34 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

    A Brillouin fiber laser at 2 ”m based on a step-index tellurite (TeO2) optical fiber

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    International audienceWe experimentally demonstrate a single frequency Brillouin fiber laser at 2-”m using a passive fiber ring cavity. A low lasing threshold of 70 mW was achieved with a 2m-length step-index tellurite-glass optical fiber

    Desulfurization and ring opening of thiirane induced by tantalocene trihydride complexes: Synthesis, reactivity and X-ray structure of Cpâ€Č2Ta(=S)(S-iPr) with Cpâ€Č=η5-C5H4tBu

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    The reaction of the tantalocene trihydride complexes Cpâ€Č2TaH3 1 (Cpâ€Č=η5-C5H4tBu) or Cp″CpTaH3 1â€Č (Cp″=η5-C5H2-1,2-Me 2-4-tBu) with propylene sulfide was found to proceed via an unprecedented sulfur transfer and regioselective ring opening reaction at once to yield sulfido-thiolato tantalocene complexes Cpâ€Č2Ta(=S)(S-iPr) 2a whose structure has been determined by X-ray crystallography or Cp″CpTa(=S)(S-iPr) 2â€Ča. Complex 1 reacts with ethylene sulfide to give Cpâ€Č2Ta(=S)(S-Et) 2b. The reactivity of 2a towards a variety of electrophilic moities has been investigated: protonation (with HBF4) and alkylation (with MeI) reactions occur at the terminal sulfur ligand, leading to Cpâ€Č2Ta(SH)(S-iPr)BF4 4a, Cpâ€Č2Ta(SMe)(S-iPr)I 5a; the reaction of 2b with EtI was found to yield Cpâ€Č2Ta(S-Et)2I 6b. Complex 2a (or 2â€Č) binds the unsaturated organometallic fragments W(CO)5 and W(CO)4; the new heterobimetallic complexes Cpâ€Č2Ta(S-iPr)(ÎŒ-S)W(CO)5 7a (or 7â€Ča) and Cpâ€Č(ÎŒ-S,S-iPr)W(CO)4 8a (or 8â€Ča) were formed. Inversion of configuration at the bridging ÎŒ-S atoms has been observed at low temperature for 8a and has been studied by dynamic 1H-NMR spectroscopy. © 1999 Elsevier Science S.A
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