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Seang S, Itani O, Monsel G, Abdi B, Marcelin AG, Valantin MA, Palich R, Fayçal A, Pourcher V, Katlama C, Tubiana R. Long COVID-19 symptoms: clinical characteristics and recovery rate among non-severe outpatients over a six-month follow-up. Infect Dis Now 2022; 52:165-169. [PMID: 35158095 PMCID: PMC8832844 DOI: 10.1016/j.idnow.2022.02.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 05/07/2021] [Revised: 11/08/2021] [Accepted: 02/08/2022] [Indexed: 01/08/2023]
Abstract
Background To describe persistent symptoms in long COVID-19 non-severe outpatients and report the 6-month clinical recovery (CR) rate. Methods Observational study enrolling outpatients (≥ 18 years) with confirmed non-severe COVID-19 (positive nasopharyngeal RT-PCR or presence of SARS-CoV-2 antibodies) who consulted for persistent symptoms after the first pandemic wave (March-May 2020). CR was assessed at the 6-month visit and defined as complete (no symptom), partial (persistent symptoms of lower intensity) or lack of recovery (no improvement). Results Sixty-three patients (79% women, mean age: 48 years) enrolled; main symptoms (mean 81 days after acute infection): asthenia/myalgia (77%), dyspnea (51%), headaches (35%), cough (33%). At 6 months (n = 56), 30% had complete, 57% partial, and 13% lack of recovery. The proportion of patients with > 2 persistent symptoms was 26% at 6 months (main symptoms: dyspnea [54%] and asthenia/myalgia [46%]). Conclusion We observed a slow but high recovery rate at 6 months among these outpatients.
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Affiliation(s)
- S Seang
- Sorbonne University, Infectious Diseases department, Pitié-Salpêtrière hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute (iPLESP), INSERM 1136, Paris, France.
| | - O Itani
- AP-HP, Infectious Diseases department, Pitié-Salpêtrière hospital, Paris, France
| | - G Monsel
- AP-HP, Infectious Diseases department, Pitié-Salpêtrière hospital, Paris, France
| | - B Abdi
- Sorbonne University, Virology department, Pitié-Salpêtrière hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute (iPLESP), INSERM 1136, Paris, France
| | - A-G Marcelin
- Sorbonne University, Virology department, Pitié-Salpêtrière hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute (iPLESP), INSERM 1136, Paris, France
| | - M-A Valantin
- Sorbonne University, Infectious Diseases department, Pitié-Salpêtrière hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute (iPLESP), INSERM 1136, Paris, France
| | - R Palich
- Sorbonne University, Infectious Diseases department, Pitié-Salpêtrière hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute (iPLESP), INSERM 1136, Paris, France
| | - A Fayçal
- Sorbonne University, Infectious Diseases department, Pitié-Salpêtrière hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute (iPLESP), INSERM 1136, Paris, France
| | - V Pourcher
- Sorbonne University, Infectious Diseases department, Pitié-Salpêtrière hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute (iPLESP), INSERM 1136, Paris, France
| | - C Katlama
- Sorbonne University, Infectious Diseases department, Pitié-Salpêtrière hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute (iPLESP), INSERM 1136, Paris, France
| | - R Tubiana
- Sorbonne University, Infectious Diseases department, Pitié-Salpêtrière hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute (iPLESP), INSERM 1136, Paris, France
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Palich R, Veyri M, Vozy A, Marot S, Gligorov J, Benderra MA, Maingon P, Morand-Joubert L, Adjoutah Z, Marcelin AG, Spano JP, Barrière J. High seroconversion rate but low antibody titers after two injections of BNT162b2 (Pfizer-BioNTech) vaccine in patients treated with chemotherapy for solid cancers. Ann Oncol 2021; 32:1294-1295. [PMID: 34171494 PMCID: PMC8217700 DOI: 10.1016/j.annonc.2021.06.018] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 06/13/2021] [Indexed: 11/09/2022] Open
Affiliation(s)
- R Palich
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié Salpêtrière Hospital, Departments of Medical Oncology and Infectious Diseases, Paris, France.
| | - M Veyri
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié Salpêtrière Hospital, Department of Medical Oncology, Institut Universitaire de Cancérologie (IUC), CLIP(2) Galilée, Paris, France
| | - A Vozy
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié Salpêtrière Hospital, Department of Medical Oncology, Institut Universitaire de Cancérologie (IUC), CLIP(2) Galilée, Paris, France
| | - S Marot
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié Salpêtrière Hospital, Department of Virology, Paris, France
| | - J Gligorov
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Tenon Hospital, Department of Medical Oncology, Inserm U938, Institut Universitaire de Cancérologie (IUC), CLIP(2) Galilée, Paris, France
| | - M-A Benderra
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Tenon Hospital, Department of Medical Oncology, Inserm U938, Institut Universitaire de Cancérologie (IUC), CLIP(2) Galilée, Paris, France
| | - P Maingon
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié Salpêtrière Hospital, Department of Oncology Radiotherapy, Institut Universitaire de Cancérologie (IUC), CLIP(2) Galilée, Paris, France
| | - L Morand-Joubert
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Assistance Publique-Hôpitaux de Paris (AP-HP), Saint Antoine Hospital, Department of Virology, Paris, France
| | - Z Adjoutah
- Department of Biology, Cerballiance, Cagnes-sur-Mer, France
| | - A-G Marcelin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié Salpêtrière Hospital, Department of Virology, Paris, France
| | - J-P Spano
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié Salpêtrière Hospital, Department of Medical Oncology, Institut Universitaire de Cancérologie (IUC), CLIP(2) Galilée, Paris, France
| | - J Barrière
- Department of Medical Oncology, Polyclinique Saint Jean, Cagnes-sur-Mer, France
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Palich R, Wirden M, Peytavin G, Lê MP, Seang S, Abdi B, Schneider L, Tubiana R, Valantin MA, Paccoud O, Soulié C, Calvez V, Katlama C, Marcelin AG. Persistent low-level viraemia in antiretroviral treatment-experienced patients is not linked to viral resistance or inadequate drug concentrations. J Antimicrob Chemother 2021; 75:2981-2985. [PMID: 32642769 DOI: 10.1093/jac/dkaa273] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 05/15/2020] [Accepted: 05/24/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To assess genotypic sensitivity scores (GSSs), plasma antiretroviral concentrations (PACs) and immunovirological outcomes at Week 96 (W96) in patients with persistent low-level viraemia (LLV). METHODS On 1 January 2017, we analysed data from patients on three-drug regimens with persistent LLV defined as at least two consecutive plasma viral loads (pVLs) between 21 and 200 copies/mL (including one pVL of ≥50 copies/mL), at the Pitié-Salpêtrière Hospital. Outcomes were: GSS, PACs and HIV-DNA load at study entry; and virological status and proportion of patients with resistance-associated mutations (RAMs) at W96. RESULTS Fifty-seven patients were included, with median age of 52.6 years (IQR 45.2-57.9), last CD4 count of 658 cells/mm3 (IQR 462-909) and total ART duration of 10.2 years (IQR 5.7-15.2). LLV duration was 14.0 months (IQR 5.5-22.3). GSS was 3 in 46/57 (81%) patients and PACs were adequate in 53/57 (93%) patients. Median total HIV-DNA was 2.65 log10 copies/106 cells (IQR 2.44-2.86). During follow-up, 26/57 (46%) had experienced ART modifications. At W96, 38/57 (67%) patients remained with LLV, 15/60 (26%) had achieved confirmed pVL of <20 copies/mL and 4/57 (7%) had virological failure. The four virological failures were due to three ART interruptions and one incomplete adherence (selection of Y181C RAM). No factors (patient characteristics at study entry, GSS, PACs, total HIV-DNA load and ART modification) were associated with W96 viral outcome, except for time from HIV diagnosis and the LLV duration at study entry. CONCLUSIONS A substantial number of patients harbouring LLV had no resistance to ART and adequate PACs. Two-thirds of these patients remained with this LLV status.
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Affiliation(s)
- R Palich
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - M Wirden
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Virology, F-75013 Paris, France
| | - G Peytavin
- Bichat University Hospital, AP-HP, Pharmacology and Toxicology Department, IAME, INSERM 1137, Paris, France
| | - M-P Lê
- Bichat University Hospital, AP-HP, Pharmacology and Toxicology Department, IAME, INSERM 1137, Paris, France
| | - S Seang
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - B Abdi
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Virology, F-75013 Paris, France
| | - L Schneider
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - R Tubiana
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - M-A Valantin
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - O Paccoud
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - C Soulié
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Virology, F-75013 Paris, France
| | - V Calvez
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Virology, F-75013 Paris, France
| | - C Katlama
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - A-G Marcelin
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Virology, F-75013 Paris, France
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Tebano G, Soulié C, Schneider L, Blanc C, Agher R, Seang S, Valantin MA, Palich R, Tubiana R, Peytavin G, Marcelin AG, Assoumou L, Katlama C. Long-term follow-up of HIV-infected patients on dolutegravir monotherapy. J Antimicrob Chemother 2021; 75:675-680. [PMID: 31800056 DOI: 10.1093/jac/dkz478] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 10/06/2019] [Accepted: 10/21/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In recent years, dolutegravir monotherapy has been explored as a drug-reduced regimen for HIV patients. METHODS This was a retrospective observational study, including patients virologically suppressed for ≥6 months, without previous virological failure (VF) under integrase inhibitors (INIs), who had been switched to dolutegravir monotherapy (50 mg/day). The primary aim was to report the proportion of VF at week 48 (W48) and week 96 (W96) of dolutegravir monotherapy. The evolution from baseline to W48 of residual viraemia on ultra-deep sequencing and HIV DNA was also evaluated. RESULTS Sixty-one patients were included. Prior to switching to dolutegravir monotherapy, they had a median (IQR) of 15.4 (6.5-19.9) years of antiretroviral exposure, 5.8 (3.2-10.3) years of viral suppression and 687 (461-848) CD4+ cells/mm3. They remained on dolutegravir monotherapy for a median (IQR) of 100 (29-148) weeks. Forty-two out of 61 patients (68.9%) reached W48 and 32 out of 61 patients (52.5%) reached W96. VF occurred in three patients, with the emergence of INI resistance. VF occurred before W24 and in patients pre-exposed to INIs. At W48, the probability of VF (Kaplan-Meier analysis) was 5.6% (95% CI = 1.8%-16.4%). The same result was obtained at W96. Detectable residual viraemia did not increase and median HIV DNA did not change significantly (2.4 log/106 cells at baseline and 2.3 log/106 cells at W48). Dolutegravir plasma concentration was above the IC90 in 41/41 samples, from 22 patients. CONCLUSIONS Long-term follow-up showed a low risk of VF under dolutegravir monotherapy, in a selected population of patients with previous long-term virological suppression and low HIV reservoir.
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Affiliation(s)
- G Tebano
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP); AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - C Soulié
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP); AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Laboratoire de Virologie, F75013 Paris, France
| | - L Schneider
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP); AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - C Blanc
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP); AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - R Agher
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP); AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - S Seang
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP); AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - M A Valantin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP); AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - R Palich
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP); AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - R Tubiana
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP); AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - G Peytavin
- AP-HP, Hôpital Bichat-Claude Bernard, Laboratoire de Pharmacologie-Toxicologie; IAME, UMR 1137, Université Paris Diderot, Sorbonne Paris Cité and INSERM, Paris, France
| | - A G Marcelin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP); AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Laboratoire de Virologie, F75013 Paris, France
| | - L Assoumou
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), F-75013 Paris, France
| | - C Katlama
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP); AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
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Palich R, Veyri M, Marot S, Vozy A, Gligorov J, Maingon P, Marcelin AG, Spano JP. Weak immunogenicity after a single dose of SARS-CoV-2 mRNA vaccine in treated cancer patients. Ann Oncol 2021; 32:1051-1053. [PMID: 33932501 PMCID: PMC8081573 DOI: 10.1016/j.annonc.2021.04.020] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 04/25/2021] [Indexed: 01/13/2023] Open
Affiliation(s)
- R Palich
- Sorbonne Université, INSERM, Pierre Louis Institute of Epidemiology and Public Health (iPLESP), Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Medical Oncology, Pitié Salpêtrière Hospital, Paris, France; Sorbonne Université, INSERM, Pierre Louis Institute of Epidemiology and Public Health (iPLESP), Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Infectious Diseases, Pitié Salpêtrière Hospital, Paris, France.
| | - M Veyri
- Sorbonne Université, INSERM, Pierre Louis Institute of Epidemiology and Public Health (iPLESP), Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié Salpêtrière Hospital, Department of Medical Oncology, Institut Universitaire de Cancérologie (IUC), CLIP(2) Galilée, Paris, France
| | - S Marot
- Sorbonne Université, INSERM, Pierre Louis Institute of Epidemiology and Public Health (iPLESP), Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Virology, Pitié Salpêtrière Hospital, Paris, France
| | - A Vozy
- Sorbonne Université, INSERM, Pierre Louis Institute of Epidemiology and Public Health (iPLESP), Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié Salpêtrière Hospital, Department of Medical Oncology, Institut Universitaire de Cancérologie (IUC), CLIP(2) Galilée, Paris, France
| | - J Gligorov
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Medical Oncology, Tenon Hospital, Institut Universitaire de Cancérologie (IUC), CLIP(2) Galilée, Paris, France
| | - P Maingon
- Sorbonne Université, INSERM, Pierre Louis Institute of Epidemiology and Public Health (iPLESP), Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié Salpêtrière Hospital, Department of Oncology Radiotherapy, Institut Universitaire de Cancérologie (IUC), CLIP(2) Galilée, Paris, France
| | - A-G Marcelin
- Sorbonne Université, INSERM, Pierre Louis Institute of Epidemiology and Public Health (iPLESP), Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Virology, Pitié Salpêtrière Hospital, Paris, France
| | - J-P Spano
- Sorbonne Université, INSERM, Pierre Louis Institute of Epidemiology and Public Health (iPLESP), Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié Salpêtrière Hospital, Department of Medical Oncology, Institut Universitaire de Cancérologie (IUC), CLIP(2) Galilée, Paris, France
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Cousyn L, Sellem B, Palich R, Bendetowicz D, Agher R, Delorme C, Tubiana R, Valantin MA, Seang S, Schneider L, Fayçal A, Dudoit Y, Abdi B, Ndoadoumgue A, Assoumou L, Katlama C. Olfactory and gustatory dysfunctions in COVID-19 outpatients: A prospective cohort study. Infect Dis Now 2021; 51:440-444. [PMID: 33766735 PMCID: PMC7983360 DOI: 10.1016/j.idnow.2021.03.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 03/04/2021] [Accepted: 03/15/2021] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To describe the characteristics, evolution and risk factors for long-term persistence of olfactory and gustatory dysfunctions (OGD) in COVID-19 outpatients. PATIENTS AND METHODS We conducted a prospective study in SARS-CoV-2 infected outpatients with OGD. Weekly phone interviews were set up starting from COVID-19 onset symptoms and over the course of 60 days, using standardized questionnaires that included a detailed description of general symptoms and OGD. The primary outcome was the proportion of patients with complete recovery of OGD at D30. Rate and time to recovery of OGD, as well as risk factors for late recovery (>30 days), were evaluated using Cox regression models. RESULTS Ninety-eight outpatients were included. The median time to onset of OGD after first COVID-19 symptoms was 2 days (IQR 0-4). The 30-day recovery rate from OGD was 67.5% (95% CI 57.1-75.4) and the estimated median time of OGD recovery was 20 days (95% CI 13-26). Risk factors for late recovery of OGD were a complete loss of smell or taste at diagnosis (HR=0.26, 95% CI 0.12-0.56, P=0.0005) and age over 40 years (HR=0.56, 95% CI 0.36-0.89, P=0.01). CONCLUSIONS COVID-19 patients with complete loss of smell or taste and over age 40 are more likely to develop persistent OGD and should rapidly receive sensorial rehabilitation.
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Affiliation(s)
- L Cousyn
- Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Paris Brain Institute (Inserm, CNRS, Sorbonne Université), Paris, France.
| | - B Sellem
- Department of Infectious Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - R Palich
- Department of Infectious Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Inserm, Sorbonne Université, Institut Pierre-Louis d'épidémiologie et de santé publique (IPLESP), Paris, France
| | - D Bendetowicz
- Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Paris Brain Institute (Inserm, CNRS, Sorbonne Université), Paris, France
| | - R Agher
- Department of Infectious Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Inserm, Sorbonne Université, Institut Pierre-Louis d'épidémiologie et de santé publique (IPLESP), Paris, France
| | - C Delorme
- Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - R Tubiana
- Department of Infectious Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Inserm, Sorbonne Université, Institut Pierre-Louis d'épidémiologie et de santé publique (IPLESP), Paris, France
| | - M-A Valantin
- Department of Infectious Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Inserm, Sorbonne Université, Institut Pierre-Louis d'épidémiologie et de santé publique (IPLESP), Paris, France
| | - S Seang
- Department of Infectious Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Inserm, Sorbonne Université, Institut Pierre-Louis d'épidémiologie et de santé publique (IPLESP), Paris, France
| | - L Schneider
- Department of Infectious Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Inserm, Sorbonne Université, Institut Pierre-Louis d'épidémiologie et de santé publique (IPLESP), Paris, France
| | - A Fayçal
- Department of Infectious Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Y Dudoit
- Department of Infectious Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Inserm, Sorbonne Université, Institut Pierre-Louis d'épidémiologie et de santé publique (IPLESP), Paris, France
| | - B Abdi
- Inserm, Sorbonne Université, Institut Pierre-Louis d'épidémiologie et de santé publique (IPLESP), Paris, France; Department of Virology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - A Ndoadoumgue
- Inserm, Sorbonne Université, Institut Pierre-Louis d'épidémiologie et de santé publique (IPLESP), Paris, France
| | - L Assoumou
- Inserm, Sorbonne Université, Institut Pierre-Louis d'épidémiologie et de santé publique (IPLESP), Paris, France
| | - C Katlama
- Department of Infectious Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Inserm, Sorbonne Université, Institut Pierre-Louis d'épidémiologie et de santé publique (IPLESP), Paris, France
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Palich R, Wakim Y, Itani O, Paccoud O, Boussouar S, Lévy-Soussan M, Soulie C, Godefroy N, Bleibtreu A. Clinical, biological and radiological features, 4-week outcomes and prognostic factors in COVID-19 elderly inpatients. Infect Dis Now 2021; 51:368-373. [PMID: 33495763 PMCID: PMC7816947 DOI: 10.1016/j.idnow.2020.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 11/26/2020] [Accepted: 12/04/2020] [Indexed: 02/06/2023]
Abstract
Objective To describe clinical, biological, radiological presentation and W4 status in COVID-19 elderly patients. Patients and methods All patients ≥ 70 years with confirmed SARS-CoV-2 infection and hospitalized in the Infectious Diseases department of the Pitié-Salpêtrière hospital, Paris, France, from March 1st to April 15th 2020 were included. The primary outcome was death four weeks after hospital admission. Data on demographics, clinical features, laboratory tests, CT-scan findings, therapeutic management and complications were collected. Results All in all, 100 patients were analyzed, including 49 patients ≥ 80 years. Seventy percent had ≥2 comorbidities. Respiratory features were often severe as 48% needed oxygen support upon admission. Twenty-eight out of 43 patients (65%) with a CT-scan had mild to severe parenchymal impairment, and 38/43 (88%) had bilateral impairment. Thirty-two patients presented respiratory distress requiring oxygen support ≥ 6 liters/minute. Twenty-four deaths occurred, including 21 during hospitalization in our unit, 2 among the 8 patients transferred to ICU, and one at home after discharge from hospital, leading to a global mortality rate of 24% at W4. Age, acute renal failure and respiratory distress were associated with mortality at W4. Conclusion A substantial proportion of elderly COVID-19 patients with several comorbidities and severe clinical features survived, a finding that could provide arguments against transferring the most fragile patients to ICU.
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Affiliation(s)
- R Palich
- Sorbonne Université, Inserm, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Infectious Diseases, 47-83, boulevard de l'hôpital, 75013 Paris, France.
| | - Y Wakim
- Sorbonne Université, Inserm, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Infectious Diseases, 47-83, boulevard de l'hôpital, 75013 Paris, France
| | - O Itani
- Sorbonne Université, Inserm, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Infectious Diseases, 47-83, boulevard de l'hôpital, 75013 Paris, France
| | - O Paccoud
- Sorbonne Université, Inserm, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Infectious Diseases, 47-83, boulevard de l'hôpital, 75013 Paris, France
| | - S Boussouar
- Sorbonne Université, LIB-Laboratoire d'imagerie biomédicale, Inserm, CNRS, ICAN Institute of CardioMetabolism and Nutrition, ACTION Study Group, Cardiothoracic Imaging Unit, AP-HP, Pitié-Salpêtrière Hospital, 75013 Paris, France
| | - M Lévy-Soussan
- Sorbonne Université, AP-HP, Pitié-Salpêtrière Hospital, Department of Palliative Care, 75013 Paris, France
| | - C Soulie
- Sorbonne Université, Inserm, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Virology, 75013 Paris, France
| | - N Godefroy
- Sorbonne Université, Inserm, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Infectious Diseases, 47-83, boulevard de l'hôpital, 75013 Paris, France
| | - A Bleibtreu
- Sorbonne Université, Inserm, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Infectious Diseases, 47-83, boulevard de l'hôpital, 75013 Paris, France
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Brin C, Godefroy N, Simon A, Robert J, Bebear C, Agher R, Monsel G, Palich R, Caumes E. Caractères épidémiologiques cliniques et thérapeutiques des infections à Mycoplasma genitalium dans un centre parisien. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Noël L, Tubiana R, Simon A, Valantin MA, Palich R, Blanc C, Katlama C, Marcelin AG, Calvez V, Todesco E. Low immune response rate of HIV-infected patients to a single injection of hepatitis A vaccine. Infect Dis Now 2020; 51:94-96. [PMID: 33022294 DOI: 10.1016/j.medmal.2020.09.016] [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: 03/29/2020] [Revised: 04/01/2020] [Accepted: 09/24/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES We aimed to evaluate the immune response of HIV-1 positive patients to a single injection of HAV vaccine in a context of vaccine shortage during the 2017 European outbreak. METHODS We retrospectively enrolled all HIV-1 positive patients vaccinated by a single injection of HAV vaccine Vaqta 50®. HAV serology was performed before and>30 days after the vaccine injection. RESULTS Among the 73 patients, HIV-1 viral load was≤50 copies/mL in 93.2% of the cases. Medians of CD4 and median ratio of T CD4/CD8 cells were 658/mm3 and 0.9, respectively. A low immune response rate (59.7%) was observed among the patients. Responders had a significantly higher CD4/CD8 cell ratio than non-responders. CONCLUSIONS A serologic control should be recommended in this population in the event of a single injection vaccination schedule. During routine follow-up, and prior to any untoward event, physicians should assess the vaccination coverage of HIV-infected patients.
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Affiliation(s)
- L Noël
- Inserm, laboratoire de virologie, institut Pierre-Louis d'épidémiologie et de Santé Publique (iPLESP), hôpital Pitié-Salpêtrière, Sorbonne Université, AP-HP, 75013 Paris, France
| | - R Tubiana
- Inserm, service de maladies infectieuses et tropicales, institut Pierre-Louis d'épidémiologie et de Santé Publique (iPLESP), hôpital Pitié-Salpêtrière, Sorbonne Université, AP-HP, 75013 Paris, France
| | - A Simon
- Service de médecine interne, hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France
| | - M-A Valantin
- Inserm, service de maladies infectieuses et tropicales, institut Pierre-Louis d'épidémiologie et de Santé Publique (iPLESP), hôpital Pitié-Salpêtrière, Sorbonne Université, AP-HP, 75013 Paris, France
| | - R Palich
- Inserm, service de maladies infectieuses et tropicales, institut Pierre-Louis d'épidémiologie et de Santé Publique (iPLESP), hôpital Pitié-Salpêtrière, Sorbonne Université, AP-HP, 75013 Paris, France
| | - C Blanc
- Inserm, service de maladies infectieuses et tropicales, institut Pierre-Louis d'épidémiologie et de Santé Publique (iPLESP), hôpital Pitié-Salpêtrière, Sorbonne Université, AP-HP, 75013 Paris, France
| | - C Katlama
- Inserm, service de maladies infectieuses et tropicales, institut Pierre-Louis d'épidémiologie et de Santé Publique (iPLESP), hôpital Pitié-Salpêtrière, Sorbonne Université, AP-HP, 75013 Paris, France
| | - A-G Marcelin
- Inserm, laboratoire de virologie, institut Pierre-Louis d'épidémiologie et de Santé Publique (iPLESP), hôpital Pitié-Salpêtrière, Sorbonne Université, AP-HP, 75013 Paris, France
| | - V Calvez
- Inserm, laboratoire de virologie, institut Pierre-Louis d'épidémiologie et de Santé Publique (iPLESP), hôpital Pitié-Salpêtrière, Sorbonne Université, AP-HP, 75013 Paris, France
| | - E Todesco
- Inserm, laboratoire de virologie, institut Pierre-Louis d'épidémiologie et de Santé Publique (iPLESP), hôpital Pitié-Salpêtrière, Sorbonne Université, AP-HP, 75013 Paris, France.
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Palich R, Wakim Y, Itani O, Paccoud O, Boussouar S, Levy-Soussan M, Soulie C, Godefroy N, Bleibtreu A. « Cent nuances de COVID » : étude descriptive monocentrique des infections à SARS-CoV-2 de 100 patients âgés de plus de 70 ans. Med Mal Infect 2020. [PMCID: PMC7442126 DOI: 10.1016/j.medmal.2020.06.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Poizot-Martin I, Obry-Roguet V, Duvivier C, Lions C, Huleux T, Jacomet C, Ferry T, Cheret A, Allavena C, Bani-Sadr F, Palich R, Cabié A, Fresard A, Pugliese P, Delobel P, Lamaury I, Hustache-Mathieu L, Brégigeon S, Makinson A, Rey D. Kaposi sarcoma among people living with HIV in the French DAT'AIDS cohort between 2010 and 2015. J Eur Acad Dermatol Venereol 2020; 34:1065-1073. [PMID: 31953902 PMCID: PMC7318618 DOI: 10.1111/jdv.16204] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 12/17/2019] [Indexed: 01/16/2023]
Abstract
Background Although antiretroviral therapy (ART) has reduced the risk of Kaposi sarcoma (KS), KS cases still occur in HIV‐infected people. Objective To describe all KS cases observed between 2010 and 2015 in a country with high ART coverage. Methods Retrospective study using longitudinal data from 44 642 patients in the French Dat’AIDS multicenter cohort. Patients’ characteristics were described at KS diagnosis according to ART exposure and to HIV‐plasma viral load (HIV‐pVL) (≤50 or >50) copies/mL. Results Among the 209 KS cases diagnosed during the study period, 33.2% occurred in ART naïve patients, 17.3% in ART‐experienced patients and 49.5% in patients on ART, of whom 23% for more than 6 months. Among these patients, 24 (11.5%) had HIV‐pVL ≤50 cp/mL, and 16 (66%) were treated with a boosted‐PI‐based regimen. The distribution of KS localization did not differ by ART status nor by year of diagnosis. Limitations Data on human herpesvirus 8, treatment modalities for KS and response rate were not collected. Conclusion Half of KS cases observed in the study period occurred in patients not on ART, reflecting the persistence of late HIV diagnosis. Factors associated with KS in patients on ART with HIV‐pVL ≤50 cp/mL remain to be explored.
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Affiliation(s)
- I Poizot-Martin
- Aix-Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, APHM Sainte-Marguerite, Service d'Immuno-Hématologie Clinique, Marseille, France
| | - V Obry-Roguet
- Aix-Marseille Université, APHM Sainte-Marguerite, Service d'Immuno-Hématologie Clinique, Marseille, France
| | - C Duvivier
- Service de Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker-Pasteur, APHP-Hôpital Necker-Enfants Malades, Paris, France.,IHU Imagine, Paris, France.,Institut Cochin - CNRS 8104 - INSERM U1016 - RIL Team: Retrovirus, Infection and Latency, Université de Paris, Paris, France.,Centre Médical de l'Institut Pasteur, Institut Pasteur, Paris, France
| | - C Lions
- Aix-Marseille Université, APHM Sainte-Marguerite, Service d'Immuno-Hématologie Clinique, Marseille, France
| | - T Huleux
- Service Universitaire des Maladies Infectieuses et du Voyageur - Centre Hospitalier G. DRON, Tourcoing, France
| | - C Jacomet
- Centre Hospitalier Universitaire de Clermont-Ferrand, Département des Maladies Infectieuses et Tropicales, Clermont Ferrand, France
| | - T Ferry
- Service de Maladies Infectieuses, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Villeurbanne, France
| | - A Cheret
- Sorbonne Paris Cité, EA7327, Université Paris Descartes, Paris, France.,Service de Médecine Interne - Immunologie Clinique - Hôpital Bicêtre, AP-HP, Le Kremlin-Bicêtre, France
| | - C Allavena
- Service des Maladies Infectieuses et Tropicales, CHU Hôtel-Dieu, Nantes, France
| | - F Bani-Sadr
- Département de Médecine Interne, Maladies Infectieuses et Immunologie Clinique, Hêpital Robert Debré, Centre Hospitalier Universitaire, Reims, France
| | - R Palich
- Service des Maladies Infectieuses et Tropicales, GHPS Pitié Salpêtrière APHP, Paris, France.,UMR 1136, Sorbonne Universités UPMC Université Paris 6-INSERM-IPLESP, Paris, France
| | - A Cabié
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Martinique, Fort-de-France, France.,EA 4537 Maladies Infectieuses et Tropicales dans la Caraï be, Université des Antilles, Pointe-à-Pitre, France.,INSERM CIC1424 Centre d'Investigation Clinique Antilles Guyane, Centre Hospitalier Andrée Rosemon, Cayenne, France
| | - A Fresard
- Centre Hospitalier Universitaire de Saint-Étienne, Département des Maladies Infectieuses et Tropicales, Saint-Etienne, France
| | - P Pugliese
- CHU de Nice, Universite Côte d'Azur, Nice, France
| | - P Delobel
- CHU de Toulouse, Service des Maladies Infectieuses et Tropicales-INSERM, UMR1043-Université Toulouse III Paul Sabatier, Toulouse, France
| | - I Lamaury
- Département d'Infectiologie, Dermatologie et Immunologie Clinique, Pointe-à-Pitre Cedex, France
| | - L Hustache-Mathieu
- Service des Maladies Infectieuses et Tropicales, CHRU de Besançon - Hôpital Jean Minjoz, Besançon, France
| | - S Brégigeon
- Aix-Marseille Université, APHM Sainte-Marguerite, Service d'Immuno-Hématologie Clinique, Marseille, France
| | - A Makinson
- Centre Hospitalier Universitaire de Montpellier, Département des Maladies Infectieuses et Tropicales, INSERM U1175/IRD UMI 233, Montpellier, France
| | - D Rey
- Le Trait d'Union, Centre de Soins de l'infection par le VIH, Hôpitaux Universitaires, Strasbourg, France
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Palich R, Ghosn J, Chaillon A, Boilet V, Néré ML, Chaix ML, Delaugerre C, Thiebault R, Lévy Y, Lelièvre JD. Étude du rebond virologique dans le sperme après l’arrêt du traitement antirétroviral, au cours d’un essai vaccinal thérapeutique mené en double aveugle (VRI02/ANRS149-LIGHT). Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Palich R, Irenge L, Barte de Sainte Fare E, Augier A, Gala JL, Malvy D. EMERG-03 - Persistance du virus Ebola dans l’environnement d’un centre de traitement en Guinée forestière. Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30363-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Palich R, Martin-Blondel G, Cuzin L, Le Talec JY, Boyer P, Massip P, Delobel P. VIH-09 - Prophylaxie post-exposition du VIH : expériences de consultation chez des homosexuels masculins devenus séropositifs. Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30554-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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