1
|
Luong Nguyen LB, Lemoine M, Ndow G, Nayagam S, Shimakawa Y. TREAT-B or Treat All: time for a broader vision on hepatitis B elimination - Author's reply. Lancet Glob Health 2024; 12:e917. [PMID: 38762294 DOI: 10.1016/s2214-109x(24)00175-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 04/11/2024] [Indexed: 05/20/2024]
Affiliation(s)
- Liem Binh Luong Nguyen
- Institut Pasteur, Université Paris Cité, Unité d'Épidémiologie des Maladies Émergentes, Paris 75015, France; CIC Cochin Pasteur, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Maud Lemoine
- Department of Surgery and Cancer, Liver Unit, St Mary's Hospital, Imperial College London, London, UK; Medical Research Council Unit, London School of Hygiene & Tropical Medicine, Fajara, The Gambia
| | - Gibril Ndow
- Department of Surgery and Cancer, Liver Unit, St Mary's Hospital, Imperial College London, London, UK; Medical Research Council Unit, London School of Hygiene & Tropical Medicine, Fajara, The Gambia
| | - Shevanthi Nayagam
- Department of Surgery and Cancer, Liver Unit, St Mary's Hospital, Imperial College London, London, UK; Medical Research Council Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK
| | - Yusuke Shimakawa
- Institut Pasteur, Université Paris Cité, Unité d'Épidémiologie des Maladies Émergentes, Paris 75015, France.
| |
Collapse
|
2
|
Khoury G, Ward JK, Mancini J, Gagneux-Brunon A, Luong Nguyen LB. Health Literacy and Health Care System Confidence as Determinants of Attitudes to Vaccines in France: Representative Cross-Sectional Study. JMIR Public Health Surveill 2024; 10:e45837. [PMID: 38713494 PMCID: PMC11109853 DOI: 10.2196/45837] [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: 01/19/2023] [Revised: 10/05/2023] [Accepted: 01/25/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Health literacy involves individuals' knowledge, personal skills, and confidence to take action to evaluate and appraise health-related information and improve their health or that of their community. OBJECTIVE This study aimed to analyze the association between health literacy and attitude toward vaccines, adjusted with other factors. METHODS We used the SLAVACO Wave 3, a survey conducted in December 2021 among a sample of 2022 individuals, representative of the French adult population. We investigated factors associated with the attitude toward vaccines using respondents' different sociodemographic data, health literacy levels, and the health care system confidence levels using a multinomial logistic regression analysis. RESULTS Among the participants, 440.4 (21.8%) were classified as "distrustful of vaccines in general," 729.2 (36.1%) were "selectively hesitant," and 852.4 (42.2%) were "nonhesitant." In our model, the level of health literacy was not statistically different between the "distrustful of vaccines in general" and the "selectively hesitant" (P=.48), but it was associated with being a "nonhesitant" (adjusted odds ratio [aOR] 1.86, 95% CI 1.25-2.76). The confidence in the health care system was a strong predictor for a "nonhesitant" attitude toward vaccines (aOR 12.4, 95% CI 7.97-19.2). We found a positive correlation of 0.34 (P<.001) between health literacy and confidence in the health care system, but the interaction term between health literacy and health care system confidence was not significant in our model. CONCLUSIONS Health literacy was associated with a "nonhesitant" attitude toward vaccines. The findings demonstrated that health literacy and confidence in the health care system are modestly correlated. Therefore, to tackle the subject of vaccine hesitancy, the main focus should be on increasing the population's confidence and on increasing their health literacy levels or providing vaccine information addressing the needs of less literate citizens.
Collapse
Affiliation(s)
- Georges Khoury
- CIC Cochin Pasteur, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jeremy K Ward
- Cermes3, CNRS, INSERM, Université Paris Cité, Paris, France
| | - Julien Mancini
- Cancer, Biomedicine & Society Group, APHM, Hop Timone, Public Health Department (BIOSTIC), INSERM, IRD, ISSPAM, SESSTIM, Aix-Marseille University, Marseille, France
| | - Amandine Gagneux-Brunon
- Centre International de Recherche en Infectiologie, Team GIMAP, Inserm, U1111, CNRS, UMR530, CHU de Saint-Etienne, Saint-Etienne, France
| | - Liem Binh Luong Nguyen
- CIC Cochin Pasteur, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
| |
Collapse
|
3
|
Rose AM, Nicolay N, Sandonis Martín V, Mazagatos C, Petrović G, Baruch J, Denayer S, Seyler L, Domegan L, Launay O, Machado A, Burgui C, Vaikutyte R, Niessen FA, Loghin II, Husa P, Aouali N, Panagiotakopoulos G, Tolksdorf K, Horváth JK, Howard J, Pozo F, Gallardo V, Nonković D, Džiugytė A, Bossuyt N, Demuyser T, Duffy R, Luong Nguyen LB, Kislaya I, Martínez-Baz I, Gefenaite G, Knol MJ, Popescu C, Součková L, Simon M, Michelaki S, Reiche J, Ferenczi A, Delgado-Sanz C, Lovrić Makarić Z, Cauchi JP, Barbezange C, Van Nedervelde E, O'Donnell J, Durier C, Guiomar R, Castilla J, Jonikaite I, Bruijning-Verhagen PC, Lazar M, Demlová R, Wirtz G, Amerali M, Dürrwald R, Kunstár MP, Kissling E, Bacci S, Valenciano M. Vaccine effectiveness against COVID-19 hospitalisation in adults (≥ 20 years) during Omicron-dominant circulation: I-MOVE-COVID-19 and VEBIS SARI VE networks, Europe, 2021 to 2022. Euro Surveill 2023; 28:2300187. [PMID: 37997665 PMCID: PMC10668256 DOI: 10.2807/1560-7917.es.2023.28.47.2300187] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 03/23/2023] [Accepted: 07/24/2023] [Indexed: 11/25/2023] Open
Abstract
IntroductionThe I-MOVE-COVID-19 and VEBIS hospital networks have been measuring COVID-19 vaccine effectiveness (VE) in participating European countries since early 2021.AimWe aimed to measure VE against PCR-confirmed SARS-CoV-2 in patients ≥ 20 years hospitalised with severe acute respiratory infection (SARI) from December 2021 to July 2022 (Omicron-dominant period).MethodsIn both networks, 46 hospitals (13 countries) follow a similar test-negative case-control protocol. We defined complete primary series vaccination (PSV) and first booster dose vaccination as last dose of either vaccine received ≥ 14 days before symptom onset (stratifying first booster into received < 150 and ≥ 150 days after last PSV dose). We measured VE overall, by vaccine category/product, age group and time since first mRNA booster dose, adjusting by site as a fixed effect, and by swab date, age, sex, and presence/absence of at least one commonly collected chronic condition.ResultsWe included 2,779 cases and 2,362 controls. The VE of all vaccine products combined against hospitalisation for laboratory-confirmed SARS-CoV-2 was 43% (95% CI: 29-54) for complete PSV (with last dose received ≥ 150 days before onset), while it was 59% (95% CI: 51-66) after addition of one booster dose. The VE was 85% (95% CI: 78-89), 70% (95% CI: 61-77) and 36% (95% CI: 17-51) for those with onset 14-59 days, 60-119 days and 120-179 days after booster vaccination, respectively.ConclusionsOur results suggest that, during the Omicron period, observed VE against SARI hospitalisation improved with first mRNA booster dose, particularly for those having symptom onset < 120 days after first booster dose.
Collapse
Affiliation(s)
| | - Nathalie Nicolay
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | | | - Clara Mazagatos
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - Joaquin Baruch
- IDCU within Health promotion and disease prevention Directorate, G'mangia, Malta
| | | | - Lucie Seyler
- Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Lisa Domegan
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Odile Launay
- Inserm, CIC Cochin-Pasteur, Paris, France
- AP-HP, Hôpital Cochin, Paris, France
- Faculty of Medicine, University of Paris City, Paris, France
| | - Ausenda Machado
- National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | - Cristina Burgui
- Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - F Annabel Niessen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Isabela I Loghin
- St. Parascheva Clinical Hospital of Infectious Diseases, Iasi, Romania
- Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Petr Husa
- Faculty of Medicine, Masaryk University, Brno, Czechia
- University Hospital Brno, Brno, Czechia
| | | | | | | | - Judit Krisztina Horváth
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | | | - Francisco Pozo
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
| | - Virtudes Gallardo
- Dirección General de Salud Pública y Ordenación Farmacéutica, Junta de Andalucía, Spain
| | - Diana Nonković
- Teaching Public Health Institute of Split-Dalmatia County, Split, Croatia
| | - Aušra Džiugytė
- IDCU within Health promotion and disease prevention Directorate, G'mangia, Malta
| | | | | | - Róisín Duffy
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Irina Kislaya
- National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | - Iván Martínez-Baz
- Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Giedre Gefenaite
- Faculty of Medicine, Lund University, Lund, Sweden
- Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Mirjam J Knol
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Corneliu Popescu
- Dr Victor Babes Clinical Hospital of Infectious and Tropical Diseases, Bucharest, Romania
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | | | - Marc Simon
- Centre Hospitalier de Luxembourg, Luxembourg
| | | | | | - Annamária Ferenczi
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | - Concepción Delgado-Sanz
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - John Paul Cauchi
- IDCU within Health promotion and disease prevention Directorate, G'mangia, Malta
| | | | | | - Joan O'Donnell
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Raquel Guiomar
- National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - Patricia Cjl Bruijning-Verhagen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Mihaela Lazar
- "Cantacuzino" National Military Medical Institute for Research-Development, Bucharest, Romania
| | | | - Gil Wirtz
- Centre Hospitalier de Luxembourg, Luxembourg
| | - Marina Amerali
- National Public Health Organisation (EODY), Athens, Greece
| | | | - Mihály Pál Kunstár
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | | | - Sabrina Bacci
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | | |
Collapse
|
4
|
Rose AM, Nicolay N, Sandonis Martín V, Mazagatos C, Petrović G, Niessen FA, Machado A, Launay O, Denayer S, Seyler L, Baruch J, Burgui C, Loghin II, Domegan L, Vaikutytė R, Husa P, Panagiotakopoulos G, Aouali N, Dürrwald R, Howard J, Pozo F, Sastre-Palou B, Nonković D, Knol MJ, Kislaya I, Luong Nguyen LB, Bossuyt N, Demuyser T, Džiugytė A, Martínez-Baz I, Popescu C, Duffy R, Kuliešė M, Součková L, Michelaki S, Simon M, Reiche J, Otero-Barrós MT, Lovrić Makarić Z, Bruijning-Verhagen PC, Gomez V, Lesieur Z, Barbezange C, Van Nedervelde E, Borg ML, Castilla J, Lazar M, O'Donnell J, Jonikaitė I, Demlová R, Amerali M, Wirtz G, Tolksdorf K, Valenciano M, Bacci S, Kissling E. Vaccine effectiveness against COVID-19 hospitalisation in adults (≥ 20 years) during Alpha- and Delta-dominant circulation: I-MOVE-COVID-19 and VEBIS SARI VE networks, Europe, 2021. Euro Surveill 2023; 28:2300186. [PMID: 37997666 PMCID: PMC10668259 DOI: 10.2807/1560-7917.es.2023.28.47.2300186] [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: 03/23/2023] [Accepted: 07/24/2023] [Indexed: 11/25/2023] Open
Abstract
IntroductionTwo large multicentre European hospital networks have estimated vaccine effectiveness (VE) against COVID-19 since 2021.AimWe aimed to measure VE against PCR-confirmed SARS-CoV-2 in hospitalised severe acute respiratory illness (SARI) patients ≥ 20 years, combining data from these networks during Alpha (March-June)- and Delta (June-December)-dominant periods, 2021.MethodsForty-six participating hospitals across 14 countries follow a similar generic protocol using the test-negative case-control design. We defined complete primary series vaccination (PSV) as two doses of a two-dose or one of a single-dose vaccine ≥ 14 days before onset.ResultsWe included 1,087 cases (538 controls) and 1,669 cases (1,442 controls) in the Alpha- and Delta-dominant periods, respectively. During the Alpha period, VE against hospitalisation with SARS-CoV2 for complete Comirnaty PSV was 85% (95% CI: 69-92) overall and 75% (95% CI: 42-90) in those aged ≥ 80 years. During the Delta period, among SARI patients ≥ 20 years with symptom onset ≥ 150 days from last PSV dose, VE for complete Comirnaty PSV was 54% (95% CI: 18-74). Among those receiving Comirnaty PSV and mRNA booster (any product) ≥ 150 days after last PSV dose, VE was 91% (95% CI: 57-98). In time-since-vaccination analysis, complete all-product PSV VE was > 90% in those with their last dose < 90 days before onset; ≥ 70% in those 90-179 days before onset.ConclusionsOur results from this EU multi-country hospital setting showed that VE for complete PSV alone was higher in the Alpha- than the Delta-dominant period, and addition of a first booster dose during the latter period increased VE to over 90%.
Collapse
Affiliation(s)
| | - Nathalie Nicolay
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | | | - Clara Mazagatos
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - F Annabel Niessen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Ausenda Machado
- National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | - Odile Launay
- Inserm, CIC Cochin-Pasteur, Paris, France
- AP-HP, Hôpital Cochin, Paris, France
- Faculty of Medicine, University of Paris City, Paris, France
| | | | - Lucie Seyler
- Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Joaquin Baruch
- IDCU within Health promotion and disease prevention Directorate, G'mangia, Malta
| | - Cristina Burgui
- Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Isabela I Loghin
- St. Parascheva Clinical Hospital of Infectious Diseases, Iasi, Romania
- Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Lisa Domegan
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Petr Husa
- Faculty of Medicine, Masaryk University, Brno, Czechia
- University Hospital Brno, Brno, Czechia
| | | | | | | | | | - Francisco Pozo
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
| | - Bartolomé Sastre-Palou
- Servicio de Medicina Preventiva Hospital Universitario Son Espases, Servicio de Epidemiología, Consellería de Salut, Palma, Spain
| | - Diana Nonković
- Teaching Public Health Institute of Split-Dalmatia County, Split, Croatia
| | - Mirjam J Knol
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Irina Kislaya
- National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | | | | | | | - Aušra Džiugytė
- IDCU within Health promotion and disease prevention Directorate, G'mangia, Malta
| | - Iván Martínez-Baz
- Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Corneliu Popescu
- Dr Victor Babes Clinical Hospital of Infectious and Tropical Diseases, Bucharest, Romania
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Róisín Duffy
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Monika Kuliešė
- Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | | | - Marc Simon
- Centre Hospitalier de Luxembourg, Luxembourg
| | | | - María Teresa Otero-Barrós
- Servicio de Epidemiología, Dirección General de Salud Pública, Consejería de Sanidad de Galicia, Santiago de Compostela, A Coruna, Spain
| | | | - Patricia Cjl Bruijning-Verhagen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Verónica Gomez
- National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | | | | | | | - Maria-Louise Borg
- IDCU within Health promotion and disease prevention Directorate, G'mangia, Malta
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Mihaela Lazar
- "Cantacuzino" National Military Medical Institute for Research-Development, Bucharest, Romania
| | - Joan O'Donnell
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | | | - Marina Amerali
- National Public Health Organisation (EODY), Athens, Greece
| | - Gil Wirtz
- Luxembourg Institute of Health, Luxembourg
| | | | | | - Sabrina Bacci
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | | |
Collapse
|
5
|
Luong Nguyen LB, Goupil de Bouillé J, Menant L, Noret M, Dumas A, Salmona M, Le Goff J, Delaugerre C, Crépey P, Zeggagh J. A randomised controlled trial to study the transmission of SARS-CoV-2 and other respiratory viruses during indoor clubbing events (ANRS0066s ITOC study). Clin Infect Dis 2023; 77:ciad603. [PMID: 37795682 PMCID: PMC10724450 DOI: 10.1093/cid/ciad603] [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: 03/11/2023] [Revised: 07/05/2023] [Accepted: 10/04/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND In the context of the circulation of the SARS-CoV-2 B.1.617.2 (Delta) variant, vaccination re-authorised mass indoor gatherings. The "Indoor Transmission of COVID-19" (ITOC) trial (ClinicalTrials.gov, NCT05311865) aimed to assess the risk of transmission of SARS-CoV-2 and other respiratory viruses during an indoor clubbing event among participants fully-vaccinated against COVID-19. METHODS ITOC, a randomised, controlled trial in the Paris region (France), enrolled healthy volunteers aged 18-49 years, fully-vaccinated against COVID-19, with no co-morbidities or symptoms, randomised 1:1 to be interventional group "attendees" or control "non-attendees". The intervention, a 7-hour indoor event in a nightclub at full capacity, with no masking, prior SARS-CoV-2 test result or social distancing required. The primary-outcome measure was the numbers of RT-PCR-determined SARS-CoV-2-positive subjects on self-collected saliva 7 days post-gathering in the per-protocol population. Secondary endpoints focused on 20 other respiratory viruses. RESULTS Healthy participants (n = 1,216) randomised 2:1 by blocks up to 10, 815 attendees and 401 non-attendees, yielding 529 and 287 subjects, respectively, with day-7 saliva samples. One day-7 sample from each group was positive. Looking at all respiratory viruses together, the clubbing event was associated with an increased risk of infection of 1.59 [95% CI 1.04-2.61]. CONCLUSIONS In the context of low Delta-VOC circulation, no evidence of SARS-CoV-2 transmission among asymptomatic and vaccinated participants was found, but the risk of other respiratory virus transmission was higher.
Collapse
Affiliation(s)
- Liem Binh Luong Nguyen
- CIC Cochin Pasteur, Hôpital Cochin Port-Royal, AP-HP, Université de Paris Cité, Paris, France
| | - Jeanne Goupil de Bouillé
- Service de Maladies Infectieuses et Tropicales, Hôpital Avicenne, AP-HP, Bobigny, France
- LEPS Laboratoire Éducations et Promotion de Santé, Université Paris 13, Bobigny, France
| | - Lola Menant
- Université de Rennes, EHESP, CNRS, Inserm, Arènes—UMR 6051, RSMS—U 1309, Rennes, France
| | - Marion Noret
- Réseau National de Recherche Clinique en Infectiologie (RENARCI), Service de Maladies Infectieuses et Tropicales, Hôpital Saint-Louis, AP-HP, Paris, France
| | - Audrey Dumas
- ANRS∣Emerging Infectious Diseases, Paris, France
| | - Maud Salmona
- Service de Virologie, Hôpital Saint-Louis, AP-HP, Université de Paris Cité, Paris, France
| | - Jérôme Le Goff
- Service de Virologie, Hôpital Saint-Louis, AP-HP, Université de Paris Cité, Paris, France
| | - Constance Delaugerre
- Service de Virologie, Hôpital Saint-Louis, AP-HP, Université de Paris Cité, Paris, France
| | - Pascal Crépey
- Université de Rennes, EHESP, CNRS, Inserm, Arènes—UMR 6051, RSMS—U 1309, Rennes, France
| | - Jeremy Zeggagh
- Service de Maladies Infectieuses et Tropicales, Hôpital Saint-Louis, AP-HP, Paris, France
| |
Collapse
|
6
|
Nguyen LBL, Soumah AA, Hoang VT, Nguyen AT, Pham TH, Royer-Devaux S, Madec Y. Performances of Dried Blood Spots and Point-of-Care Devices to Identify Virological Failure in HIV-Infected Patients: A Systematic Review and Meta-Analysis. AIDS Patient Care STDS 2023; 37:66-83. [PMID: 36787410 DOI: 10.1089/apc.2022.0135] [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] [Indexed: 02/16/2023] Open
Abstract
To broaden access to HIV viral load monitoring (VLM), the use of blood samples from dried blood spots (DBS) or point-of-care (POC) devices, could be of great help in settings where plasma is not easily accessible. The variety of assays available makes the choice complex. This systematic review and meta-analysis aims to estimate the sensitivity and specificity of DBS and POC devices to identify patients in virological failure using World Health Organization (WHO) recommendations (viral load ≥1000 copies/mL), compared with plasma, for the assays currently available. Four databases were searched for articles, and two reviewers independently identified articles reporting sensitivity and specificity of DBS and/or POC to identify patients in virological failure. We excluded articles that used other thresholds as well as articles with a total number of participants below 50 to avoid reporting bias. Heterogeneity and factors associated with assays' performances were assessed by I2 statistics and metaregression. The protocol of this review follows the PRISMA guidelines. Out of 941 articles, 47 were included: 32 DBS evaluations and 16 POC evaluations. Overall, when using DBS, the Abbott RT HIV-1, Roche CAP-CTM, NucliSENS BioMerieux and Aptima assays presented sensitivity and specificity exceeding 85%, but reported results were highly heterogeneous. Factors associated with better performances were high volume of blood and the use of the same assay for DBS and plasma VLM. Regarding the POC devices, SAMBA I, SAMBA II, and GeneXpert devices presented high sensitivity and specificity exceeding 90%, with less heterogeneity. DBS is suitable VLM, but performances can vary greatly depending on the protocols, and should be performed in trained centers. POC is suitable for VLM with less risk of heterogeneity but is more intensive in costs and logistics.
Collapse
Affiliation(s)
- Liem Binh Luong Nguyen
- Epidemiology of Emerging Diseases, Université de Paris, Institut Pasteur, Paris, France.,Assistance Publique Hôpitaux de Paris (AP-HP), CIC 1417 Cochin Pasteur, Hôpital Cochin, Paris, France
| | - Abou Aissata Soumah
- Epidemiology of Emerging Diseases, Université de Paris, Institut Pasteur, Paris, France
| | - Van Thuan Hoang
- Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
| | - Anh Tuan Nguyen
- National Institute of Health and Epidemiology (NIHE), Hanoi, Vietnam
| | - Thang Hong Pham
- National Institute of Health and Epidemiology (NIHE), Hanoi, Vietnam
| | | | - Yoann Madec
- Epidemiology of Emerging Diseases, Université de Paris, Institut Pasteur, Paris, France
| |
Collapse
|
7
|
Jean K, Tawheed A, Luong Nguyen LB, Heikal T, Eldaly U, Elhadidy N, Elghaieb A, Aboudonia A, Tondeur L, Dublineau A, Fontanet A, El-Kassas M. Changes in Presentation, Treatment, and Survival of Patients with Hepatocellular Carcinoma in Damietta, Egypt, 2007-2019: A Retrospective Monocentric Cohort Study. J Hepatocell Carcinoma 2023; 10:99-111. [PMID: 36721637 PMCID: PMC9884455 DOI: 10.2147/jhc.s391511] [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: 10/07/2022] [Accepted: 01/12/2023] [Indexed: 01/26/2023] Open
Abstract
Introduction We aimed to assess temporal changes in the presentation and survival of patients with hepatocellular carcinoma (HCC) in the northern Egypt region, one of the regions reporting the highest incidence of the disease globally. Methods We conducted a monocentric retrospective study. Patients presenting at the Damietta Oncology referral center between 2007 and 2019 with a diagnosed HCC were eligible. Individual, clinical and tumor characteristics at HCC diagnosis, including the Barcelona Clinic Liver Cancer (BCLC) staging, were retrieved from medical files and patients' final vital status was ascertained by combining various data sources. Patients were divided into 2 groups based on diagnosis period: pre- and post-2014. Survival was analysed based on Kaplan-Meier curves and differences in restricted mean survival time (RMST). Results Data from 5097 patients (among 5210 eligible, 97.8%) were analyzed. We observed a significant trend toward HCC diagnosed at earlier stage in the post- vs pre-2014 period (BCLC stage 0/A or B: 37.2% vs 27.1%, p<10-3). Overall patient's survival after the HCC diagnosis was poor, with a median of 8.1 months. The BCLC staging system performed well in predicting survival. Despite a trend toward HCC diagnosed at earlier stages, we did not observe a significant improvement in survival over time. Overall, treatments offered in this medical center were in line with international guidelines, and 16.1% of the patients who received a curative treatment had an improved survival (30.7 months in median). However, HCC recurrence was frequent among patients cured for HCC, with a median time to recurrence of 22 months. Discussion Overall survival after HCC diagnosis in Egypt remains poor but is significantly improved by curative therapy. Despite a trend toward earlier diagnosis of HCC, we did not observe a general improvement in survival over time, which remains to be clearly understood.
Collapse
Affiliation(s)
- Kévin Jean
- Laboratoire MESuRS, Conservatoire national des arts et métiers, Paris, France,Unité PACRI, Institut Pasteur, Conservatoire national des arts et métiers, Paris, France,Correspondence: Kévin Jean, Laboratoire MESuRS, Conservatoire national des arts et métiers, 292 rue Saint Martin, Paris, 75003, France, Email
| | - Ahmed Tawheed
- Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt
| | - Liem Binh Luong Nguyen
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris-Cité, Paris, France
| | - Tarek Heikal
- Medical Oncology Department, Damietta Oncology Center, Damietta, Egypt
| | - Usama Eldaly
- Medical Oncology Department, Damietta Oncology Center, Damietta, Egypt
| | - Neveen Elhadidy
- Pharmaceutical Services Department, Damietta Oncology Center, Damietta, Egypt
| | - Ahmed Elghaieb
- Radiology Department, Damietta Oncology Center, Damietta, Egypt
| | - Ahmed Aboudonia
- Radiology Department, Damietta Oncology Center, Damietta, Egypt
| | - Laura Tondeur
- Laboratoire MESuRS, Conservatoire national des arts et métiers, Paris, France
| | - Amélie Dublineau
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris-Cité, Paris, France
| | - Arnaud Fontanet
- Unité PACRI, Institut Pasteur, Conservatoire national des arts et métiers, Paris, France,Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris-Cité, Paris, France
| | - Mohamed El-Kassas
- Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt
| |
Collapse
|
8
|
Dauriat G, Beaumont L, Luong Nguyen LB, Renaud Picard B, Penhouet M, Coiffard B, Salpin M, Demant X, Saint Raymond C, Carlier N, Messika J, Reynaud Gaubert M, Danner I, Gallais F, Roux A, Le Pavec J. Efficacy of three COVID-19 vaccine doses in lung transplant recipients: a multicentre cohort study. Eur Respir J 2023; 61:13993003.00502-2022. [PMID: 36265877 PMCID: PMC9644237 DOI: 10.1183/13993003.00502-2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 08/11/2022] [Indexed: 01/24/2023]
Abstract
QUESTION ADDRESSED BY THE STUDY Do three coronavirus disease 2019 (COVID-19) vaccine doses induce a serological response in lung transplant recipients? METHODS We retrospectively included 1071 adults (551 (52%) males) at nine transplant centres in France. Each had received three COVID-19 vaccine doses in 2021, after lung transplantation. An anti-spike protein IgG response, defined as a titre >264 BAU·mL-1 after the third dose (median (interquartile range (IQR)) 3.0 (1.7-4.1) months), was the primary outcome and adverse events were the secondary outcomes. Median (IQR) age at the first vaccine dose was 54 (40-63) years and median (IQR) time from transplantation to the first dose was 64 (30-110) months. RESULTS Median (IQR) follow-up after the first dose was 8.3 (6.7-9.3) months. A vaccine response developed in 173 (16%) patients. Factors independently associated with a response were younger age at vaccination, longer time from transplantation to vaccination and absence of corticosteroid or mycophenolate therapy. After vaccination, 51 (5%) patients (47 non-responders (47/898 (5%)) and four (4/173 (2%)) responders) experienced COVID-19, at a median (IQR) of 6.6 (5.1-7.3) months after the third dose. No responders had severe COVID-19 compared with 15 non-responders, including six who died of the disease. CONCLUSIONS Few lung transplant recipients achieved a serological response to three COVID-19 vaccine doses, indicating a need for other protective measures. Older age and use of mycophenolate or corticosteroids were associated with absence of a response. The low incidence of COVID-19 might reflect vaccine protection via cellular immunity and/or good adherence to shielding measures.
Collapse
Affiliation(s)
- Gaëlle Dauriat
- Service de Pneumologie et Transplantation Pulmonaire, Hôpital Marie Lannelogue, Groupe Hospitalier Paris-Saint Joseph, Le Plessis-Robinson, France
| | - Laurence Beaumont
- Service de Transplantation Pulmonaire et Centre de Compétence de la Mucoviscidose, Hôpital Foch, Suresnes, France
- These authors contributed equally to this work
| | - Liem Binh Luong Nguyen
- Inserm, CIC 1417, Hôpital Cochin, AP-HP, Paris, France
- These authors contributed equally to this work
| | - Benjamin Renaud Picard
- Service de Pneumologie, Groupe de Transplantation Pulmonaire, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Morgane Penhouet
- Service de Pneumologie, Institut du Thorax, CHU Nantes, Nantes, France
| | - Benjamin Coiffard
- Service de Pneumologie et Equipe de Transplantation Pulmonaire, CHU Nord, AP-HM, Aix-Marseille Université, Marseille, France
| | - Mathilde Salpin
- Service de Pneumologie, Hôpital Bichat, AP-HP, Paris, France
| | - Xavier Demant
- Service de Pneumologie, Hôpital Haut-Lévêque, Université de Bordeaux, Pessac, France
| | - Christel Saint Raymond
- Clinique Universitaire de Pneumologie, Pôle Thorax et Vaisseaux, CHU Grenoble, INSERM1055, Université Grenoble Alpes, Grenoble, France
| | - Nicolas Carlier
- Service de Pneumologie, Hôpital Cochin, AP-HP, APHP-CUP, Paris, France
| | | | - Martine Reynaud Gaubert
- Service de Pneumologie et Equipe de Transplantation Pulmonaire, CHU Nord, AP-HM, Aix-Marseille Université, Marseille, France
| | - Isabelle Danner
- Service de Pneumologie, Institut du Thorax, CHU Nantes, Nantes, France
| | - Floriane Gallais
- Laboratoire de Virologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Antoine Roux
- Service de Transplantation Pulmonaire et Centre de Compétence de la Mucoviscidose, Hôpital Foch, Suresnes, France
| | - Jérôme Le Pavec
- Service de Pneumologie et Transplantation Pulmonaire, Hôpital Marie Lannelogue, Groupe Hospitalier Paris-Saint Joseph, Le Plessis-Robinson, France
- Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| |
Collapse
|
9
|
Bonneton M, Sambourg J, Luong Nguyen LB, Trillou C, Dohou J, Saint Lary O, Schuers M, Lachâtre M, Launay O. A national platform for Covid-19 vaccine studies recruitment in France: Covireivac volunteer's characteristics. Hum Vaccin Immunother 2022; 18:2109364. [PMID: 36018773 DOI: 10.1080/21645515.2022.2109364] [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] [Indexed: 12/15/2022] Open
Abstract
During the Covid-19 pandemic, the urgent need for safe and effective vaccines has led to many vaccine trials, implying fast and extensive recruitment of volunteers. In France, until 2020, vaccine clinical research participants were usually recruited locally, through center-based pools of volunteers, and local communication plans. Covireivac is a French public online platform launched on 10/01/2020 that enables national, large-scale recruitment of volunteers for Covid-19 vaccine studies. On the Covireivac website, all adult participants registered online, gave their informed consent, and filled out two online forms with information on their identity, health status (comorbidities, treatments), and known exposure to SARS-CoV-2. Since July 2021, volunteers could mention if their children are interested in participating in a Covid-19 vaccine trial. The objective of this work is to describe Covireivac's volunteer characteristics registered from 10/01/2020 to 11/02/2022. To identify independent volunteer characteristics associated with a period of registration we performed a multivariate logistic regression. Among 54,424 registrations, 52,391 (96%) were analysed; 61% were male (n = 31,893), median age was 50 y; 13% (n = 6586) were healthcare workers. At registration, 15,879 volunteers (33%) reported at least one comorbidity, among whom 16% (n = 7349) were obese and 17% (n = 8346) had hypertension. Most volunteers registered during the first month (n = 35,876, 66%). The Covireivac platform allowed quick and large recruitment of potential volunteers for Covid-19 vaccine trials and could be used on a larger scale for vaccine trials in France. It could facilitate recruitment in vaccine trials and provide sponsors with better visibility of the recruitment capacities of clinical research centers.
Collapse
Affiliation(s)
- Marion Bonneton
- CIC Cochin Pasteur, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Paris, France.,Innovative Clinical Research Network in Vaccinology (I-REIVAC), F-CRIN, Paris, France
| | - Jessica Sambourg
- CIC Cochin Pasteur, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Liem Binh Luong Nguyen
- CIC Cochin Pasteur, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Paris, France.,Université Paris Cité, Paris, France
| | - Christine Trillou
- French Clinical Research Infrastructure Network (F-CRIN), Inserm, Toulouse, France
| | - Joyce Dohou
- French Clinical Research Infrastructure Network (F-CRIN), Inserm, Toulouse, France
| | - Olivier Saint Lary
- Collège National des Enseignants en Médecine Générale, Paris, France.,Primary Care and Prevention, CESP, Université Paris-Saclay, Le kremlin Bicetre, France
| | - Mathieu Schuers
- Collège National des Enseignants en Médecine Générale, Paris, France.,LIMICS, U1142, Sorbonne Université, Paris, France
| | - Marie Lachâtre
- CIC Cochin Pasteur, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Odile Launay
- CIC Cochin Pasteur, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Paris, France.,Innovative Clinical Research Network in Vaccinology (I-REIVAC), F-CRIN, Paris, France.,Université Paris Cité, Paris, France
| |
Collapse
|
10
|
Goupil de Bouillé J, Luong Nguyen LB, Crépey P, Garlantezec R, Doré V, Dumas A, Ben Mechlia M, Tattevin P, Gaudart J, Spire B, Lert F, Yazdanpanah Y, Delaugerre C, Noret M, Zeggagh J. Transmission of SARS-CoV-2 during indoor clubbing events: A clustered randomized, controlled, multicentre trial protocol. Front Public Health 2022; 10:981213. [PMID: 36438274 PMCID: PMC9687087 DOI: 10.3389/fpubh.2022.981213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Received: 06/29/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction The SARS-CoV-2 pandemic led to the implementation of several non-pharmaceutical interventions (NPIs), from closings of bars and restaurants to curfews and lockdowns. Vaccination campaigns started hoping it could efficiently alleviate NPI. The primary objective of the "Indoor Transmission of COVID-19" (ITOC) study is to determine among a fully vaccinated population the relative risk of SARS-CoV-2 transmission during one indoor clubbing event. Secondary objectives are to assess the transmission of other respiratory viruses, risk exposure, and attitudes toward COVID-19 vaccination, health pass, and psychological impact of indoor club closing. Methods and analysis Four thousand four hundred healthy volunteers aged 18-49 years and fully vaccinated will be included in Paris region. The intervention is an 8-hour indoor clubbing event with no masks, no social distance, maximum room capacity, and ventilation. A reservation group of up to 10 people will recruit participants, who will be randomized 1:1 to either the experimental group (2,200 volunteers in two venues with capacities of 1,000 people each) or the control group (2,200 volunteers asked not to go to the club). All participants will provide a salivary sample on the day of the experiment and 7 days later. They also will answer several questionnaires. Virological analyses include polymerase chain reaction (PCR) of salivary samples and air of the venue, investigating SARS-CoV-2 and 18 respiratory viruses. Ethics and dissemination Ethical clearance was first obtained in France from the institutional review board (Comité de Protection des Personnes Ile de France VII - CPP), and the trial received clearance from the French National Agency for Medicines and Health Products (Agence National de Sécurité du Médicament - ANSM). The trial is supported and approved by The Agence Nationale Recherche sur le SIDA, les hépatites et maladies émergences (ANRS-MIE). Positive, negative, and inconclusive results will be published in peer-reviewed scientific journals. Trial registration number IDR-CB 2021-A01473-38. Clinicaltrial.gov, identifier: NCT05311865.
Collapse
Affiliation(s)
- Jeanne Goupil de Bouillé
- Service de Maladies Infectieuses et Tropicales, Hôpital Avicenne, AP-HP, Bobigny, France,LEPS Laboratoire Éducations et Pratiques de Santé, Université Paris 13, Bobigny, France,*Correspondence: Jeanne Goupil de Bouillé
| | | | - Pascal Crépey
- Univ Rennes, EHESP, CNRS, INSERM, Arènes - UMR 6051, RSMS - U 1309, Rennes, France
| | - Ronan Garlantezec
- CHU de Rennes, University Rennes, INSERM, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) – UMR_S 1085, Rennes, France
| | | | - Audrey Dumas
- ANRS, Agence Nationale Recherche Sida, Paris, France
| | | | - Pierre Tattevin
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - Jean Gaudart
- Aix Marseille University, APHM, INSERM, IRD, SESSTIM, ISSPAM, UMR1252, Hop Timone, BioSTIC, Biostatistic and ICT, Marseille, France
| | - Bruno Spire
- Aix Marseille University, APHM, INSERM, IRD, SESSTIM, ISSPAM, UMR1252, Marseille, France
| | - France Lert
- ANRS, Agence Nationale Recherche Sida, Paris, France
| | - Yazdan Yazdanpanah
- ANRS, Agence Nationale Recherche Sida, Paris, France,Service de Maladies Infectieuses et Tropicales, Hôpital Bichat, AP-HP, Paris, France
| | - Constance Delaugerre
- Service de Virologie, Hôpital Saint-Louis, AP-HP, INSERM U944, Université de Paris, Paris, France
| | | | - Jeremy Zeggagh
- Service de Maladies Infectieuses et Tropicales, Hôpital Saint-Louis, AP-HP, Paris, France
| |
Collapse
|
11
|
Luong Nguyen LB, Ghosn J, Durier C, Tachot C, Tartour E, Touati A, Simon T, Autran B, Ortega Perez I, Telford E, Ward JK, Michels D, Meyer L, Rousseau A, Berard L, de Lamballerie X, Launay O. A prospective national cohort evaluating ring MVA vaccination as post-exposure prophylaxis for monkeypox. Nat Med 2022; 28:1983-1984. [PMID: 35831633 DOI: 10.1038/d41591-022-00077-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
12
|
Henriot P, Castry M, Luong Nguyen LB, Shimakawa Y, Jean K, Temime L. Meta-analysis: risk of hepatitis C virus infection associated with hospital-based invasive procedures. Aliment Pharmacol Ther 2022; 56:558-569. [PMID: 35758763 PMCID: PMC9543323 DOI: 10.1111/apt.17106] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/08/2022] [Accepted: 06/13/2022] [Indexed: 12/09/2022]
Abstract
BACKGROUND Healthcare settings, where invasive procedures are frequently performed, may play an important role in the transmission dynamics of blood-borne pathogens when compliance with infection control precautions is suboptimal. AIMS To understand and quantify the role of hospital-based invasive procedures on hepatitis C virus (HCV) transmission. METHODS We conducted a systematic review and meta-analysis to identify recent studies reporting association measures of HCV infection risk that are linked to iatrogenic procedures. Based on expert opinion, invasive procedures were categorised into 10 groups for which pooled measures were calculated. Finally, the relationship between pooled measures and the country-level HCV prevalence or the Healthcare Access and Quality (HAQ) index was assessed by meta-regression. RESULTS We included 71 studies in the analysis. The most frequently evaluated procedures were blood transfusion (66 measures) and surgery (43 measures). The pooled odds ratio (OR) of HCV infection varied widely, ranging from 1.46 (95% confidence interval: 1.14-1.88) for dental procedures to 3.22 (1.7-6.11) for transplantation. The OR for blood transfusion was higher for transfusions performed before 1998 (3.77, 2.42-5.88) than for those without a specified/recent date (2.20, 1.77-2.75). In procedure-specific analyses, the HCV infection risk was significantly negatively associated with the HAQ for endoscopy and positively associated with HCV prevalence for endoscopy and surgery. CONCLUSIONS Various invasive procedures were significantly associated with HCV infection. Our results provide a ranking of procedures in terms of HCV risk that may be used for prioritisation of infection control interventions, especially in high HCV prevalence settings.
Collapse
Affiliation(s)
- Paul Henriot
- MESuRS LaboratoryConservatoire National des Arts et MétiersParisFrance,PACRI UnitConservatoire National des Arts et Métiers/Institut PasteurParisFrance
| | | | | | - Yusuke Shimakawa
- PACRI UnitConservatoire National des Arts et Métiers/Institut PasteurParisFrance,Unité d'Epidémiologie des Maladies ÉmergentesInstitut PasteurParisFrance
| | - Kévin Jean
- MESuRS LaboratoryConservatoire National des Arts et MétiersParisFrance,PACRI UnitConservatoire National des Arts et Métiers/Institut PasteurParisFrance
| | - Laura Temime
- MESuRS LaboratoryConservatoire National des Arts et MétiersParisFrance,PACRI UnitConservatoire National des Arts et Métiers/Institut PasteurParisFrance
| |
Collapse
|
13
|
Binh Luong Nguyen L, Lachâtre M, Launay O. [Vaccination contre le SARS-CoV-2, le Graal ?]. Rev Prat 2022; 72:517-522. [PMID: 35899638] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
ANTI-SARS-COV-2 VACCINATION, THE GRAIL? The Covid-19 pandemic, which caused an unprecedented health crisis, was partially controlled by the rapid development of effective vaccines against SARS-CoV-2. To date, 5 vaccines are approved in Europe, 10 are recognized by the World Health Organization and more than 150 vaccine candidates are in clinical development. This emerging pandemic disease context has shown the value of research and real-life data. The five vaccines used in France have been developed using different technologies with convincing Phase 3 results. Real-life data have provided additional information on the effectiveness and safety of these vaccines: they have shown the importance of a booster dose to protect against severe forms of delta and omicron variants; they have made it possible to characterize and measure the incidence of rare adverse events, such as myocardial toxicity in mRNA vaccines or the risk of thrombocytopenic thrombosis in vectorized vaccines. However, research must continue as many questions remain unanswered.
Collapse
Affiliation(s)
- Liem Binh Luong Nguyen
- Assistance publique-Hôpitaux de Paris, hôpital Cochin, Inserm, centre d'investigation clinique (CIC) 1417, Paris, France
| | - Marie Lachâtre
- Assistance publique-Hôpitaux de Paris, hôpital Cochin, Inserm, centre d'investigation clinique (CIC) 1417, Paris, France
| | - Odile Launay
- Assistance publique-Hôpitaux de Paris, hôpital Cochin, Inserm, centre d'investigation clinique (CIC) 1417, Paris, France - Université Paris Cité, Inserm, F-CRIN, I-REIVAC, COVIREIVAC, Paris, France
| |
Collapse
|
14
|
Hermine O, Mariette X, Porcher R, Djossou F, Nguyen Y, Arlet JB, Savale L, Diehl JL, Georgin-Lavialle S, Cadranel J, Pialoux G, Lacombe K, Mekinian A, Gros H, Lescure X, Ghosn J, Coupez E, Grapin K, Rapp C, Michel M, Lecapitaine AL, Michot JM, Costedoat-Chalumeau N, Nguyen LBL, Semerano L, Raffi F, Aguillar C, Rouzaud C, Gottenberg JE, Hansmann Y, Bienvenu B, London J, Fantchou FS, Ackermann F, Gros A, Morel A, Gambier N, Sène D, Mégarbane B, Azoulay E, Bureau S, Dougados M, Emmerich J, Fartoukh M, Guidet B, Humbert M, Mahevas M, Pène F, Schlemmer F, Pourcher-Martinez V, Tibi A, Baron G, Perrodeau E, Baron S, Steg G, Yazdapanah Y, Simon T, Resche-Rigon M, Tharaux PL, Ravaud P. Tocilizumab plus dexamethasone versus dexamethasone in patients with moderate-to-severe COVID-19 pneumonia: A randomised clinical trial from the CORIMUNO-19 study group. EClinicalMedicine 2022; 46:101362. [PMID: 35350097 PMCID: PMC8949640 DOI: 10.1016/j.eclinm.2022.101362] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 02/07/2022] [Accepted: 03/08/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND In moderate-to-severe COVID-19 pneumonia, dexamethasone (DEX) and tocilizumab (TCZ) reduce the occurrence of death and ventilatory support. We investigated the efficacy and safety of DEX+TCZ in an open randomized clinical trial. METHODS From July 24, 2020, through May 18, 2021, patients with moderate-to-severe COVID-19 pneumonia requiring oxygen (>3 L/min) were randomly assigned to receive DEX (10 mg/d 5 days tapering up to 10 days) alone or combined with TCZ (8 mg/kg IV) at day 1, possibly repeated with a fixed dose of 400 mg i.v. at day 3. The primary outcome was time from randomization to mechanical ventilation support or death up to day 14, analysed on an intent-to-treat basis using a Bayesian approach. ClinicalTrials.gov number, NCT04476979. FINDINGS A total of 453 patients were randomized, 3 withdrew consent, 450 were analysed, of whom 226 and 224 patients were assigned to receive DEX or TCZ+DEX, respectively. At day 14, mechanical ventilation or death occurred in 32/226 (14%) and 27/224 (12%) in the DEX and TCZ+DEX arms, respectively (hazard ratio [HR] 0·85, 90% credible interval [CrI] 0·55 to 1·31). At day 14, the World health Organization (WHO) clinical progression scale (CPS) was significantly improved in the TCZ+DEX arm (OR 0·69, 95% CrI, 0·49 to 0.97). At day 28, the cumulative incidence of oxygen supply independency was 82% in the TCZ+DEX arms and 72% in the DEX arm (HR 1·36, 95% CI 1·11 to 1·67). On day 90, 24 deaths (11%) were observed in the DEX arm and 18 (8%) in the TCZ+DEX arm (HR 0·77, 95% CI 0·42-1·41). Serious adverse events were observed in 25% and 21% in DEX and TCZ+DEX arms, respectively. INTERPRETATION Mechanical ventilation need and mortality were not improved with TCZ+DEX compared with DEX alone. The safety of both treatments was similar. However, given the wide confidence intervals for the estimate of effect, definitive interpretation cannot be drawn. FUNDING Programme Hospitalier de Recherche Clinique [PHRC COVID-19-20-0151, PHRC COVID-19-20-0029], Fondation de l'Assistance Publique - Hôpitaux de Paris (Alliance Tous Unis Contre le Virus) and from Fédération pour la Recherche Médicale" (FRM). Tocilizumab was provided by Roche.
Collapse
Affiliation(s)
- Olivier Hermine
- Département d'hématologie, Hôpital Necker, Assistance Publique Hôpitaux de Paris, Université de Paris, 149 rue de Sèvres, Paris 75015, France
- Laboratory of physiopathology and treatment of Hematological malignancies, Institut imagine, INSERM U1153, Université de Paris, Paris, France
- Corresponding author at: Département d'hématologie, Hôpital Necker, Assistance Publique Hôpitaux de Paris, Université de Paris, 149 rue de Sèvres, Paris 75015, France.
| | - Xavier Mariette
- Département de Rhumatologie, Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, Université Paris Saclay, Le Kremlin Bicêtre, France
| | - Raphael Porcher
- Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153), Inserm / Université Paris, Centre d'épidémiologie clinique, Hôpital Hôtel-Dieu, France
| | - Felix Djossou
- Service de maladies infectieuses et tropicales (UMIT), TBIP, Univ. de Guyane, Cayenne 97300, French Guiana
- Univ. de Lille, CNRS, Inserm, Institut Pasteur de Lille, U1019-UMR9017-CIIL Centre d'Infection et d'Immunité de Lille, Lille 59000, France
| | - Yann Nguyen
- Département de Médecine interne, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Jean-Benoît Arlet
- Département de Médecine interne, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Laurent Savale
- Université Paris–Saclay, INSERM UMR_S999, Assistance Publique Hôpitaux de Paris, Service de Pneumologie et Soins Intensifs Respiratoires, Hôpital Bicêtre, Le Kremlin Bicêtre, France
| | - Jean Luc Diehl
- Département de Réanimation, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Sophie Georgin-Lavialle
- Département de Médecine Interne, Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Jacques Cadranel
- Département de Pneumologie, Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Gilles Pialoux
- Département de Maladies Infectieuses, Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Karine Lacombe
- Département de Maladies Infectieuses, Hôpital Saint Antoine, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Arsène Mekinian
- Département de Médecine Interne, Hôpital Saint Antoine, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Hélène Gros
- Service de Médecine Interne et Maladies Infectieuses, CHI Robert Ballanger, Aulnay sous Bois 93600, France
| | - Xavier Lescure
- Département de Maladies infectieuses, Hôpital Bichat, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Jade Ghosn
- Département de Maladies infectieuses, Hôpital Bichat, Assistance Publique Hôpitaux de Paris, and INSERM UMRS 1137 IAME, Université de Paris, Paris France
| | - Elisabeth Coupez
- Département de Réanimation, Hôpital Gabriel Montpied, CHU de Clermont Ferrand Université de Clermont Ferrand, France
| | - Kevin Grapin
- Département de Pneumologie, Hôpital Gabriel Montpied, CHU de Clermont Ferrand, Université de Clermont Ferrand, France
| | - Christophe Rapp
- Service de Médecine Interne, Hôpital Américain, Neuilly, France
| | - Marc Michel
- Département de Médecine interne, Hôpital Henri Mondor, Assistance Publique Hôpitaux de Paris, Université de Paris Est Créteil, Créteil France
| | | | - Jean Marie Michot
- Service d'hématologie, Institut Gustave Roussy, Université Paris Saclay, Villejuif, France
| | - Nathalie Costedoat-Chalumeau
- Département de Médecine Interne, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Liem Binh Luong Nguyen
- CIC Cochin Pasteur, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Luca Semerano
- Service de Rhumatologie, Hôpital Avicenne, Assistance Publique Hôpitaux de Paris, Université de Paris Nord Sorbonne, Bobigny, France
| | - François Raffi
- Department of Infectious Diseases, Hotel-Dieu Hospital and INSERM CIC 1413, Nantes University Hospital, Nantes, France
| | - Claire Aguillar
- Département de maladies Infectieuses, Hôpital Necker, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Claire Rouzaud
- Département de maladies Infectieuses, Hôpital Necker, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
- Département de maladies Infectieuses, Hôpital Saint Joseph, University of Paris, Paris France
| | - Jacques Eric Gottenberg
- Service de Rhumatologie, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Yves Hansmann
- Service de maladies infectieuses, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Boris Bienvenu
- Département de médecine Interne, Hôpital Saint Joseph, Marseille, France
| | - Jonathan London
- Service de Médecine interne, Hôpital des Diaconesse-Croix saint Simon, Paris, France
| | - Franklin Samou Fantchou
- Service de Maladies Infectieuses, Centre hospitalier du centre Hospitalier de l'ouest Guyanais, Saint Laurent du Maroni, France
| | | | - Antoine Gros
- Service de Réanimation Médico-chirurgicale, Hôpital André Mignot, Versailles, France
| | - Alexandre Morel
- Service d'Hématologie, Hôpital Privé d'Antony, Antony, France
| | - Nicolas Gambier
- Service de Maladies Infectieuses, Centre Hospitalier Saint Denis, Hôpital Delafontaine, Saint Denis, France
| | - Damien Sène
- Service de Médecine Interne, Hôpital de Lariboisière, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Bruno Mégarbane
- Réanimation Médicale et Toxicologique, Hôpital de Lariboisière, Assistance Publique Hôpitaux de Paris, Université de Paris, INSERM UMRS-1144, Paris France
| | - Elie Azoulay
- Département de Réanimation, Hôpital Saint Louis, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Serge Bureau
- Direction de la recherche clinique, Hôpital Saint Louis, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Maxime Dougados
- Département de Rhumatologie, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Joseph Emmerich
- Département de médecine vasculaire, Hôpital Saint Joseph, Université de Paris, Paris France
| | - Muriel Fartoukh
- Département de Réanimation, Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Bertrand Guidet
- Département de Réanimation, Hôpital Saint Antoine, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Marc Humbert
- Université Paris–Saclay, INSERM UMR_S999, Assistance Publique Hôpitaux de Paris, Service de Pneumologie et Soins Intensifs Respiratoires, Hôpital Bicêtre, Le Kremlin Bicêtre, France
| | - Mathieu Mahevas
- Département de Médecine interne, Hôpital Henri Mondor, Assistance Publique Hôpitaux de Paris, Université de Paris Est Créteil, Créteil France
| | - Frédéric Pène
- Service de Médecine Intensive et Réanimation, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris. Centre, Université de Paris, Paris France
| | - Frédéric Schlemmer
- Université de Paris Est Créteil, Assistance Publique-Hôpitaux de Paris, Unité de Pneumologie - Service de Médecine Intensive et Réanimation, Hôpitaux Universitaires Henri Mondor, Créteil France
| | - Valérie Pourcher-Martinez
- Département de Maladies Infectieuses, Hôpital de la Pitié Salpétrière, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Annick Tibi
- Agence Générale des Equipements et Produits de Santé, Assistance Publique des hôpitaux de Paris, Paris, France
| | - Gabriel Baron
- Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153), Inserm / Université Paris, Centre d'épidémiologie clinique, Hôpital Hôtel-Dieu, France
| | - Elodie Perrodeau
- Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153), Inserm / Université Paris, Centre d'épidémiologie clinique, Hôpital Hôtel-Dieu, France
| | - Stéphanie Baron
- Département de physiologie et explorations fonctionelles, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Gabriel Steg
- Département de cardiologie, Hôpital Bichat, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Yazdan Yazdapanah
- Département de Maladies infectieuses, Hôpital Bichat, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Tabassome Simon
- Service de pharmacologie clinique, centre de recherche clinique de Paris Est, Hôpital Saint Antoine, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Matthieu Resche-Rigon
- Service de biostatistique et information médicale, INSERM U153, Hôpital Saint Louis, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Pierre-Louis Tharaux
- INSERM U970 Paris Cardiovascular Centre (PARCC), Université de Paris, Paris, France
| | - Philippe Ravaud
- Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153), Inserm / Université Paris, Centre d'épidémiologie clinique, Hôpital Hôtel-Dieu, France
| |
Collapse
|
15
|
Galmiche S, Luong Nguyen LB, Tartour E, de Lamballerie X, Wittkop L, Loubet P, Launay O. Immunological and clinical efficacy of COVID-19 vaccines in immunocompromised populations: a systematic review. Clin Microbiol Infect 2022; 28:163-177. [PMID: 35020589 PMCID: PMC8595936 DOI: 10.1016/j.cmi.2021.09.036] [Citation(s) in RCA: 94] [Impact Index Per Article: 47.0] [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] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 01/13/2023]
Abstract
BACKGROUND Available data show that COVID-19 vaccines may be less effective in immunocompromised populations, who are at increased risk of severe COVID-19. OBJECTIVES We conducted a systematic review of literature to assess immunogenicity, efficacy and effectiveness of COVID-19 vaccines in immunocompromised populations. DATA SOURCES We searched Medline and Embase databases. STUDY ELIGIBILITY CRITERIA, PATIENTS, INTERVENTIONS We included studies of COVID-19 vaccines after complete vaccination in immunocompromised patients until 31 August 2021. Studies with <10 patients, safety data only and case series of breakthrough infections were excluded. METHODS Risk of bias was assessed via the tool developed by the National Institutes of Health on interventional and observational studies. Immunogenicity was assessed through non-response rate defined as no anti-SARS-CoV-2 spike protein antibodies, efficacy and effectiveness by the relative reduction in risk of SARS-CoV-2 infection or COVID-19. We collected factors associated with the risk of non-response. We presented collected data by immunosuppression type. RESULTS We screened 5917 results, included 162 studies. There were 157 on immunogenicity in 25 209 participants, including 7835 cancer or haematological malignancy patients (31.1%), 6302 patients on dialysis (25.0%), 5974 solid organ transplant recipients (23.7%) and 4680 immune-mediated disease patients (18.6%). Proportion of non-responders seemed higher among solid organ transplant recipients (range 18-100%) and patients with haematological malignancy (range 14-61%), and lower in patients with cancer (range 2-36%) and patients on dialysis (range 2-30%). Risk factors for non-response included older age, use of corticosteroids, immunosuppressive or anti-CD20 agent. Ten studies evaluated immunogenicity of an additional dose. Five studies evaluated vaccine efficacy or effectiveness: three on SARS-CoV-2 infection (range 71-81%), one on COVID-19-related hospitalization (62.9%), one had a too small sample size. CONCLUSIONS This systematic review highlights the risk of low immunogenicity of COVID-19 vaccines in immunocompromised populations, especially solid organ transplant recipients and patients with haematological malignancy. Despite lack of vaccine effectiveness data, enhanced vaccine regimens may be necessary.
Collapse
Affiliation(s)
- Simon Galmiche
- Assistance Publique - Hôpitaux de Paris (AP-HP), CIC Cochin Pasteur, Hôpital Cochin, Paris, France
| | - Liem Binh Luong Nguyen
- Assistance Publique - Hôpitaux de Paris (AP-HP), CIC Cochin Pasteur, Hôpital Cochin, Paris, France
| | - Eric Tartour
- AP-HP, Immunologie Biologique, Hôpital Européen Georges Pompidou, Paris, France
| | - Xavier de Lamballerie
- Aix Marseille Université, IRD 190, INSERM 1207, Unité des Virus Emergents, UVE, IHU Méditerranée Infection, Marseille, France
| | - Linda Wittkop
- Institut de Santé Publique d'Epidémiologie et de Développement, INSERM, Bordeaux Population Health Research Center, UMR 1219, Centre d'Investigation Clinique-Epidémiologie Clinique 1401, University of Bordeaux, Service d'Information Médicale, CHU de Bordeaux, Pôle de Santé Publique, Bordeaux, France
| | - Paul Loubet
- INSERM U1047, Department of Infectious and Tropical Diseases, CHU Nîmes, Université Montpellier, Nîmes, France
| | - Odile Launay
- Université de Paris, Faculté de Médecine Paris Descartes, AP-PH, Inserm, CIC Cochin Pasteur, Paris, France.
| |
Collapse
|
16
|
Launay O, Artaud C, Lachâtre M, Ait-Ahmed M, Klein J, Luong Nguyen LB, Durier C, Jansen B, Tomberger Y, Jolly N, Grossmann A, Tabbal H, Brunet J, Gransagne M, Choucha Z, Batalie D, Delgado A, Müllner M, Tschismarov R, Berghmans PJ, Martin A, Ramsauer K, Escriou N, Gerke C. Safety and immunogenicity of a measles-vectored SARS-CoV-2 vaccine candidate, V591 / TMV-083, in healthy adults: results of a randomized, placebo-controlled Phase I study. EBioMedicine 2022; 75:103810. [PMID: 35045362 PMCID: PMC8761070 DOI: 10.1016/j.ebiom.2021.103810] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [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: 08/02/2021] [Revised: 12/20/2021] [Accepted: 12/27/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND V591 (TMV-083) is a live recombinant measles vector-based vaccine candidate expressing a pre-fusion stabilized SARS-CoV-2 spike protein. METHODS We performed a randomized, placebo-controlled Phase I trial with an unblinded dose escalation and a double-blind treatment phase at 2 sites in France and Belgium to evaluate the safety and immunogenicity of V591. Ninety healthy SARS-CoV-2 sero-negative adults (18-55 years of age) were randomized into 3 cohorts, each comprising 24 vaccinees and 6 placebo recipients. Participants received two intramuscular injections of a low dose vaccine (1 × 105 median Tissue Culture Infectious Dose [TCID50]), one or two injections of a high dose vaccine (1 × 106 TCID50), or placebo with a 28 day interval. Safety was assessed by solicited and unsolicited adverse events. Immunogenicity was measured by SARS-CoV-2 spike protein-binding antibodies, neutralizing antibodies, spike-specific T cell responses, and anti-measles antibodies. ClinicalTrials.gov, NCT04497298. FINDINGS Between Aug 10 and Oct 13, 2020, 148 volunteers were screened of whom 90 were randomized. V591 showed a good safety profile at both dose levels. No serious adverse events were reported. At least one treatment-related adverse event was reported by 15 (20.8%) participants receiving V591 vs. 6 (33.3%) of participants receiving placebo. Eighty-one percent of participants receiving two injections of V591 developed spike-binding antibodies after the second injection. However, neutralizing antibodies were detectable on day 56 only in 17% of participants receiving the low dose and 61% receiving the high dose (2 injections). Spike-specific T cell responses were not detected. Pre-existing anti-measles immunity had a statistically significant impact on the immune response to V591, which was in contrast to previous results with the measles vector-based chikungunya vaccine. INTERPRETATION While V591 was generally well tolerated, the immunogenicity was not sufficient to support further development. FUNDING Themis Bioscience GmbH, a subsidiary of Merck & Co. Inc., Kenilworth, NJ, USA; Coalition for Epidemic Preparedness Innovations (CEPI).
Collapse
Affiliation(s)
- Odile Launay
- Université de Paris, CIC Cochin-Pasteur; APHP, Hôpital Cochin; INSERM CIC1417, Paris, France
| | - Cécile Artaud
- Institut Pasteur, Université de Paris, Centre de Recherche Translationnelle, Paris, France
| | - Marie Lachâtre
- Université de Paris, CIC Cochin-Pasteur; APHP, Hôpital Cochin; INSERM CIC1417, Paris, France
| | - Mohand Ait-Ahmed
- Institut Pasteur, Université de Paris, Centre de Recherche Translationnelle, Paris, France
| | - Jelle Klein
- SGS, Clinical Pharmacology Unit, Antwerpen, Belgium
| | - Liem Binh Luong Nguyen
- Université de Paris, CIC Cochin-Pasteur; APHP, Hôpital Cochin; INSERM CIC1417, Paris, France
| | | | | | - Yvonne Tomberger
- Themis Bioscience GmbH, Vienna, Austria, a subsidiary of Merck & Co. Inc., Kenilworth, NJ, United States
| | - Nathalie Jolly
- Institut Pasteur, Université de Paris, Centre de Recherche Translationnelle, Paris, France
| | - Anna Grossmann
- Themis Bioscience GmbH, Vienna, Austria, a subsidiary of Merck & Co. Inc., Kenilworth, NJ, United States
| | - Houda Tabbal
- Institut Pasteur, Université de Paris, CNRS UMR3569, Génétique Moléculaire des Virus à ARN, Paris, France
| | - Jérémy Brunet
- Institut Pasteur, Université de Paris, Département de Santé Globale, Paris, France
| | - Marion Gransagne
- Institut Pasteur, Université de Paris, Département de Santé Globale, Paris, France
| | - Zaineb Choucha
- Institut Pasteur, Université de Paris, Département de Santé Globale, Paris, France
| | - Damien Batalie
- Institut Pasteur, Université de Paris, CNRS UMR3569, Génétique Moléculaire des Virus à ARN, Paris, France
| | | | - Matthias Müllner
- Themis Bioscience GmbH, Vienna, Austria, a subsidiary of Merck & Co. Inc., Kenilworth, NJ, United States
| | - Roland Tschismarov
- Themis Bioscience GmbH, Vienna, Austria, a subsidiary of Merck & Co. Inc., Kenilworth, NJ, United States
| | | | - Annette Martin
- Institut Pasteur, Université de Paris, CNRS UMR3569, Génétique Moléculaire des Virus à ARN, Paris, France
| | - Katrin Ramsauer
- Themis Bioscience GmbH, Vienna, Austria, a subsidiary of Merck & Co. Inc., Kenilworth, NJ, United States
| | - Nicolas Escriou
- Institut Pasteur, Université de Paris, Département de Santé Globale, Paris, France.
| | - Christiane Gerke
- Institut Pasteur, Université de Paris, Innovation Office, Vaccine Programs, Paris, France.
| |
Collapse
|
17
|
Ghelfenstein-Ferreira T, Beaumont AL, Dellière S, Peiffer-Smadja N, Pineros N, Carbonnelle E, Greub G, Abbara S, Luong Nguyen LB, Lescat M. An Educational Game Evening for Medical Residents: A Proof of Concept to Evaluate the Impact on Learning of the Use of Games. J Microbiol Biol Educ 2021; 22:00119-21. [PMID: 34594443 PMCID: PMC8442010 DOI: 10.1128/jmbe.00119-21] [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] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 06/20/2021] [Indexed: 06/13/2023]
Abstract
Insufficient knowledge of bacteria and antimicrobials leads to the emergence of multidrug-resistant-bacterium infections. Diversification of the teaching forms, such as the use of games, could be a solution. We organized an event around 3 games (Bacteria Game, KROBS, and Dawaa) to collect student feedback on the evening and assess their knowledge before and after the evening using multiple-choice questions. The preliminary results suggest a positive effect of this event, but due to the low number of participants, we see this report more as a proof of concept to assess the impact of games on the learning.
Collapse
Affiliation(s)
- Théo Ghelfenstein-Ferreira
- Laboratoire de Microbiologie Clinique, Hôpitaux Universitaires de Paris Seine-Saint-Denis Assistance Publique–Hôpitaux de Paris (AP-HP), Bobigny, France
| | - Anne-Lise Beaumont
- Service de Maladies Infectieuses, Hôpital Saint Louis, AP-HP, Paris, France
| | - Sarah Dellière
- Laboratoire de Parasitologie-Mycologie, Hôpital Saint-Louis, AP-HP, Paris, France
- Université de Paris, Paris, France
| | - Nathan Peiffer-Smadja
- Service de Maladies Infectieuses et Tropicales, Hôpital Bichat-Claude-Bernard, AP-HP, Paris, France
- Université de Paris, Paris, France
- INSERM, IAME, Paris, France
| | | | - Etienne Carbonnelle
- Laboratoire de Microbiologie Clinique, Hôpitaux Universitaires de Paris Seine-Saint-Denis Assistance Publique–Hôpitaux de Paris (AP-HP), Bobigny, France
- Université de Paris, Paris, France
- INSERM, IAME, Paris, France
- Université Sorbonne Paris Nord, Epinay Villetaneuse, France
| | - Gilbert Greub
- Institut de Microbiologie, Département des Laboratoires, Université de Lausanne, CHUV, Lausanne, Switzerland
| | - Salam Abbara
- Institut Pasteur, U1018 Inserm, UVSQ, Paris, France
| | - Liem Binh Luong Nguyen
- Université de Paris, Paris, France
- INSERM, IAME, Paris, France
- Centre d’Investigation Clinique, Hôpital Cochin, AP-HP, Paris, France
| | - Mathilde Lescat
- Laboratoire de Microbiologie Clinique, Hôpitaux Universitaires de Paris Seine-Saint-Denis Assistance Publique–Hôpitaux de Paris (AP-HP), Bobigny, France
- Université de Paris, Paris, France
- INSERM, IAME, Paris, France
- Université Sorbonne Paris Nord, Epinay Villetaneuse, France
| |
Collapse
|
18
|
Tortonese S, Scriabine I, Anjou L, Loens C, Michon A, Benabdelhak M, Ouali S, Morin G, Laifi M, Dobosziewicz H, Guillet M, Dekeyser M, Luong Nguyen LB, Grünenwald A, Dang J, Desbuissons G, Becquemont L, Snanoudj R, Legendre C, Hebibi H, Lefèvre E, Beaudreuil S, Zaidan M. COVID-19 in Patients on Maintenance Dialysis in the Paris Region. Kidney Int Rep 2020; 5:1535-1544. [PMID: 32838082 PMCID: PMC7368159 DOI: 10.1016/j.ekir.2020.07.016] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [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] [Received: 05/21/2020] [Revised: 07/14/2020] [Accepted: 07/15/2020] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Coronavirus disease 2019 (COVID-19) represents a serious threat to patients on maintenance dialysis. The clinical setting, mortality rate, and prognostic factors in these patients have not been well established. METHODS We included all dialyzed patients with COVID-19 referred to our dialysis center between March 11 and April 11, 2020. Data were obtained through the review of the medical records and were censored at the time of data cutoff, on May 11, 2020. RESULTS Forty-four patients on maintenance dialysis with COVID-19 were referred to our dialysis unit during the COVID-19 epidemic. Median age was 61 years (interquartile range [IQR]: 51.5-72.5); 65.9% were men. Comorbidities included hypertension (97.7%), diabetes mellitus (50%), and chronic cardiac (38.6%) and respiratory (27.3%) diseases. Initial symptoms were fever (79.5%), shortness of breath (29.5%), cough (43.2%), and diarrhea (13.6%). Three profiles of severity were distinguished based on the World Health Organization (WHO) progression scale. Forty-one (93.2%) were hospitalized and only 3 were maintained on outpatient hemodialysis. Thirty-three (75%) patients required oxygen therapy, including 15 (45.5%) who were referred to the intensive care unit. Overall, 27.3% of patients died, and 58.5% were discharged from hospital, including only 2 (13.3%) of those admitted to the intensive care unit. By multivariate analysis, cough, thrombopenia <120 g/l, lactate dehydrogenase (LDH) level greater than 2 times the upper limit of normal, and blood C-reactive protein (CRP) >175 mg/l were significantly associated with death. CONCLUSION A major outbreak of COVID-19 occurred in the Paris region, and spread among dialyzed patients. Our study underscores the severity of COVID-19 in these patients and identified prognostic markers.
Collapse
Affiliation(s)
- Sarah Tortonese
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
| | - Ivan Scriabine
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
| | - Louis Anjou
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
| | - Christopher Loens
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
| | - Arthur Michon
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
| | - Mohammed Benabdelhak
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
| | - Sarah Ouali
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
| | - Gabriel Morin
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
| | - Marwa Laifi
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
| | - Hélène Dobosziewicz
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
- Université Paris Saclay, Université Paris-Sud, UVSQ, Villejuif, France
| | - Matthieu Guillet
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
- Université Paris Saclay, Université Paris-Sud, UVSQ, Villejuif, France
| | - Manon Dekeyser
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
- Université Paris Saclay, Université Paris-Sud, UVSQ, Villejuif, France
| | - Liem Binh Luong Nguyen
- Unité d’épidémiologie des Maladies Emergentes, Institut Pasteur, Paris, France
- Centre d’Investigation Clinique (CIC) Cochin Pasteur, Université de Paris, Hôpital Cochin, Paris, France
| | - Anne Grünenwald
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
| | - Julien Dang
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
| | - Geoffroy Desbuissons
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
| | - Laurent Becquemont
- Université Paris Saclay, Université Paris-Sud, UVSQ, Villejuif, France
- Centre de recherche en Epidémiologie et Santé des Populations (CESP), INSERM, Villejuif, France
| | - Renaud Snanoudj
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
- Université Paris Saclay, Université Paris-Sud, UVSQ, Villejuif, France
| | - Christophe Legendre
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
| | - Hadia Hebibi
- Service de Néphrologie-Dialyse, Nephrocare, Villejuif, France
- Service de Néphrologie-Dialyse, Hôpital de Thiais, Thiais, France
| | - Edouard Lefèvre
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
| | - Séverine Beaudreuil
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
| | - Mohamad Zaidan
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
- Université Paris Saclay, Université Paris-Sud, UVSQ, Villejuif, France
- Institut national de la santé et de la recherche médicale U1163, Institut des Maladies Génétiques, Hôpital Necker-Enfants malades, Paris, France
| | - AP-HP/Universities/Inserm COVID-19 research collaboration
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
- Université Paris Saclay, Université Paris-Sud, UVSQ, Villejuif, France
- Unité d’épidémiologie des Maladies Emergentes, Institut Pasteur, Paris, France
- Centre d’Investigation Clinique (CIC) Cochin Pasteur, Université de Paris, Hôpital Cochin, Paris, France
- Centre de recherche en Epidémiologie et Santé des Populations (CESP), INSERM, Villejuif, France
- Service de Néphrologie-Dialyse, Nephrocare, Villejuif, France
- Service de Néphrologie-Dialyse, Hôpital de Thiais, Thiais, France
- Institut national de la santé et de la recherche médicale U1163, Institut des Maladies Génétiques, Hôpital Necker-Enfants malades, Paris, France
| |
Collapse
|
19
|
Richterman A, Steer-Massaro J, Jarolimova J, Luong Nguyen LB, Werdenberg J, Ivers LC. Cash interventions to improve clinical outcomes for pulmonary tuberculosis: systematic review and meta-analysis. Bull World Health Organ 2018; 96:471-483. [PMID: 29962550 PMCID: PMC6022611 DOI: 10.2471/blt.18.208959] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 04/26/2018] [Accepted: 04/30/2018] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To assess cash transfer interventions for improving treatment outcomes of active pulmonary tuberculosis in low- and middle-income countries. METHODS We searched PubMed®, Embase®, Cochrane Library and ClinicalTrials.gov for studies published until 4 August 2017 that reported on cash transfer interventions during the treatment of active pulmonary tuberculosis in low- and middle-income countries. Our primary outcome was a positive clinical outcome, defined as treatment success, treatment completion or microbiologic cure. Using the purchasing power parity conversion factor, we converted the amount of cash received per patient within each study into international dollars (Int$). We calculated odds ratio (OR) for the primary outcome using a random effects meta-analysis. FINDINGS Eight studies met eligibility criteria for review inclusion. Seven studies assessed a tuberculosis-specific intervention, with average amount of cash ranging from Int$ 193-858. One study assessed a tuberculosis-sensitive intervention, with average amount of Int$ 101. Four studies included non-cash co-interventions. All studies showed better primary outcome for the intervention group than the control group. After excluding three studies with high risk of bias, patients receiving tuberculosis-specific cash transfer were more likely to have a positive clinical outcome than patients in the control groups (OR: 1.77; 95% confidence interval: 1.57-2.01). CONCLUSION The evidence available suggests that patients in low- and middle-income countries receiving cash during treatment for active pulmonary tuberculosis are more likely to have a positive clinical outcome. These findings support the incorporation of cash transfer interventions into social protection schemes within tuberculosis treatment programmes.
Collapse
Affiliation(s)
- Aaron Richterman
- Department of Medicine, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, United States of America (USA)
| | - Jonathan Steer-Massaro
- Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston, USA
| | - Jana Jarolimova
- Department of Medicine, Massachusetts General Hospital, Boston, USA
| | - Liem Binh Luong Nguyen
- Infection, Antimicrobials, Modelling and Evolution, Unité Mixte de Recherche 1137, INSERM, Paris, France
| | | | - Louise C Ivers
- Center for Global Health, Massachusetts General Hospital, Boston, USA
| |
Collapse
|
20
|
Vonaesch P, Tondeur L, Breurec S, Bata P, Nguyen LBL, Frank T, Farra A, Rafaï C, Giles-Vernick T, Gody JC, Gouandjika-Vasilache I, Sansonetti P, Vray M. Factors associated with stunting in healthy children aged 5 years and less living in Bangui (RCA). PLoS One 2017; 12:e0182363. [PMID: 28796794 PMCID: PMC5552116 DOI: 10.1371/journal.pone.0182363] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [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: 01/26/2017] [Accepted: 07/17/2017] [Indexed: 12/31/2022] Open
Abstract
Stunting remains a major public health concern worldwide. Although its global prevalence is slowly decreasing, the actual number of affected children is still rising in Sub-Saharan Africa. In the Central African Republic (CAR), about one third of all children below the age of five are stunted. Stunting is correlated with many long-term consequences, including poor cognitive development and a higher rate of morbidity and mortality, making stunting a major contributor to poverty. In CAR, little is known about the factors that contribute to stunting. This study aimed at analysing, in a cross-sectional study, the main factors associated with stunting in a group of 414 children recruited between December 2011 and November 2013, aged five years or less and living in Bangui. For all children, demographic, socio-economic and anthropometric data were recorded and asymptomatic enteropathogen carriage was assessed in stool samples using classical microbiological assays. The study group had a mean age of 14.2±10 months. Fifty-eight percent (292/414) were boys, and 36 percent (148/414) exhibited stunted growth. Of the stunted children, 51% (75/148) showed a moderate delay in linear growth for their age group [height-for-age z-score (HAZ) between -2 and -3 SD] while 49% (73/148) presented a severe delay (HAZ < -3). Factors significantly associated with stunting included gender (aOR: 1.67; 95% CI: 1.07; 2.62 for boys compared to girls) and age (aOR of 3.98 (95% CI: 2.45; 6.46) for toddlers and aOR 4.42 (95% CI: 2.36; 8.28) for children compared to infants). Most importantly, we identified being overweight [weight-for-height z-score (WHZ) > 2 SD; aOR: 3.21; 95% CI: 1.50; 6.90 of overweight compared to normal weight] as also being significantly associated with stunting. This is the first study showing that even in the poorest countries of the world there is an association of stunting with being overweight.
Collapse
Affiliation(s)
- Pascale Vonaesch
- Unité de Pathogénie Microbienne Moléculaire, Institut Pasteur, Paris, France
- Unité d'épidémiologie et d'expertise des maladies émergentes, Institut Pasteur, Paris, France
| | - Laura Tondeur
- Unité d'épidémiologie et d'expertise des maladies émergentes, Institut Pasteur, Paris, France
| | - Sébastien Breurec
- Laboratoire de Microbiologie Clinique et Environnementale, Centre Hospitalo-Universitaire, Pointe-à-Pitre/Les Abymes, Guadeloupe, France
- Laboratoire de Bactériologie médicale, Institut Pasteur de Bangui, Bangui, République Centrafricaine
- Université des Antilles, Faculté de Médecine, Pointe-aà-Pitre, Guadeloupe, France
| | - Petula Bata
- Complexe Pédiatrique de Bangui, Bangui, République Centrafricaine
| | - Liem Binh Luong Nguyen
- Laboratoire de Bactériologie médicale, Institut Pasteur de Bangui, Bangui, République Centrafricaine
| | - Thierry Frank
- Laboratoire de Bactériologie médicale, Institut Pasteur de Bangui, Bangui, République Centrafricaine
| | - Alain Farra
- Laboratoire de Bactériologie médicale, Institut Pasteur de Bangui, Bangui, République Centrafricaine
| | - Clotaire Rafaï
- Laboratoire de Bactériologie médicale, Institut Pasteur de Bangui, Bangui, République Centrafricaine
| | - Tamara Giles-Vernick
- Unité d'épidémiologie et d'expertise des maladies émergentes, Institut Pasteur, Paris, France
| | | | | | - Philippe Sansonetti
- Unité de Pathogénie Microbienne Moléculaire, Institut Pasteur, Paris, France
| | - Muriel Vray
- Unité d'épidémiologie et d'expertise des maladies émergentes, Institut Pasteur, Paris, France
- Unité d’épidémiologie des maladies infectieuses, Institut Pasteur de Dakar, Dakar, Sénégal
- * E-mail:
| |
Collapse
|
21
|
Voiriot G, Visseaux B, Cohen J, Nguyen LBL, Neuville M, Morbieu C, Burdet C, Radjou A, Lescure FX, Smonig R, Armand-Lefèvre L, Mourvillier B, Yazdanpanah Y, Soubirou JF, Ruckly S, Houhou-Fidouh N, Timsit JF. Viral-bacterial coinfection affects the presentation and alters the prognosis of severe community-acquired pneumonia. Crit Care 2016; 20:375. [PMID: 27852281 PMCID: PMC5112669 DOI: 10.1186/s13054-016-1517-9] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 09/29/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND Multiplex polymerase chain reaction (mPCR) enables recovery of viruses from airways of patients with community-acquired pneumonia (CAP), although their clinical impact remains uncertain. METHODS Among consecutive adult patients who had undergone a mPCR within 72 hours following their admission to one intensive care unit (ICU), we retrospectively included those with a final diagnosis of CAP. Four etiology groups were clustered: bacterial, viral, mixed (viral-bacterial) and no etiology. A composite criterion of complicated course (hospital death or mechanical ventilation > 7 days) was used. A subgroup analysis compared patients with bacterial and viral-bacterial CAP matched on the bacterial pathogens. RESULTS Among 174 patients (132 men [76 %], age 63 [53-75] years, SAPSII 38 [27;55], median PSI score 106 [78;130]), bacterial, viral, mixed and no etiology groups gathered 46 (26 %), 53 (31 %), 45 (26 %) and 30 (17 %) patients, respectively. Virus-infected patients displayed a high creatine kinase serum level, a low platelet count, and a trend toward more frequent alveolar-interstitial infiltrates. A complicated course was more frequent in the mixed group (31/45, 69 %), as compared to bacterial (18/46, 39 %), viral (15/53, 28 %) and no etiology (12/30, 40 %) groups (p < 0.01). In multivariate analysis, the mixed (viral-bacterial) infection was independently associated with complicated course (reference: bacterial pneumonia; OR, 3.58; CI 95 %, 1.16-11; p = 0.03). The subgroup analysis of bacteria-matched patients confirmed these findings. CONCLUSIONS Viral-bacterial coinfection during severe CAP in adults is associated with an impaired presentation and a complicated course.
Collapse
Affiliation(s)
- Guillaume Voiriot
- Service de Réanimation Médicale et Infectieuse, Hôpital Bichat Claude Bernard, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France. .,Hôpital Bichat Claude Bernard, 46 rue Henri Huchard, Paris, 75018, France.
| | - Benoit Visseaux
- Service de Virologie, Hôpital Bichat Claude Bernard, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Johana Cohen
- Service de Réanimation Médicale et Infectieuse, Hôpital Bichat Claude Bernard, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Liem Binh Luong Nguyen
- Service de Maladies Infectieuses et Tropicales, Hôpital Bichat Claude Bernard, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Mathilde Neuville
- Service de Réanimation Médicale et Infectieuse, Hôpital Bichat Claude Bernard, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Caroline Morbieu
- Service de Maladies Infectieuses et Tropicales, Hôpital Bichat Claude Bernard, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Charles Burdet
- Service de Maladies Infectieuses et Tropicales, Hôpital Bichat Claude Bernard, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Aguila Radjou
- Service de Réanimation Médicale et Infectieuse, Hôpital Bichat Claude Bernard, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - François-Xavier Lescure
- Service de Maladies Infectieuses et Tropicales, Hôpital Bichat Claude Bernard, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Roland Smonig
- Service de Réanimation Médicale et Infectieuse, Hôpital Bichat Claude Bernard, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Laurence Armand-Lefèvre
- Service de Microbiologie, Hôpital Bichat Claude Bernard, Hôpital Bichat Claude Bernard, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Bruno Mourvillier
- Service de Réanimation Médicale et Infectieuse, Hôpital Bichat Claude Bernard, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Yazdan Yazdanpanah
- Service de Maladies Infectieuses et Tropicales, Hôpital Bichat Claude Bernard, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France.,Université Paris Diderot-Paris VII, Paris, France
| | - Jean-Francois Soubirou
- Service de Réanimation Médicale et Infectieuse, Hôpital Bichat Claude Bernard, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Stephane Ruckly
- Université de Grenoble 1, Center U823 Epidemioloy of Cancers and Severe Diseases, La Tronche, France
| | - Nadhira Houhou-Fidouh
- Service de Virologie, Hôpital Bichat Claude Bernard, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Jean-François Timsit
- Service de Réanimation Médicale et Infectieuse, Hôpital Bichat Claude Bernard, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France.,Université Paris Diderot-Paris VII, Paris, France
| |
Collapse
|
22
|
Birgand G, Leroy C, Nerome S, Luong Nguyen LB, Lolom I, Armand-Lefevre L, Ciotti C, Lecorre B, Marcade G, Fihman V, Nicolas-Chanoine MH, Pelat C, Perozziello A, Fantin B, Yazdanpanah Y, Ricard JD, Lucet JC. Costs associated with implementation of a strict policy for controlling spread of highly resistant microorganisms in France. BMJ Open 2016; 6:e009029. [PMID: 26826145 PMCID: PMC4735214 DOI: 10.1136/bmjopen-2015-009029] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [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: 01/05/2023] Open
Abstract
OBJECTIVE To assess costs associated with implementation of a strict 'search and isolate' strategy for controlling highly drug-resistant organisms (HDRO). DESIGN Review of data from 2-year prospective surveillance (01/2012 to 12/2013) of HDRO. SETTING Three university hospitals located in northern Paris. METHODS Episodes were defined as single cases or outbreaks of glycopeptide-resistant enterococci (GRE) or carbapenemase-producing Enterobacteriacae (CPE) colonisation. Costs were related to staff reinforcement, costs of screening cultures, contact precautions and interruption of new admissions. Univariate analysis, along with simple and multiple linear regression analyses, was conducted to determine variables associated with cost of HDRO management. RESULTS Overall, 41 consecutive episodes were included, 28 single cases and 13 outbreaks. The cost (mean ± SD) associated with management of a single case identified within and/or 48 h after admission was €4443 ± 11,552 and €11,445 ± 15,743, respectively (p<0.01). In an outbreak, the total cost varied from €14,864 ± 17,734 for an episode with one secondary case (€7432 ± 8867 per case) to €136,525 ± 151,231 (€12,845 ± 5129 per case) when more than one secondary case occurred. In episodes of single cases, contact precautions and microbiological analyses represented 51% and 30% of overall cost, respectively. In outbreaks, cost related to interruption of new admissions represented 77-94% of total costs, and had the greatest financial impact (R(2)=0.98, p<0.01). CONCLUSIONS In HDRO episodes occurring at three university hospitals, interruption of new admissions constituted the most costly measure in an outbreak situation.
Collapse
Affiliation(s)
- Gabriel Birgand
- INSERM, IAME, UMR 1137, Paris, France
- Univ Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité, Paris, France
- Infection Control Unit, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
| | - Christophe Leroy
- Emergency Department, AP-HP, Hôpital Louis Mourier, Colombes, France
| | - Simone Nerome
- Infection Control Unit, AP-HP, Hôpital Beaujon, Clichy, France
| | | | - Isabelle Lolom
- Infection Control Unit, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
| | | | - Céline Ciotti
- Infection Control Unit, AP-HP, Hôpital Beaujon, Clichy, France
| | - Bertrand Lecorre
- Internal Medicine Department, AP-HP, Hôpital Beaujon, Clichy, France
| | - Géraldine Marcade
- Infection Control Unit, AP-HP, Hôpital Louis Mourier, Colombes, France
| | - Vincent Fihman
- Infection Control Unit, AP-HP, Hôpital Louis Mourier, Colombes, France
| | | | - Camille Pelat
- INSERM, IAME, UMR 1137, Paris, France
- Univ Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité, Paris, France
| | - Anne Perozziello
- AP-HP, Hôpital Bichat-Claude Bernard, Medical Information Systems Program (PMSI), Paris, France
| | - Bruno Fantin
- Internal Medicine Department, AP-HP, Hôpital Beaujon, Clichy, France
| | - Yazdan Yazdanpanah
- INSERM, IAME, UMR 1137, Paris, France
- Univ Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité, Paris, France
- Infectious Diseases Department, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
| | - Jean-Damien Ricard
- INSERM, IAME, UMR 1137, Paris, France
- Univ Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité, Paris, France
- Intensive Care Unit, AP-HP, Hôpital Louis Mourier, Colombes, France
| | - Jean-Christophe Lucet
- INSERM, IAME, UMR 1137, Paris, France
- Univ Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité, Paris, France
- Infection Control Unit, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
| |
Collapse
|
23
|
Nguyen LBL, Epelboin L, Gabarre J, Lecso M, Guillot S, Bricaire F, Caumes E, Guiso N. Recurrent Bordetella holmesii bacteremia and nasal carriage in a patient receiving rituximab. Emerg Infect Dis 2014; 19:1703-5. [PMID: 24050722 PMCID: PMC3810743 DOI: 10.3201/eid1910.130345] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
24
|
Frank T, Gody JC, Nguyen LBL, Berthet N, Le Fleche-Mateos A, Bata P, Rafaï C, Kazanji M, Breurec S. First case of Elizabethkingia anophelis meningitis in the Central African Republic. Lancet 2013; 381:1876. [PMID: 23706804 DOI: 10.1016/s0140-6736(13)60318-9] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Thierry Frank
- Institut Pasteur de Bangui, Unit of Medical Biology, Bangui, Central African Republic
| | | | | | | | | | | | | | | | | |
Collapse
|