was supported by funds from the Hospices Civils de Lyon, Fondation HCL, Claude Bernard Lyon 1 University and Région Auvergne Rhône-Alpes and by partial funding by REACTing (Research and ACTion targeting emerging infectious diseases) INSERM, France and a donation from Fondation AnBer (http://fondationanber.fr/).
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Affiliation(s)
- Fabienne Venet
- Immunology Laboratory, Hôpital E. Herriot - Hospices Civils de Lyon, 5 place d'Arsonval, Lyon 69437 CEDEX 03, France; Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Université Claude Bernard-Lyon 1, Lyon, France.
| | - Morgane Gossez
- Immunology Laboratory, Hôpital E. Herriot - Hospices Civils de Lyon, 5 place d'Arsonval, Lyon 69437 CEDEX 03, France; Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Université Claude Bernard-Lyon 1, Lyon, France
| | - Frank Bidar
- EA 7426 "Pathophysiology of Injury-Induced Immunosuppression" (Université Claude Bernard Lyon 1 - Hospices Civils de Lyon - bioMérieux), Joint Research Unit HCL-bioMérieux, Lyon 69003, France; Anesthesia and Critical Care Medicine Department, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon 69437, France
| | - Maxime Bodinier
- EA 7426 "Pathophysiology of Injury-Induced Immunosuppression" (Université Claude Bernard Lyon 1 - Hospices Civils de Lyon - bioMérieux), Joint Research Unit HCL-bioMérieux, Lyon 69003, France
| | - Rémy Coudereau
- Immunology Laboratory, Hôpital E. Herriot - Hospices Civils de Lyon, 5 place d'Arsonval, Lyon 69437 CEDEX 03, France; EA 7426 "Pathophysiology of Injury-Induced Immunosuppression" (Université Claude Bernard Lyon 1 - Hospices Civils de Lyon - bioMérieux), Joint Research Unit HCL-bioMérieux, Lyon 69003, France
| | - Anne-Claire Lukaszewicz
- EA 7426 "Pathophysiology of Injury-Induced Immunosuppression" (Université Claude Bernard Lyon 1 - Hospices Civils de Lyon - bioMérieux), Joint Research Unit HCL-bioMérieux, Lyon 69003, France; Anesthesia and Critical Care Medicine Department, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon 69437, France
| | - Claire Tardiveau
- EA 7426 "Pathophysiology of Injury-Induced Immunosuppression" (Université Claude Bernard Lyon 1 - Hospices Civils de Lyon - bioMérieux), Joint Research Unit HCL-bioMérieux, Lyon 69003, France
| | - Karen Brengel-Pesce
- EA 7426 "Pathophysiology of Injury-Induced Immunosuppression" (Université Claude Bernard Lyon 1 - Hospices Civils de Lyon - bioMérieux), Joint Research Unit HCL-bioMérieux, Lyon 69003, France
| | - Valérie Cheynet
- EA 7426 "Pathophysiology of Injury-Induced Immunosuppression" (Université Claude Bernard Lyon 1 - Hospices Civils de Lyon - bioMérieux), Joint Research Unit HCL-bioMérieux, Lyon 69003, France
| | - Marie-Angélique Cazalis
- EA 7426 "Pathophysiology of Injury-Induced Immunosuppression" (Université Claude Bernard Lyon 1 - Hospices Civils de Lyon - bioMérieux), Joint Research Unit HCL-bioMérieux, Lyon 69003, France
| | - Rémi Pescarmona
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Université Claude Bernard-Lyon 1, Lyon, France; Immunology Laboratory, Lyon-Sud University Hospital - Hospices Civils de Lyon, Pierre-Bénite, France
| | - Lorna Garnier
- Immunology Laboratory, Lyon-Sud University Hospital - Hospices Civils de Lyon, Pierre-Bénite, France
| | - Marine Ortillon
- Immunology Laboratory, Hôpital E. Herriot - Hospices Civils de Lyon, 5 place d'Arsonval, Lyon 69437 CEDEX 03, France
| | - Marielle Buisson
- Centre d'Investigation Clinique de Lyon (CIC 1407 Inserm), Hospices Civils de Lyon, Lyon F-69677, France
| | - Maude Bouscambert-Duchamp
- Virology Laboratory, CNR des virus des infections Respiratoires, Institut des Agents Infectieux, Hospices Civils de Lyon, Hôpital de la Croix Rousse, Lyon, France
| | - Florence Morfin-Sherpa
- Virology Laboratory, CNR des virus des infections Respiratoires, Institut des Agents Infectieux, Hospices Civils de Lyon, Hôpital de la Croix Rousse, Lyon, France
| | - Jean-Sébastien Casalegno
- Virology Laboratory, CNR des virus des infections Respiratoires, Institut des Agents Infectieux, Hospices Civils de Lyon, Hôpital de la Croix Rousse, Lyon, France
| | - Filippo Conti
- EA 7426 "Pathophysiology of Injury-Induced Immunosuppression" (Université Claude Bernard Lyon 1 - Hospices Civils de Lyon - bioMérieux), Joint Research Unit HCL-bioMérieux, Lyon 69003, France
| | - Thomas Rimmelé
- EA 7426 "Pathophysiology of Injury-Induced Immunosuppression" (Université Claude Bernard Lyon 1 - Hospices Civils de Lyon - bioMérieux), Joint Research Unit HCL-bioMérieux, Lyon 69003, France; Anesthesia and Critical Care Medicine Department, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon 69437, France
| | - Laurent Argaud
- Medical intensive Care Department, Hospices Civils de Lyon, Edouard Herriot Hospital, Lyon 69437, France
| | - Martin Cour
- Medical intensive Care Department, Hospices Civils de Lyon, Edouard Herriot Hospital, Lyon 69437, France
| | - Mitra Saadatian-Elahi
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Université Claude Bernard-Lyon 1, Lyon, France; Service Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Edouard Herriot Hospital, Lyon 69437, France
| | - Laetitia Henaff
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Université Claude Bernard-Lyon 1, Lyon, France; Service Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Edouard Herriot Hospital, Lyon 69437, France
| | - Philippe Vanhems
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Université Claude Bernard-Lyon 1, Lyon, France; Service Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Edouard Herriot Hospital, Lyon 69437, France
| | - Guillaume Monneret
- Immunology Laboratory, Hôpital E. Herriot - Hospices Civils de Lyon, 5 place d'Arsonval, Lyon 69437 CEDEX 03, France; EA 7426 "Pathophysiology of Injury-Induced Immunosuppression" (Université Claude Bernard Lyon 1 - Hospices Civils de Lyon - bioMérieux), Joint Research Unit HCL-bioMérieux, Lyon 69003, France
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Romain-Scelle N, Elias C, Vanhems P. COVID-19 vaccine is correlated with favourable epidemiological indicators in the Auvergne-Rhône-Alpes region (France): An ecological study. Vaccine 2022; 40:695-700. [PMID: 34969543 PMCID: PMC8692069 DOI: 10.1016/j.vaccine.2021.12.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 12/08/2021] [Accepted: 12/14/2021] [Indexed: 01/25/2023]
Abstract
COVID-19 vaccination has proven to be effective in preventing severe cases, reducing viral load, and transmissibility. The aim of this study was to evaluate the impact of vaccination 11 months after implementation on epidemiological indicators and the effective reproduction number in one French region. We plotted four indicators with vaccination coverage as the explaining variable and estimated the impact of vaccination using the reduction rates in infections and hospital admissions. A reduction of 98% in COVID-19-related hospitalisation 11 months after the vaccine campaign began in January 2021 has been reported while vaccine coverage increased over time. Those results do not make it possible to postulate a causal relationship but do support the effect of vaccination against multiple variants of concern. Non-pharmaceutical measures remain necessary to attain complete epidemic control. Open epidemiological data should be considered to monitor vaccine effectiveness wherever possible.
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Affiliation(s)
- Nicolas Romain-Scelle
- Service Hygiène, Epidémiologie, Infectiovigilance et Prévention, Centre Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Christelle Elias
- Service Hygiène, Epidémiologie, Infectiovigilance et Prévention, Centre Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France,Équipe Santé Publique, Epidémiologie et Eco-évolution des Maladies Infectieuses CIRI-Centre International de Recherche en Infectiologie, Université de Lyon, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Lyon, France
| | - Philippe Vanhems
- Service Hygiène, Epidémiologie, Infectiovigilance et Prévention, Centre Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France,Équipe Santé Publique, Epidémiologie et Eco-évolution des Maladies Infectieuses CIRI-Centre International de Recherche en Infectiologie, Université de Lyon, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Lyon, France,INSERM, F-CRIN, Lyon Centre of Innovative Clinical Research Network in Vaccinology (I-REIVAC), CIC 1417, Paris, France,Corresponding author
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36
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Dessemon J, Elias C, Henaff L, Saadatian-Elahi M, Vanhems P. Venerable but Vulnerable: When Centenarians Encounter Coronavirus Disease 2019. Open Forum Infect Dis 2022; 9:ofab580. [PMID: 35028330 PMCID: PMC8753035 DOI: 10.1093/ofid/ofab580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 11/23/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Juliette Dessemon
- Équipe Santé Publique, Épidémiologie et Eco-évolution des Maladies Infectieuses, CIRI, Centre International de Recherche en Infectiologie, Université Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, Lyon, France
| | - Christelle Elias
- Unité d'Hygiène, Épidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France
| | - Laetitia Henaff
- Équipe Santé Publique, Épidémiologie et Eco-évolution des Maladies Infectieuses, CIRI, Centre International de Recherche en Infectiologie, Université Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, Lyon, France
| | - Mitra Saadatian-Elahi
- Équipe Santé Publique, Épidémiologie et Eco-évolution des Maladies Infectieuses, CIRI, Centre International de Recherche en Infectiologie, Université Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, Lyon, France
| | - Philippe Vanhems
- Équipe Santé Publique, Épidémiologie et Eco-évolution des Maladies Infectieuses, CIRI, Centre International de Recherche en Infectiologie, Université Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, Lyon, France.,Unité d'Hygiène, Épidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France.,Unité d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Centre Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France.,F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France
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Luong Ngyen LB, Bauer R, Lesieur Z, Galtier F, Duval X, Vanhems P, Lainé F, Tattevin P, Durier C, Launay O. Vaccine effectiveness against COVID-19 hospitalization in adults in France: A test negative case control study. Infect Dis Now 2021; 52:40-43. [PMID: 34920180 PMCID: PMC8673927 DOI: 10.1016/j.idnow.2021.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 10/18/2021] [Accepted: 12/08/2021] [Indexed: 11/26/2022]
Abstract
Background Measuring vaccine effectiveness (VE) using real-life data is critical to confirm the effectiveness of licensed vaccine, which could strengthen vaccination adherence. Methods We measured VE against adult COVID-19 hospitalization in five hospitals in France using a test negative design. We compared the odds of vaccinated patients hospitalized with COVID-19 with the odds of vaccinated patients hospitalized for the same symptoms with a negative test. Results A total of 853 patients (463 cases and 390 controls) were included, with a total of 170 patients vaccinated (104 with one dose, 65 with two doses, and one with three doses). There were four cases of breakthrough infections, all in immunocompromised patients. The VE was 84.0% (CI0.95 = [72.6; 90.6]) for one dose and 96.2% (CI0.95 = [86.8; 98.9]) for two doses. Conclusion Our results confirm the high VE of COVID-19 vaccine in France to prevent hospitalizations due to the alpha variant.
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Affiliation(s)
| | | | | | - Florence Galtier
- Inserm, CIC 1411, CHU de Montpellier, Saint-Éloi Hospital, Montpellier, France
| | - Xavier Duval
- Inserm, CIC 1425, AP-HP, Hôpital Bichat, Paris, France
| | - Philippe Vanhems
- Service d'hygiène, épidémiologie, infectiovigilance et prévention, hospices civils de Lyon, Lyon, France
| | | | - Pierre Tattevin
- Services de maladies infectieuses et réanimation médicale, hôpital Pontchaillou, CHU de Rennes, Rennes, France
| | | | - Odile Launay
- Inserm, CIC 1417, Hôpital Cochin, AP-HP, Paris, France; Inserm, F-CRIN I-REIVAC, Paris, France
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Pageaud S, Pothier C, Rigotti C, Eyraud-Loisel A, Bertoglio JP, Bienvenüe A, Leboisne N, Ponthus N, Gauchon R, Gueyffier F, Vanhems P, Iwaz J, Loisel S, Roy P. Expected Evolution of COVID-19 Epidemic in France for Several Combinations of Vaccination Strategies and Barrier Measures. Vaccines (Basel) 2021; 9:1462. [PMID: 34960207 PMCID: PMC8708137 DOI: 10.3390/vaccines9121462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/23/2021] [Accepted: 12/02/2021] [Indexed: 11/30/2022] Open
Abstract
The outbreak of the SARS-CoV-2 virus, enhanced by rapid spreads of variants, has caused a major international health crisis, with serious public health and economic consequences. An agent-based model was designed to simulate the evolution of the epidemic in France over 2021 and the first six months of 2022. The study compares the efficiencies of four theoretical vaccination campaigns (over 6, 9, 12, and 18 months), combined with various non-pharmaceutical interventions. In France, with the emergence of the Alpha variant, without vaccination and despite strict barrier measures, more than 600,000 deaths would be observed. An efficient vaccination campaign (i.e., total coverage of the French population) over six months would divide the death toll by 10. A vaccination campaign of 12, instead of 6, months would slightly increase the disease-related mortality (+6%) but require a 77% increase in ICU bed-days. A campaign over 18 months would increase the disease-related mortality by 17% and require a 244% increase in ICU bed-days. Thus, it seems mandatory to vaccinate the highest possible percentage of the population within 12, or better yet, 9 months. The race against the epidemic and virus variants is really a matter of vaccination strategy.
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Affiliation(s)
- Simon Pageaud
- Université de Lyon, F-69000 Lyon, France; (S.P.); (F.G.); (J.I.)
- Université Claude Bernard Lyon 1, F-69100 Villeurbanne, France
- CNRS UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, F-69100 Villeurbanne, France
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, F-69003 Lyon, France
- Laboratoire de Sciences Actuarielle et Financière (LSAF), Institut de Science Financière et d’Assurances (ISFA), Université Claude Bernard Lyon 1, F-69007 Lyon, France; (A.E.-L.); (A.B.); (N.L.); (R.G.); (S.L.)
- Fondation du Risque, Groupe Louis Bachelier, F-75002 Paris, France
| | - Catherine Pothier
- CNRS UMR 5205, Laboratoire d’InfoRmatique en Image et Systèmes d’Information (LIRIS), F-69621 Villeurbanne, France; (C.P.); (C.R.)
- Institut National des Sciences Appliquées de Lyon (INSA), F-69621 Villeurbanne, France
| | - Christophe Rigotti
- CNRS UMR 5205, Laboratoire d’InfoRmatique en Image et Systèmes d’Information (LIRIS), F-69621 Villeurbanne, France; (C.P.); (C.R.)
- Institut National des Sciences Appliquées de Lyon (INSA), F-69621 Villeurbanne, France
- INRIA Grenoble-Rhône-Alpes, F-38334 Montbonnot, France
| | - Anne Eyraud-Loisel
- Laboratoire de Sciences Actuarielle et Financière (LSAF), Institut de Science Financière et d’Assurances (ISFA), Université Claude Bernard Lyon 1, F-69007 Lyon, France; (A.E.-L.); (A.B.); (N.L.); (R.G.); (S.L.)
| | - Jean-Pierre Bertoglio
- CNRS UMR 5509, Laboratoire de Mécanique des Fluides et d’Acoustique (LMFA), F-69130 Ecully, France;
- École Centrale de Lyon, F-69130 Lyon, France;
| | - Alexis Bienvenüe
- Laboratoire de Sciences Actuarielle et Financière (LSAF), Institut de Science Financière et d’Assurances (ISFA), Université Claude Bernard Lyon 1, F-69007 Lyon, France; (A.E.-L.); (A.B.); (N.L.); (R.G.); (S.L.)
| | - Nicolas Leboisne
- Laboratoire de Sciences Actuarielle et Financière (LSAF), Institut de Science Financière et d’Assurances (ISFA), Université Claude Bernard Lyon 1, F-69007 Lyon, France; (A.E.-L.); (A.B.); (N.L.); (R.G.); (S.L.)
| | - Nicolas Ponthus
- École Centrale de Lyon, F-69130 Lyon, France;
- CNRS UMR 5513, Laboratoire de Tribologie et Dynamique des Systèmes (LTDS), F-69130 Ecully, France
- École Nationale des Travaux Publics de l’État (ENTPE), F-69120 Vaulx-en-Velin, France
| | - Romain Gauchon
- Laboratoire de Sciences Actuarielle et Financière (LSAF), Institut de Science Financière et d’Assurances (ISFA), Université Claude Bernard Lyon 1, F-69007 Lyon, France; (A.E.-L.); (A.B.); (N.L.); (R.G.); (S.L.)
| | - François Gueyffier
- Université de Lyon, F-69000 Lyon, France; (S.P.); (F.G.); (J.I.)
- Université Claude Bernard Lyon 1, F-69100 Villeurbanne, France
- CNRS UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, F-69100 Villeurbanne, France
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, F-69003 Lyon, France
| | - Philippe Vanhems
- Service d’Hygiène, Épidémiologie, Infectiovigilance et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon, F-69003 Lyon, France;
- Centre International de Recherche en Infectiologie (CIRI: Inserm U1111, CNRS UMR 5308, École Nationale Supérieure de Lyon), F-69007 Lyon, France
| | - Jean Iwaz
- Université de Lyon, F-69000 Lyon, France; (S.P.); (F.G.); (J.I.)
- Université Claude Bernard Lyon 1, F-69100 Villeurbanne, France
- CNRS UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, F-69100 Villeurbanne, France
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, F-69003 Lyon, France
| | - Stéphane Loisel
- Laboratoire de Sciences Actuarielle et Financière (LSAF), Institut de Science Financière et d’Assurances (ISFA), Université Claude Bernard Lyon 1, F-69007 Lyon, France; (A.E.-L.); (A.B.); (N.L.); (R.G.); (S.L.)
| | - Pascal Roy
- Université de Lyon, F-69000 Lyon, France; (S.P.); (F.G.); (J.I.)
- Université Claude Bernard Lyon 1, F-69100 Villeurbanne, France
- CNRS UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, F-69100 Villeurbanne, France
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, F-69003 Lyon, France
- CNRS UMR 5513, Laboratoire de Tribologie et Dynamique des Systèmes (LTDS), F-69130 Ecully, France
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Rigoine de Fougerolles T, Puig-Barbera J, Kassianos G, Vanhems P, Schelling J, Crepey P, de Lejarazu RO, Ansaldi F, Fruhwein M, Galli C, Mosnier A, Pariani E, Rasuli A, Vitoux O, Watkins J, Weinke T, Bricout H. A comparison of coronavirus disease 2019 and seasonal influenza surveillance in five European countries: France, Germany, Italy, Spain and the United Kingdom. Influenza Other Respir Viruses 2021; 16:417-428. [PMID: 34866344 PMCID: PMC8983920 DOI: 10.1111/irv.12941] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 11/07/2021] [Indexed: 11/28/2022] Open
Abstract
Background In response to the coronavirus disease (COVID‐19) outbreak that unfolded across Europe in 2020, the World Health Organisation (WHO) called for repurposing existing influenza surveillance systems to monitor COVID‐19. This analysis aimed to compare descriptively the extent to which influenza surveillance systems were adapted and enhanced and how COVID‐19 surveillance could ultimately benefit or disrupt routine influenza surveillance. Methods We used a previously developed framework in France, Germany, Italy, Spain and the United Kingdom to describe COVID‐19 surveillance and its impact on influenza surveillance. The framework divides surveillance systems into seven subsystems and 20 comparable outcomes of interest and uses five evaluation criteria based on WHO guidance. Information on influenza and COVID‐19 surveillance systems were collected from publicly available resources shared by European and national public health agencies. Results Overall, non‐medically attended, virological, primary care and mortality surveillance were adapted in most countries to monitor COVID‐19, although community, outbreak and hospital surveillance were reinforced in all countries. Data granularity improved, with more detailed demographic and medical information recorded. A shift to systematic notification for cases and deaths enhanced both geographic and population representativeness, although the sampling strategy benefited from the roll out of widespread molecular testing. Data communication was greatly enhanced, contributing to improved public awareness. Conclusions Well‐established influenza surveillance systems are a key component of pandemic preparedness, and their upgrade allowed European countries to respond to the COVID‐19 pandemic. However, uncertainties remain on how both influenza and COVID‐19 surveillance can be jointly and durably implemented.
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Affiliation(s)
| | | | - George Kassianos
- Royal College of General Practitioners, UK and British Global & Travel Health Association, London, UK
| | - Philippe Vanhems
- Department of Hygiene and Epidemiology, Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID) - Inserm - U1111 - UCBL, Lyon University Hospital and Centre International de Recherche en Infectiologie (CIRI), Lyon, France
| | - Jorg Schelling
- Medical Faculty, Ludwig-Maximilians-University, Munich, Germany
| | - Pascal Crepey
- School of Advanced Studies in Public Health, University of Rennes, Rennes, France
| | | | - Filippo Ansaldi
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Markus Fruhwein
- Dr. Fruehwein & Partners, Practise for General Medicine, Travel Medicine and Tropical Diseases, Munich, Germany
| | - Cristina Galli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Anvar Rasuli
- Medical Department, Sanofi Pasteur, Lyon, France
| | | | - John Watkins
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - Thomas Weinke
- Klinikum Ernst von Bergmann, Medizinische Klinik, Gastroenterologie, Infektiologie, Pneumologie, Potsdam, Germany
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Teoli J, Amour S, Dananché C, Dauwalder O, Gerbier-Colomban S, Mauranne CC, Zorio V, Monard C, Arnal S, Friggeri A, Lepape A, Guerin C, Rimmelé T, Argaud L, Munier-Marion E, Gustin MP, Vanhems P. Trends in the proportion of resistant bacteria involved in ventilator-associated pneumonia as the first hospital-acquired infection in intensive care units between 2003 and 2016 in Lyon, France. Am J Infect Control 2021; 49:1454-1456. [PMID: 33930517 DOI: 10.1016/j.ajic.2021.04.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 04/19/2021] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
The aim of this study was to describe the proportion of multidrug-resistant microorganisms (MDROs) involved in ventilator-associated pneumonia (VAP) as the first hospital-acquired infection in 536 adults with restricted risk factors for MDRO-related infection. We found a significant decrease in the percentage of MDROs involved in VAP between 2003 and 2016 and this percentage increased when VAP occurred after day 10.
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El Guerche-Séblain C, Chakir L, Nageshwaran G, Harris RC, Sevoz-Couche C, Vitoux O, Vanhems P. Experience from five Asia-Pacific countries during the first wave of the COVID-19 pandemic: Mitigation strategies and epidemiology outcomes. Travel Med Infect Dis 2021; 44:102171. [PMID: 34648930 PMCID: PMC8505019 DOI: 10.1016/j.tmaid.2021.102171] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 03/22/2021] [Accepted: 10/05/2021] [Indexed: 01/04/2023]
Abstract
Background With no vaccines or specific treatments, non-pharmaceutical interventions are the only tools for controlling the human-to-human transmission of the COVID-19 disease, which appeared in Wuhan, China last December and has spread globally since. Here we describe and compare the first-wave mitigation strategies and epidemiology of five Asia-Pacific countries that responded rapidly to the epidemic. Methods From January to April 2020, mitigation measures and epidemiological data for Singapore, South Korea, Japan, Taiwan, Hong Kong were screened from official local government websites and a review of investigational studies was conducted. Daily case reports and mitigation measures information were extracted. Epidemiological estimates were calculated and compared between countries. Results All five countries combined measures, focusing on contact tracing, testing, isolation efforts and healthcare management. Epidemiological data varied temporally and geographically: incubation period ranged 3.9–7.1 days, effective reproduction number at time t (Rt) ranged 0.48–1.5, with intensive care admissions 1–3% of hospitalised patients, and case fatality rates were 0.1–3%. Extrinsic estimates to the virus were lower than global estimates. Conclusion Implemented mitigation strategies in these countries allowed a rapid and successful control or delay of the first COVID-19 pandemic wave. These are valuable examples to inform subsequent waves.
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Affiliation(s)
- Clotilde El Guerche-Séblain
- Global Vaccine Epidemiology and Modelling Department (VEM)Sanofi Pasteur, Singapore. Sanofi-Aventis (Singapore) Pte. Ltd., 38, Beach Road, #18-11, South Beach Tower, Singapore; University Claude Bernard Lyon 1, Lyon, France.
| | | | - Gopinath Nageshwaran
- Global Vaccine Epidemiology and Modelling Department (VEM)Sanofi Pasteur, Singapore. Sanofi-Aventis (Singapore) Pte. Ltd., 38, Beach Road, #18-11, South Beach Tower, Singapore.
| | - Rebecca C Harris
- Global Vaccine Epidemiology and Modelling Department (VEM)Sanofi Pasteur, Singapore. Sanofi-Aventis (Singapore) Pte. Ltd., 38, Beach Road, #18-11, South Beach Tower, Singapore; Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, UK.
| | - Caroline Sevoz-Couche
- Sorbonne Université, INSERM, UMRS1158, Neurophysiologie Respiratoire Expérimentale et Clinique, F-75005, Paris, France.
| | | | - Philippe Vanhems
- Service D'Hygiène, Épidémiologie et Prévention, Hôpital Édouard Herriot, Hospices Civils de Lyon, Lyon, France; Epidemiology and International Health Team, Emergent Pathogens Laboratory, Fondation Mérieux, International Center for Research in Infectiology, National Institute of Health and Medical Research, U1111, National Center of Scientific Research, Mixed Scientific Unit 5308, École Nationale Supérieure de Lyon, Université Claude Bernard Lyon 1, Lyon, I-REIVAC, France.
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Rees CA, Hooli S, King C, McCollum ED, Colbourn T, Lufesi N, Mwansambo C, Lazzerini M, Madhi SA, Cutland C, Nunes M, Gessner BD, Basnet S, Kartasasmita CB, Mathew JL, Zaman SMAU, Paranhos-Baccala G, Bhatnagar S, Wadhwa N, Lodha R, Aneja S, Santosham M, Picot VS, Sylla M, Awasthi S, Bavdekar A, Pape JW, Rouzier V, Chou M, Rakoto-Andrianarivelo M, Wang J, Nymadawa P, Vanhems P, Russomando G, Asghar R, Banajeh S, Iqbal I, MacLeod W, Maulen-Radovan I, Mino G, Saha S, Singhi S, Thea DM, Clara AW, Campbell H, Nair H, Falconer J, Williams LJ, Horne M, Strand T, Qazi SA, Nisar YB, Neuman MI. External validation of the RISC, RISC-Malawi, and PERCH clinical prediction rules to identify risk of death in children hospitalized with pneumonia. J Glob Health 2021; 11:04062. [PMID: 34737862 PMCID: PMC8542381 DOI: 10.7189/jogh.11.04062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Existing scores to identify children at risk of hospitalized pneumonia-related mortality lack broad external validation. Our objective was to externally validate three such risk scores. METHODS We applied the Respiratory Index of Severity in Children (RISC) for HIV-negative children, the RISC-Malawi, and the Pneumonia Etiology Research for Child Health (PERCH) scores to hospitalized children in the Pneumonia REsearch Partnerships to Assess WHO REcommendations (PREPARE) data set. The PREPARE data set includes pooled data from 41 studies on pediatric pneumonia from across the world. We calculated test characteristics and the area under the curve (AUC) for each of these clinical prediction rules. RESULTS The RISC score for HIV-negative children was applied to 3574 children 0-24 months and demonstrated poor discriminatory ability (AUC = 0.66, 95% confidence interval (CI) = 0.58-0.73) in the identification of children at risk of hospitalized pneumonia-related mortality. The RISC-Malawi score had fair discriminatory value (AUC = 0.75, 95% CI = 0.74-0.77) among 17 864 children 2-59 months. The PERCH score was applied to 732 children 1-59 months and also demonstrated poor discriminatory value (AUC = 0.55, 95% CI = 0.37-0.73). CONCLUSIONS In a large external application of the RISC, RISC-Malawi, and PERCH scores, a substantial number of children were misclassified for their risk of hospitalized pneumonia-related mortality. Although pneumonia risk scores have performed well among the cohorts in which they were derived, their performance diminished when externally applied. A generalizable risk assessment tool with higher sensitivity and specificity to identify children at risk of hospitalized pneumonia-related mortality may be needed. Such a generalizable risk assessment tool would need context-specific validation prior to implementation in that setting.
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Affiliation(s)
- Chris A Rees
- Division of Pediatric Emergency Medicine, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Shubhada Hooli
- Section of Pediatric Emergency Medicine, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA
| | - Carina King
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden and Institute for Global Health, University College London, London, UK
| | - Eric D McCollum
- Global Program in Respiratory Sciences, Eudowood Division of Pediatric Respiratory Sciences, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, USA and Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Tim Colbourn
- Institute for Global Health, University College London, London, UK
| | | | | | - Marzia Lazzerini
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Shabir Ahmed Madhi
- South African Medical Research Council: Vaccines and Infectious Diseases Analytics Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Clare Cutland
- South African Medical Research Council: Vaccines and Infectious Diseases Analytics Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Marta Nunes
- South African Medical Research Council: Vaccines and Infectious Diseases Analytics Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases Unit, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Sudha Basnet
- Center for Intervention Science in Maternal and Child Health, University of Bergen, Norway
| | - Cissy B Kartasasmita
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Joseph L Mathew
- Pediatric Pulmonology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | | | - Nitya Wadhwa
- Translational Health Science and Technology Institute, Faridabad, India
| | - Rakesh Lodha
- All India Institute of Medical Sciences, New Delhi, India
| | - Satinder Aneja
- School of Medical Sciences & Research, Sharda University, Greater Noida, India
| | - Mathuram Santosham
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Mariam Sylla
- Gabriel Touré Hospital, Department of Pediatrics, Bamako, Mali
| | - Shally Awasthi
- King George's Medical University, UP, Department of Pediatrics, Lucknow, India
| | | | | | | | - Monidarin Chou
- University of Health Sciences Faculty of Medicine, Rodolph Mérieux Laboratory, Phom Phen, Cambodia
| | | | - Jianwei Wang
- Chinese Academy of Medical Sciences & Peking Union, Medical College Institute of Pathogen Biology, MOH Key Laboratory of Systems Biology of Pathogens and Dr Christophe Mérieux Laboratory, Beijing, China
| | - Pagbajabyn Nymadawa
- Mongolian Academy of Sciences, Academy of Medical Sciences, Ulaanbaatar, Mongolia
| | - Philippe Vanhems
- Hospices Civils de Lyon, Infection Control Unit; CIRI, Centre International de Recherche en Infectiologie, (Team PHE3ID), Université Claude Bernard Lyon, Lyon, France
| | - Graciela Russomando
- Universidad Nacional de Asuncion, Instituto de Investigaciones en Ciencias de la Salud, San Lorenzo, Paraguay
| | - Rai Asghar
- Rawalpindi Medical College, Rawalpindi, Pakistan
| | | | | | - William MacLeod
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Irene Maulen-Radovan
- Instituto Nactional de Pediatria Division de Investigacion Insurgentes, Mexico City, Mexico
| | - Greta Mino
- Children's Hospital Dr Francisco de Ycaza Bustamante, Head of Department, Infectious diseases, Guayaquil, Ecuador
| | - Samir Saha
- Dhaka Shishu Hospital, Dhaka, Bangladesh
| | | | - Donald M Thea
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Alexey W Clara
- US Centers for Disease Control, Central American Region, Guatemala City, Guatemala
| | - Harry Campbell
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, Scotland
| | - Harish Nair
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, Scotland
| | - Jennifer Falconer
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, Scotland
| | - Linda J Williams
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, Scotland
| | - Margaret Horne
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, Scotland
| | - Tor Strand
- Research Department, Innlandet Hospital Trust, Lillehammer, Norway
| | - Shamim A Qazi
- Department of Maternal, Newborn, Child and Adolescent Health (Retired), World Health Organization, Geneva, Switzerland
| | - Yasir B Nisar
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Mark I Neuman
- Division of Emergency Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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El Guerche-Séblain C, Rigoine De Fougerolles T, Sampson K, Jennings L, Van Buynder P, Shu Y, Sekawi Z, Yee-Sin L, Walls T, Vitoux O, Yin JK, Wong A, Schellevis F, Vanhems P. Comparison of influenza surveillance systems in Australia, China, Malaysia and expert recommendations for influenza control. BMC Public Health 2021; 21:1750. [PMID: 34563151 PMCID: PMC8466892 DOI: 10.1186/s12889-021-11765-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 08/29/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The Western Pacific Region (WPR) is exposed each year to seasonal influenza and is often the source of new influenza virus variants and novel pathogen emergence. National influenza surveillance systems play a critical role in detecting emerging viruses, monitoring influenza epidemics, improving public disease awareness and promoting pandemic preparedness, but vary widely across WPR countries. The aim of this study is to improve existing influenza surveillance systems by systematically comparing selected WPR influenza surveillance systems. METHODS Three national influenza surveillance systems with different levels of development (Australia, China and Malaysia) were compared and their adherence to World Health Organization (WHO) guidance was evaluated using a structured framework previously tested in several European countries consisting of seven surveillance sub-systems, 19 comparable outcomes and five evaluation criteria. Based on the results, experts from the Asia-Pacific Alliance for the Control of Influenza (APACI) issued recommendations for the improvement of existing surveillance systems. RESULTS Australia demonstrated the broadest scope of influenza surveillance followed by China and Malaysia. In Australia, surveillance tools covered all sub-systems. In China, surveillance did not cover non-medically attended respiratory events, primary care consultations, and excess mortality modelling. In Malaysia, surveillance consisted of primary care and hospital sentinel schemes. There were disparities between the countries across the 5 evaluation criteria, particularly regarding data granularity from health authorities, information on data representativeness, and data communication, especially the absence of publicly available influenza epidemiological reports in Malaysia. This dual approach describing the scope of surveillance and evaluating the adherence to WHO guidance enabled APACI experts to make a number of recommendations for each country that included but were not limited to introducing new surveillance tools, broadening the use of specific existing surveillance tools, collecting and sharing data on virus characteristics, developing immunization status registries, and improving public health communication. CONCLUSIONS Influenza monitoring in Australia, China, and Malaysia could benefit from the expansion of existing surveillance sentinel schemes, the broadened use of laboratory confirmation and the introduction of excess-mortality modelling. The results from the evaluation can be used as a basis to support expert recommendations and to enhance influenza surveillance capabilities.
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Affiliation(s)
- Clotilde El Guerche-Séblain
- Global Medical Evidence Generation (MEG) Lead, Influenza Sanofi Pasteur, Medical Influenza Franchise, Sanofi-Aventis (Singapore) Pte. Ltd. 38, Beach Road, #18-11, South Beach Tower, Sanofi Pasteur, Singapore, Singapore.
- University Claude Bernard Lyon 1, Lyon, France.
| | | | - Kim Sampson
- Asia-Pacific Alliance for the Control of Influenza (APACI), Melbourne, Australia
- Australian Immunisation Coalition, Melbourne, Australia
| | - Lance Jennings
- University of Otago, Christchurch, New Zealand
- Canterbury Health Laboratories, Christchurch, New Zealand
| | - Paul Van Buynder
- Department of Public Health, Griffith University, Griffith, Victoria, Australia
| | - Yuelong Shu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Zamberi Sekawi
- Chair Malaysia Influenza Working Group (MIWG), Universiti Putra, Seri Kembangan, Malaysia
| | - Leo Yee-Sin
- National Center for Infectious Diseases (NCID), Singapore, Singapore
| | - Tony Walls
- University of Otago, Christchurch, New Zealand
- Paediatric Society of New Zealand Infection and Immunization Special Interest Group, Christchurch, New Zealand
| | | | - J Kevin Yin
- Global Medical Affairs, Sanofi Pasteur, Singapore, Singapore
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Ada Wong
- Public Affairs, Sanofi Pasteur, Singapore, Singapore
| | - Francois Schellevis
- Netherlands Institute for Health Services Research, Utrecht, The Netherlands
- Department of General Practice, Amsterdam Public Health Research Institute, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - Philippe Vanhems
- Unité d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France
- PHE3ID, Centre International de Recherche en Infectiologie, Institut National de la Santé et de la Recherche Médicale U1111, CNRS Unité Mixte de Recherche 5308, École Nationale Supérieure de Lyon, Université Claude Bernard Lyon 1, Lyon, France
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Descamps A, Lenzi N, Galtier F, Lainé F, Lesieur Z, Vanhems P, Amour S, L'Honneur AS, Fidouh N, Foulongne V, Lagathu G, Duval X, Merle C, Lina B, Carrat F, Launay O, Loubet P. In-hospital and midterm out-hospital complications of adults hospitalised with respiratory syncytial virus infection in France, 2017-2019: an observational study. Eur Respir J 2021; 59:13993003.00651-2021. [PMID: 34446468 DOI: 10.1183/13993003.00651-2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 07/06/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To describe the clinical characteristics and in/out-hospital outcomes of respiratory syncytial virus (RSV) infection among adults hospitalised with influenza-like illness (ILI) and compared against patients admitted for influenza. METHODS Adults hospitalised with ILI were prospectively included from five French university hospitals over two consecutive winter seasons (2017/2018 and 2018/2019). RSV and influenza virus were detected by multiplex RT-PCR on nasopharyngeal swabs. RSV-positive patients were compared to RSV-negative and influenza-positive hospitalised patients. Poisson regression models were used to estimate the adjusted prevalence ratio (aPR) associated with in-hospital and post-discharge outcomes between RSV and influenza infections. The in-hospital outcome was a composite of the occurrence of at least one complication, length of stay ≥7 days, intensive care unit (ICU) admission, use of mechanical ventilation and in-hospital death. Post-discharge outcome included 30/90-day all-cause mortality and 90-day readmission rates. RESULTS Overall, 1,428 hospitalised adults with ILI were included. RSV was detected in 8% (114/1428) and influenza virus in 31% (437/1428). Patients hospitalised with RSV were older than those with influenza (mean age, 73.0 versus 68.8 years; p=0.015) with a higher frequency of respiratory (52% versus 39%, p=0.012) or cardiac chronic diseases (52% versus 41%, p=0.039) and longer hospitalisation duration (median stay 8 versus 6 days, p<0.001). Anti-influenza therapies were less prescribed among RSV than influenza patients (20% versus 66%, p<0.001). In-hospital composite outcome was poorer in RSV patients (adjusted prevalence ratio (aPR)=1.5; 95% Confidence Interval (95% CI) 1.1-2.1) than in those hospitalised with influenza. No difference was observed for the post-discharge composite outcome (aPR=1.1; 95% CI 0.8-1.6). CONCLUSION RSV infection results in serious respiratory illness with in-hospital outcomes worse than influenza and with similar midterm post-discharge outcomes.
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Affiliation(s)
- Alexandre Descamps
- Université de Paris, Inserm CIC 1417, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, CIC Cochin Pasteur, Paris, France
| | - Nezha Lenzi
- Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France
| | - Florence Galtier
- Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France.,Inserm CIC 1411, Montpellier University Hospital, Montpellier, France
| | - Fabrice Lainé
- Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France.,Inserm CIC 1414, CHU Rennes, Rennes, France
| | - Zineb Lesieur
- Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France
| | - Philippe Vanhems
- Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France.,Service Hygiène, Épidémiologie, Infection, Vigilance et Prévention (SHEIP), Hôpital Édouard Herriot, Hospices Civils de Lyon, Lyon, France.,Centre International de Recherche en Infectiologie (CIRI), Equipe Public Health Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID), Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, Lyon, France
| | - Sélilah Amour
- Service Hygiène, Épidémiologie, Infection, Vigilance et Prévention (SHEIP), Hôpital Édouard Herriot, Hospices Civils de Lyon, Lyon, France.,Centre International de Recherche en Infectiologie (CIRI), Equipe Public Health Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID), Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, Lyon, France
| | | | | | - Vincent Foulongne
- Service de Virologie, CHU Montpellier, Hôpital Saint Eloi, Montpellier, France
| | - Gisèle Lagathu
- Laboratoire de virologie, Pôle micro-organismes, CHU Rennes, Rennes, France
| | - Xavier Duval
- Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France.,Assistance Publique Hôpitaux de Paris, Hôpital Bichat, Centre d'Investigation Clinique, Inserm CIC 1425, Paris, France.,Université de Paris, IAME, INSERM, Paris, France
| | - Corinne Merle
- Infectious Diseases Department, Montpellier University Hospital, Montpellier, France
| | - Bruno Lina
- Hospices Civils de Lyon, Laboratoire de Virologie, Institut des Agents Infectieux (IAI), Centre National de Référence des virus Respiratoires France Sud, Hôpital de la Croix-Rousse, Lyon, France
| | - Fabrice Carrat
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Assistance Publique Hôpitaux de Paris, Hôpital Saint Antoine, Paris, France
| | - Odile Launay
- Université de Paris, Inserm CIC 1417, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, CIC Cochin Pasteur, Paris, France.,Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France.,Last authors contributed equally to this article
| | - Paul Loubet
- Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France .,Department of Infectious and Tropical Disease, VBMI, INSERM U1047, CHU Nîmes, Univ Montpellier, Nîmes, France.,Last authors contributed equally to this article
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Saadatian-Elahi M, Amour S, Elias C, Henaff L, Dananché C, Vanhems P. Tobacco smoking and severity of COVID-19: Experience from a hospital-based prospective cohort study in Lyon, France. J Med Virol 2021; 93:6822-6827. [PMID: 34314045 PMCID: PMC8426692 DOI: 10.1002/jmv.27233] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 07/24/2021] [Indexed: 12/14/2022]
Abstract
Information gathered so far from published studies attest the existence of a complex relationship between tobacco smoking and the severity of COVID-19. We investigated the association between smoking habits and the severity of COVID-19 in patients hospitalized in university-affiliated hospitals in Lyon, France. Baseline sociodemographic, clinical and biological characteristics of adult COVID-19 hospitalized patients presenting from the community were prospectively collected and analyzed. Tobacco exposure was documented at admission. Characteristics of patients hospitalized in medical wards to those admitted or transferred to intensive care units (ICUs) were compared using Mann-Whitney and Χ2 or Fisher's exact test. A composite endpoint including admission or transfer to ICU or death was created as a proxy for severe outcome. Adjusted odds ratio (aOR) and 95% confidence interval (95% CI) were calculated to identify variables independently associated with a severe outcome. Of the 645 patients with documented information on smoking habits, 62.6% were never-smokers, 32.1% ex-smokers, and 5.3% active smokers. Past tobacco use was independently associated with an increased risk of severe outcome (aOR: 1.71; 95% CI: 1.12-2.63), whereas a nonsignificant protective trend was found for active smoking. The results suggest that past smoking is associated with enhanced risk of progressing toward severe COVID-19 disease in hospitalized patients.
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Affiliation(s)
- Mitra Saadatian-Elahi
- Service Hygiène, Epidémiologie, Infectiovigilance et Prévention, Centre Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France.,Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID), Inserm - U1111, Lyon, France
| | - Sélilah Amour
- Service Hygiène, Epidémiologie, Infectiovigilance et Prévention, Centre Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France.,Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID), Inserm - U1111, Lyon, France
| | - Christelle Elias
- Service Hygiène, Epidémiologie, Infectiovigilance et Prévention, Centre Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France.,Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID), Inserm - U1111, Lyon, France
| | - Laetitia Henaff
- Service Hygiène, Epidémiologie, Infectiovigilance et Prévention, Centre Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France.,Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID), Inserm - U1111, Lyon, France
| | - Cédric Dananché
- Service Hygiène, Epidémiologie, Infectiovigilance et Prévention, Centre Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France.,Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID), Inserm - U1111, Lyon, France
| | - Philippe Vanhems
- Service Hygiène, Epidémiologie, Infectiovigilance et Prévention, Centre Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France.,Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID), Inserm - U1111, Lyon, France
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46
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Khanafer N, Vanhems P, Bennia S, Martin-Gaujard G, Juillard L, Rimmelé T, Argaud L, Martin O, Huriaux L, Marcotte G, Hernu R, Floccard B, Cassier P, Group S. Factors Associated with Clostridioides (Clostridium) Difficile Infection and Colonization: Ongoing Prospective Cohort Study in a French University Hospital. Int J Environ Res Public Health 2021; 18:ijerph18147528. [PMID: 34299978 PMCID: PMC8307155 DOI: 10.3390/ijerph18147528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/13/2021] [Indexed: 01/03/2023]
Abstract
Introduction: Clostridioides (Clostridium) difficile can be isolated from stool in 3% of healthy adults and in at least 10% of asymptomatic hospitalized patients. C. difficile, the most common cause of hospital-acquired infectious diarrhea in the developed world, has re-emerged in recent years with increasing incidence and severity. In an effort to reduce the spread of the pathogen, published recommendations suggest isolation and contact precautions for patients suffering from C. difficile infection (CDI). However, asymptomatic colonized patients are not targeted by infection control policies, and active surveillance for colonization is not routinely performed. Moreover, given the current changes in the epidemiology of CDI, particularly the emergence of new virulent strains either in the hospital or community settings, there is a need for identification of factors associated with colonization by C. difficile and CDI. Methods and analysis: We are carrying out a prospective, observational, cohort study in Edouard Herriot Hospital, Hospices Civils de Lyon, a 900-bed university hospital in Lyon, France. All consecutive adult patients admitted on selected units are eligible to participate in the study. Stool samples or rectal swabs for C. difficile testing are obtained on admission, every 3–5 days during hospitalization, at the onset of diarrhea (if applicable), and at discharge. Descriptive and logistic regression analyses will be completed to mainly estimate the proportion of asymptomatic colonization at admission, and to evaluate differences between factors associated with colonization and those related to CDI. Ethics: The study is conducted in accordance with the ethical principles of the Declaration of Helsinki, French law, and the Good Clinical Practice guidelines. The study protocol design was approved by the participating units, the ethics committee and the hospital institutional review board (Comité de protection des personnes et Comission Nationale de l’Informatique et des Libertés; N°: 00009118). Dissemination: The results of this study will be disseminated by presenting the findings locally at each participating ward, as well as national and international scientific meetings. Findings will be shared with interested national societies crafting guidelines in CDI.
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Affiliation(s)
- Nagham Khanafer
- International Center for Infectiology Research (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, Lyon 1 University, 69342 Lyon, France;
- Department of Hygiene, Epidemiology, and Prevention, Edouard Herriot Hospital, Hospices Civils de Lyon, 69437 Lyon, France;
- European Study Group for Clostridioides Difficile (ESGCD), 4001 Basel, Switzerland
- Correspondence:
| | - Philippe Vanhems
- International Center for Infectiology Research (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, Lyon 1 University, 69342 Lyon, France;
- Department of Hygiene, Epidemiology, and Prevention, Edouard Herriot Hospital, Hospices Civils de Lyon, 69437 Lyon, France;
- INSERM, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), 75679 Paris, France
| | - Sabrina Bennia
- Department of Hygiene, Epidemiology, and Prevention, Edouard Herriot Hospital, Hospices Civils de Lyon, 69437 Lyon, France;
| | | | - Laurent Juillard
- Nephrology Department, Edouard Herriot Hospital, Hospices Civils de Lyon, 69002 Lyon, France;
| | - Thomas Rimmelé
- Anesthesia and Intensive Care Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, 69437 Lyon, France; (T.R.); (O.M.); (L.H.); (G.M.); (B.F.)
- EA 7426 PI3 (Pathophysiology of Injury-Induced Immunosuppression), Lyon 1 University, Hospices Civils de Lyon, Biomérieux, 69437 Lyon, France
| | - Laurent Argaud
- Medical Intensive Care Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, 69437 Lyon, France; (L.A.); (R.H.)
| | - Olivier Martin
- Anesthesia and Intensive Care Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, 69437 Lyon, France; (T.R.); (O.M.); (L.H.); (G.M.); (B.F.)
| | - Laetitia Huriaux
- Anesthesia and Intensive Care Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, 69437 Lyon, France; (T.R.); (O.M.); (L.H.); (G.M.); (B.F.)
| | - Guillaume Marcotte
- Anesthesia and Intensive Care Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, 69437 Lyon, France; (T.R.); (O.M.); (L.H.); (G.M.); (B.F.)
| | - Romain Hernu
- Medical Intensive Care Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, 69437 Lyon, France; (L.A.); (R.H.)
| | - Bernard Floccard
- Anesthesia and Intensive Care Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, 69437 Lyon, France; (T.R.); (O.M.); (L.H.); (G.M.); (B.F.)
| | - Pierre Cassier
- Environnemental Laboratory, Institut des Agents Infectieux, Hospices Civils de Lyon, 69317 Lyon, France;
| | - Study Group
- Edouard Herriot Hospital, Hospices Civils de Lyon, 69437 Lyon, France;
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47
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Casalegno JS, Ploin D, Cantais A, Masson E, Bard E, Valette M, Fanget R, Targe SC, Myar-Dury AF, Doret-Dion M, Massoud M, Queromes G, Vanhems P, Claris O, Butin M, Pillet S, Ader F, Bin S, Gaymard A, Lina B, Morfin F, Javouhey E, Gillet Y. Characteristics of the delayed respiratory syncytial virus epidemic, 2020/2021, Rhône Loire, France. Euro Surveill 2021; 26:2100630. [PMID: 34296674 PMCID: PMC8299747 DOI: 10.2807/1560-7917.es.2021.26.29.2100630] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 07/21/2021] [Indexed: 11/20/2022] Open
Abstract
The Rhône-Loire metropolitan areas' 2020/21 respiratory syncytial virus (RSV) epidemic was delayed following the implementation of non-pharmaceutical interventions (NPI), compared with previous seasons. Very severe lower respiratory tract infection incidence among infants ≤ 3 months decreased twofold, the proportion of cases among children aged > 3 months to 5 years increased, and cases among adults > 65 years were markedly reduced. NPI appeared to reduce the RSV burden among at-risk groups, and should be promoted to minimise impact of future RSV outbreaks.
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Affiliation(s)
- Jean-Sebastien Casalegno
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Centre de Biologie Nord, Institut des Agents Infectieux, Laboratoire de Virologie, Lyon, France
- Centre national de référence des virus des infections respiratoires (dont la grippe), Hôpital de la Croix-Rousse, Lyon, France
- Centre International de Recherche en Infectiologie (CIRI), Laboratoire de Virologie et Pathologie Humaine - VirPath Team, INSERM U1111, CNRS UMR5308, École Normale Supérieure de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Lyon, France
| | - Dominique Ploin
- Centre International de Recherche en Infectiologie (CIRI), Laboratoire de Virologie et Pathologie Humaine - VirPath Team, INSERM U1111, CNRS UMR5308, École Normale Supérieure de Lyon, Lyon, France
- Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Service de Réanimation Pédiatrique et d'Accueil des Urgences, Bron, France
| | - Aymeric Cantais
- Centre Hospitalier Universitaire de Saint-Étienne, Service des Urgences Pédiatriques, Saint-Priest-en-Jarez, France
- Groupe Immunité des Muqueuses et Agents Pathogènes (GIMAP) EA-3064, Faculté de Médecine de Saint-Etienne, Campus Santé-Innovations de Saint-Etienne, Saint-Priest-en-Jarez, France
| | - Elsa Masson
- Université Claude Bernard Lyon 1, Lyon, France
- Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Service de Réanimation Pédiatrique et d'Accueil des Urgences, Bron, France
| | - Emilie Bard
- Université Claude Bernard Lyon 1, Lyon, France
- Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Service de Réanimation Pédiatrique et d'Accueil des Urgences, Bron, France
| | - Martine Valette
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Centre de Biologie Nord, Institut des Agents Infectieux, Laboratoire de Virologie, Lyon, France
- Centre national de référence des virus des infections respiratoires (dont la grippe), Hôpital de la Croix-Rousse, Lyon, France
- Centre International de Recherche en Infectiologie (CIRI), Laboratoire de Virologie et Pathologie Humaine - VirPath Team, INSERM U1111, CNRS UMR5308, École Normale Supérieure de Lyon, Lyon, France
| | - Remi Fanget
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Centre de Biologie Nord, Institut des Agents Infectieux, Laboratoire de Virologie, Lyon, France
- Centre national de référence des virus des infections respiratoires (dont la grippe), Hôpital de la Croix-Rousse, Lyon, France
- Centre International de Recherche en Infectiologie (CIRI), Laboratoire de Virologie et Pathologie Humaine - VirPath Team, INSERM U1111, CNRS UMR5308, École Normale Supérieure de Lyon, Lyon, France
| | | | | | - Muriel Doret-Dion
- Université Claude Bernard Lyon 1, Lyon, France
- Hospices Civils de Lyon, Service de Gynécologie-Obstétrique, Hôpital Femme-Mère-Enfant, Bron, France
| | - Mona Massoud
- Hospices Civils de Lyon, Service de Gynécologie-Obstétrique, Hôpital Femme-Mère-Enfant, Bron, France
| | - Gregory Queromes
- Centre International de Recherche en Infectiologie (CIRI), Laboratoire de Virologie et Pathologie Humaine - VirPath Team, INSERM U1111, CNRS UMR5308, École Normale Supérieure de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Lyon, France
| | - Philippe Vanhems
- Hospices Civils de Lyon, Centre Hospitalier Édouard Herriot, Service Hygiène, Épidémiologie et Prévention, Lyon, France
- Centre International de Recherche en Infectiologie (CIRI), Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID) INSERM U1111, CNRS UMR5308, École Normale Supérieure de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Lyon, France
| | - Olivier Claris
- Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, Service de Néonatologie et de Réanimation Néonatale, Bron, France
- Université Claude Bernard Lyon 1, Lyon, France
| | - Marine Butin
- Hospices Civils de Lyon, Pôle IMER, Unité de Recherche Clinique, Lyon, France
- Université Claude Bernard Lyon 1, Lyon, France
| | - Sylvie Pillet
- Centre Hospitalier Universitaire de Saint-Étienne, Laboratoire de Virologie, Saint-Priest-en-Jarez, France
- Groupe Immunité des Muqueuses et Agents Pathogènes (GIMAP) EA-3064, Faculté de Médecine de Saint-Etienne, Campus Santé-Innovations de Saint-Etienne, Saint-Priest-en-Jarez, France
| | - Florence Ader
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Service des Maladies Infectieuses et Tropicales, Lyon, France
- Université Claude Bernard Lyon 1, Lyon, France
| | - Sylvie Bin
- Hospices Civils de Lyon, Pôle IMER, Unité de Recherche Clinique, Lyon, France
| | - Alexandre Gaymard
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Centre de Biologie Nord, Institut des Agents Infectieux, Laboratoire de Virologie, Lyon, France
- Centre national de référence des virus des infections respiratoires (dont la grippe), Hôpital de la Croix-Rousse, Lyon, France
- Centre International de Recherche en Infectiologie (CIRI), Laboratoire de Virologie et Pathologie Humaine - VirPath Team, INSERM U1111, CNRS UMR5308, École Normale Supérieure de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Lyon, France
| | - Bruno Lina
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Centre de Biologie Nord, Institut des Agents Infectieux, Laboratoire de Virologie, Lyon, France
- Centre national de référence des virus des infections respiratoires (dont la grippe), Hôpital de la Croix-Rousse, Lyon, France
- Centre International de Recherche en Infectiologie (CIRI), Laboratoire de Virologie et Pathologie Humaine - VirPath Team, INSERM U1111, CNRS UMR5308, École Normale Supérieure de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Lyon, France
| | - Florence Morfin
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Centre de Biologie Nord, Institut des Agents Infectieux, Laboratoire de Virologie, Lyon, France
- Centre national de référence des virus des infections respiratoires (dont la grippe), Hôpital de la Croix-Rousse, Lyon, France
- Centre International de Recherche en Infectiologie (CIRI), Laboratoire de Virologie et Pathologie Humaine - VirPath Team, INSERM U1111, CNRS UMR5308, École Normale Supérieure de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Lyon, France
| | - Etienne Javouhey
- Université Claude Bernard Lyon 1, Lyon, France
- Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Service de Réanimation Pédiatrique et d'Accueil des Urgences, Bron, France
| | - Yves Gillet
- Université Claude Bernard Lyon 1, Lyon, France
- Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Service de Réanimation Pédiatrique et d'Accueil des Urgences, Bron, France
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48
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Lepape A, Machut A, Gerbier-Colomban S, Kuczewski E, Rasigade JP, Timsit JF, Vanhems P, Wallet F, Savey A, Friggeri A. Automated surveillance in French ICUs: is it feasible? Results from a survey in French ICUs participating in a surveillance network. J Hosp Infect 2021; 115:1-4. [PMID: 34048849 DOI: 10.1016/j.jhin.2021.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 05/07/2021] [Accepted: 05/10/2021] [Indexed: 11/29/2022]
Abstract
A survey was undertaken to evaluate the level of computerization in intensive care units (ICUs) within a French network dedicated to the surveillance of healthcare-associated infections, antimicrobial use (AMU) and antimicrobial resistance (AMR) in ICUs (REA-REZO). Ninety-eight ICUs responded, and patient records were computerized in 57%, antimicrobial prescriptions were computerized in 59% and AMR epidemiology was computerized in 72%. AMU and AMR feedback was provided to the ICU itself for 77% and 65% of ICUs, respectively, and feedback was provided to the national surveillance for 79% and 65% of ICUs, respectively. This study suggests that the level of computerization in ICUs requires further improvement.
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Affiliation(s)
- A Lepape
- Hospices Civils de Lyon, Hôpital Henry Gabrielle, REA-REZO Surveillance Network, Infections and Antibiotic Resistance in ICU, Saint Genis Laval, Lyon, France; Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Critical Care, Pierre-Bénite, Lyon, France; Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases, Centre International de Recherche en Infectiologie, INSERM, Lyon, France.
| | - A Machut
- Hospices Civils de Lyon, Hôpital Henry Gabrielle, REA-REZO Surveillance Network, Infections and Antibiotic Resistance in ICU, Saint Genis Laval, Lyon, France; CPIAS Auvergne-Rhône-Alpes, Hospices Civils de Lyon, Hôpital Henry Gabrielle, Saint Genis Laval, Lyon, France
| | - S Gerbier-Colomban
- Hospices Civils de Lyon, Centre Hospitalier Edouard Herriot, Service Hygiène, Epidémiologie et Prévention, Lyon, France
| | - E Kuczewski
- Hospices Civils de Lyon, Centre Hospitalier Edouard Herriot, Service Hygiène, Epidémiologie et Prévention, Lyon, France
| | - J-P Rasigade
- Hospices Civils de Lyon, Hôpital de la Croix Rousse, Institut des Agents Infectieux, Lyon, France; Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases, Centre International de Recherche en Infectiologie, INSERM, Lyon, France
| | - J-F Timsit
- AP-HP, Bichat Claude Bernard University Hospital, Medical and Infectious Diseases Intensive Care Unit, Paris, France; University Sorbonne Paris Nord, Paris, France
| | - P Vanhems
- Hospices Civils de Lyon, Centre Hospitalier Edouard Herriot, Service Hygiène, Epidémiologie et Prévention, Lyon, France; Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases, Centre International de Recherche en Infectiologie, INSERM, Lyon, France
| | - F Wallet
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Critical Care, Pierre-Bénite, Lyon, France; Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases, Centre International de Recherche en Infectiologie, INSERM, Lyon, France
| | - A Savey
- Hospices Civils de Lyon, Hôpital Henry Gabrielle, REA-REZO Surveillance Network, Infections and Antibiotic Resistance in ICU, Saint Genis Laval, Lyon, France; CPIAS Auvergne-Rhône-Alpes, Hospices Civils de Lyon, Hôpital Henry Gabrielle, Saint Genis Laval, Lyon, France; Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases, Centre International de Recherche en Infectiologie, INSERM, Lyon, France
| | - A Friggeri
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Critical Care, Pierre-Bénite, Lyon, France; Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases, Centre International de Recherche en Infectiologie, INSERM, Lyon, France
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Vanhems P. A breath of humanity in the era of Covid-19 vaccine. Vaccine 2021; 39:3649. [PMID: 34053788 PMCID: PMC8141784 DOI: 10.1016/j.vaccine.2021.05.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/04/2021] [Accepted: 05/19/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Philippe Vanhems
- Service d'Hygiène, Épidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France; Équipe Santé Publique, Epidémiologie et Eco-évolution des Maladies Infectieuses, Centre International de Recherche en Infectiologie (CIRI), Lyon, France; Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France; Hôpital Edouard Herriot, Lyon, France.
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Bénet T, Amour S, Valette M, Saadatian-Elahi M, Aho-Glélé LS, Berthelot P, Denis MA, Grando J, Landelle C, Astruc K, Paris A, Pillet S, Lina B, Vanhems P. Incidence of Asymptomatic and Symptomatic Influenza Among Healthcare Workers: A Multicenter Prospective Cohort Study. Clin Infect Dis 2021; 72:e311-e318. [PMID: 32750120 DOI: 10.1093/cid/ciaa1109] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 08/03/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Influenza is an important cause of viral hospital-acquired infection involving patients, healthcare workers (HCW), and visitors. The frequency of asymptomatic influenza among HCW with possible subsequent transmission is poorly described. The objective is to determine the cumulative incidence of asymptomatic, paucisymptomatic, and symptomatic influenza among HCW. METHOD A multicenter prospective cohort study was done in 5 French university hospitals, including 289 HCW during the 2016-2017 influenza season. HCW had 3 physical examinations (time [T] 0, before epidemic onset; T.1, before epidemic peak; T.2, T.3, after epidemic peak). A blood sample was taken each time for influenza serology and a nasal swab was collected at T1 and T2 for influenza detection by polymerase chain reaction (PCR). Positive influenza was defined as either a positive influenza PCR, and/or virus-specific seroconversion against influenza A, the only circulating virus, with no vaccination record during follow-up. Symptoms were self-reported daily between T1 and T2. Cumulative incidence of influenza was stratified by clinical presentation per 100 HCW. RESULTS Of the 289 HCW included, 278 (96%) completed the entire follow-up. Overall, 62 HCW had evidence of influenza of whom 46.8% were asymptomatic, 41.9% were paucisymptomatic, and 11.3% were symptomatic. Cumulative influenza incidence was 22.3% (95% confidence interval [CI]: 17.4%-27.2%). Cumulative incidence of asymptomatic influenza was 5.8% (95% CI: 3.3%-9.2%), 13.7% (95% CI: 9.9%-18.2%) for paucisymptomatic influenza, and 2.9% (95% CI: 1.3%-5.5%) for symptomatic influenza. CONCLUSIONS Asymptomatic and paucisymptomatic influenza were frequent among HCW, representing 47% and 42% of the influenza burden, respectively. These findings highlight the importance of systematic implementation of infection control measures among HCW regardless of respiratory symptoms from preventing nosocomial transmission of influenza. CLINICAL TRIALS REGISTRATION NCT02868658.
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Affiliation(s)
- Thomas Bénet
- Service d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France.,Équipe Épidémiologie et Santé Internationale, Laboratoire des Pathogènes Émergents, Fondation Mérieux, Centre International de Recherche en Infectiologie, Institut National de la Santé et de la Recherche Médicale U1111, Centre National de la Recherche Scientifique Unité Mixte de Recherche 5308, École Nationale Supérieure de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Sélilah Amour
- Service d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France
| | - Martine Valette
- Centre National de Référence des Infections Respiratoires, Région Sud.,Laboratoire de Virologie, Hôpital de la Croix-Rousse, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France
| | - Mitra Saadatian-Elahi
- Service d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France
| | | | - Philippe Berthelot
- Unité de Gestion du Risque Infectieux, Service d'Infectiologie, CHU de Saint-Etienne, Saint-Etienne, France.,Laboratoire des Agents Infectieux et Hygiène, CHU de Saint-Etienne, Saint-Etienne, France
| | - Marie-Agnès Denis
- Service de médecine et santé au travail, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France.,Ifsttar, UMRESTTE, UMR T_9405 Univ Lyon, Université Claude Bernard Lyon1, Lyon, France
| | - Jacqueline Grando
- Service d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France
| | - Caroline Landelle
- Service d'hygiène hospitalière, CHU Grenoble Alpes, Grenoble, France.,Université Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, Grenoble, France
| | - Karine Astruc
- Service d'Epidémiologie et d'Hygiène Hospitalière, CHU de Dijon, Dijon, France
| | - Adeline Paris
- Centre d'Investigation Clinique, Inserm CIC1406, CHU de Grenoble Alpes, Grenoble, France
| | - Sylvie Pillet
- Laboratoire des Agents Infectieux et Hygiène, CHU de Saint-Etienne, Saint-Etienne, France
| | - Bruno Lina
- Centre National de Référence des Infections Respiratoires, Région Sud.,Laboratoire de Virologie, Hôpital de la Croix-Rousse, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France.,Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Lyon center, France
| | - Philippe Vanhems
- Service d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France.,Équipe Épidémiologie et Santé Internationale, Laboratoire des Pathogènes Émergents, Fondation Mérieux, Centre International de Recherche en Infectiologie, Institut National de la Santé et de la Recherche Médicale U1111, Centre National de la Recherche Scientifique Unité Mixte de Recherche 5308, École Nationale Supérieure de Lyon, Université Claude Bernard Lyon 1, Lyon, France.,Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Lyon center, France
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