Association of Dynamics of Anellovirus Loads With Hospital-Acquired Pneumonia in Patients With Brain Injury During the Intensive Care Unit Stay

International audienceBackground : Critical illness induces immune disorders associated with an increased risk of hospital-acquired pneumonia (HAP) and acute respiratory distress syndrome (ARDS). Torque teno virus (TTV), from the Anelloviridae family, is proposed as a biomarker to measure the level of immunosuppression. Our objective was to describe the kinetics of TTV DNA loads and their association with critical illness–related complications. Methods : We performed a longitudinal study in 115 patients with brain injury from a prospective cohort, collected endotracheal and blood samples at 3 successive time points after admission in the intensive care unit (ICU) (T1, 0–4 days post ICU admission; T2, 5–10; T3, 11–18), and measured viral DNA loads using the TTV R-GENE kit (BioMérieux) and a pan-Anelloviridae in-house quantitative real-time polymerase chain reaction. Results : TTV DNA was detected in the blood of 69%, 71%, and 64% of patients with brain injury at T1, T2, and T3, respectively. Time-associated variations of TTV and anellovirus DNA loads were observed. Using a linear mixed-effects model, we found that HAP and ARDS were associated with lower blood anellovirus DNA loads. Conclusions : Our results show that HAP or ARDS in patients who are critically ill is associated with changes in anellovirus DNA loads and should be evaluated further as a biomarker of immune disorders leading to these complications

Increased risk of severe COVID-19 in hospitalized patients with SARS-CoV-2 Alpha variant infection: a multicentre matched cohort study

International audienceBackground: The impact of the variant of concern (VOC) Alpha on the severity of COVID-19 has been debated. We report our analysis in France.Methods: We conducted an exposed/unexposed cohort study with retrospective data collection, comparing patients infected by VOC Alpha to contemporaneous patients infected by historical lineages. Participants were matched on age (± 2.5 years), sex and region of hospitalization. The primary endpoint was the proportion of hospitalized participants with severe COVID-19, defined as a WHO-scale > 5 or by the need of a non-rebreather mask, occurring up to day 29 after admission. We used a logistic regression model stratified on each matched pair and accounting for factors known to be associated with the severity of the disease.Results: We included 650 pairs of patients hospitalized between Jan 1, 2021, and Feb 28, 2021, in 47 hospitals. Median age was 70 years and 61.3% of participants were male. The proportion of participants with comorbidities was high in both groups (85.0% vs 90%, p = 0.004). Infection by VOC Alpha was associated with a higher odds of severe COVID-19 (41.7% vs 38.5%-aOR = 1.33 95% CI [1.03-1.72]).Conclusion: Infection by the VOC Alpha was associated with a higher odds of severe COVID-19