23 research outputs found

    Vaccine breakthrough hypoxemic COVID-19 pneumonia in patients with auto-Abs neutralizing type I IFNs

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    Life-threatening `breakthrough' cases of critical COVID-19 are attributed to poor or waning antibody response to the SARS- CoV-2 vaccine in individuals already at risk. Pre-existing autoantibodies (auto-Abs) neutralizing type I IFNs underlie at least 15% of critical COVID-19 pneumonia cases in unvaccinated individuals; however, their contribution to hypoxemic breakthrough cases in vaccinated people remains unknown. Here, we studied a cohort of 48 individuals ( age 20-86 years) who received 2 doses of an mRNA vaccine and developed a breakthrough infection with hypoxemic COVID-19 pneumonia 2 weeks to 4 months later. Antibody levels to the vaccine, neutralization of the virus, and auto- Abs to type I IFNs were measured in the plasma. Forty-two individuals had no known deficiency of B cell immunity and a normal antibody response to the vaccine. Among them, ten (24%) had auto-Abs neutralizing type I IFNs (aged 43-86 years). Eight of these ten patients had auto-Abs neutralizing both IFN-a2 and IFN-., while two neutralized IFN-omega only. No patient neutralized IFN-ss. Seven neutralized 10 ng/mL of type I IFNs, and three 100 pg/mL only. Seven patients neutralized SARS-CoV-2 D614G and the Delta variant (B.1.617.2) efficiently, while one patient neutralized Delta slightly less efficiently. Two of the three patients neutralizing only 100 pg/mL of type I IFNs neutralized both D61G and Delta less efficiently. Despite two mRNA vaccine inoculations and the presence of circulating antibodies capable of neutralizing SARS-CoV-2, auto-Abs neutralizing type I IFNs may underlie a significant proportion of hypoxemic COVID-19 pneumonia cases, highlighting the importance of this particularly vulnerable population

    COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

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    Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≀ 18 years: 69, 48, 23; 85%), older adults (≄ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

    Organisation sanitaire d'un rassemblement annuel de gens du voyage dans la commune de Nevoy (Loiret)

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    TOURS-BU MĂ©decine (372612103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

    Distribution of potentially toxic epiphytic dinoflagellates in Saint Martin Island (Caribbean Sea, Lesser Antilles)

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    International audienceFor the first time, distribution of epiphytic dinoflagellates was studied in Saint Martin Island (Lesser Antilles) during the cyclonic season (between September 1 st and 3 rd 2015). The present study provides a semi-quantitative analysis because the fresh weight of each macrophyte was estimated around 10 g. The identified genera were: Ostreopsis, Prorocentrum, Coolia, Amphidinium, and Gambierdiscus in order of decreasing abundance. Highest average abundance values of the genera Ostreopsis and Amphidinium were hosted by macrophytes of the Phaeophyceae group with ca. 15,000 and 60 cells g-1 respectively. Epiphytic Coolia cells were mainly observed on seagrasses with the highest average abundance value of ca. 1000 cells g-1 whereas the genera Gambierdiscus and Prorocentrum were principally associated with Florideophyceae with the highest average abundances of ca. 70 and 1500 cells g FW-1 respectively. This preliminary study indicates the most relevant locations to survey the biodiversity of potentially toxic epiphytic dinoflagellates in Saint Martin Island

    Effect of thermal pretreatment at 70 degrees C for one hour (EU hygienization conditions) of various organic wastes on methane production under mesophilic anaerobic digestion

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    International audienceThe impact of hygienization as mild thermal pretreatment on the methane production of various organic wastes was investigated, including digestate issued from hydrolysis tank, thickened sludge from a municipal wastewater treatment plant (MWWTP sludge) and from a mixed domestic-industrial wastewater treatment plant (D-I WWTP sludge), sludge from a meat-processing plant (MP sludge), sieving rejection from a pork slaughterhouse, pork liver, cattle slurry, cattle scraping slurry and date seeds. They were thermally pretreated at 70 degrees C for one hour and subsequently put into AD digesters incubated at 37 degrees C for individual methane potential test. The modified Gompertz model was employed to evaluate the kinetic parameters of methane production curves (R-2 = 0.944-0.999). The results were compared with the untreated samples. Significant enhancement of methane potentials induced by thermal treatment (p < 0.05) was observed when it comes to the pork liver (+8.6%), the slaughterhouse sieving rejection (+11.1%), the thickened MWWTP sludge (+12.5%) and the digestate issued from hydrolysis tank (+18.0%). The maximum methane production rates of the 4 substrates mentioned above were increased by thermal pretreatment as well (from 13.5% to 64%, p < 0.05). The lag time of the methane production was shortened for the digestate from hydrolysis tank and the MWWTP sludge (by 48.6% and 62.2% respectively, p < 0.05). No significant enhancement was obtained for the cattle slurry, the cattle scraping slurry and the D-I WWTP sludge. Additionally, the maximum methane production rate and the methane potential were reduced by thermal pretreatment for the MP sludge and the date seeds respectively (p < 0.05). In this paper, possible mechanisms were discussed to explain the different methane production behaviors of substrates after the mild thermal pretreatment

    Performance Evaluation of the Access anti-HBc Total Assay on the DxI 9000 Access Immunoassay Analyzer

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    International audienceThis study evaluated the diagnostic and analytical performances of the Access anti-HBV core antigen (anti-HBc Total) assay on the DxI 9000 Access Immunoassay System (Beckman Coulter Inc.). The multicenter study involved both prospective and retrospective sample collection from non-selected blood donors, hospitalized patients, or presumed anti-HBc Total positive individuals. Fresh/previously-frozen samples were tested with the Access and comparator assays to determine concordance; discrepant samples were tested with a second CE-marked assay. Among the 5983 non-selected fresh blood donor samples deemed anti-HBc Total negative, clinical specificity of the Access assay was 99.58% (95%CI: 99.38–99.72%). Clinical specificity was 99.27% (97.37–99.80%) among 273 anti-HBc Total negative hospitalized patient samples. Clinical sensitivity on 450 anti-HBc Total positive samples was 99.78% (98.75–99.96%). Evaluation in seroconversion panels revealed an average 1.4-day earlier detection versus a comparator assay. The Access assay demonstrated excellent clinical and analytical performances comparable to existing CE-marked anti-HBc Total assays. NCT04904835

    Impact on disease mortality of clinical, biological, and virological characteristics at hospital admission and overtime in COVID‐19 patients

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    International audienc

    Vaccine breakthrough hypoxemic COVID-19 pneumonia in patients with auto-Abs neutralizing type I IFNs

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    International audienceLife-threatening ‘breakthrough’ cases of critical COVID-19 are attributed to poor or waning antibody response to the SARS-CoV-2 vaccine in individuals already at risk. Pre-existing autoantibodies (auto-Abs) neutralizing type I IFNs underlie at least 15% of critical COVID-19 pneumonia cases in unvaccinated individuals; however, their contribution to hypoxemic breakthrough cases in vaccinated people remains unknown. Here, we studied a cohort of 48 individuals (age 20-86 years) who received 2 doses of an mRNA vaccine and developed a breakthrough infection with hypoxemic COVID-19 pneumonia 2 weeks to 4 months later. Antibody levels to the vaccine, neutralization of the virus, and auto-Abs to type I IFNs were measured in the plasma. Forty-two individuals had no known deficiency of B cell immunity and a normal antibody response to the vaccine. Among them, ten (24%) had auto-Abs neutralizing type I IFNs (aged 43-86 years). Eight of these ten patients had auto-Abs neutralizing both IFN-α2 and IFN-ω, while two neutralized IFN-ω only. No patient neutralized IFN-ÎČ. Seven neutralized 10 ng/mL of type I IFNs, and three 100 pg/mL only. Seven patients neutralized SARS-CoV-2 D614G and the Delta variant (B.1.617.2) efficiently, while one patient neutralized Delta slightly less efficiently. Two of the three patients neutralizing only 100 pg/mL of type I IFNs neutralized both D61G and Delta less efficiently. Despite two mRNA vaccine inoculations and the presence of circulating antibodies capable of neutralizing SARS-CoV-2, auto-Abs neutralizing type I IFNs may underlie a significant proportion of hypoxemic COVID-19 pneumonia cases, highlighting the importance of this particularly vulnerable population
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