Revue de bibliographie quotidienne Covid-19

Publié par Bernard Pradines

Revue de bibliographie quotidienne Covid-19

Sans me livrer à une vraie revue de la littérature scientifique, je repère surtout les publications qui me semblent dignes d’intérêt depuis le 18 mars 2021 (voir aussi les archives 1, archives 2 ) dans le listing quotidien de Kamps et Hoffmann : https://covidreference.com/top10

Remarques en français en caractères bleus.

A noter que les mises à jour de cette page ne feront pas systématiquement l'objet d'un avis de publication par courriel comme les autres articles.

25 juillet 2021

Else H. COVID and mass sport events: early studies yield limited insights. Nature 2021, published 22 July. Full text: https://www.nature.com/articles/d41586-021-02016-5

Grands rassemblements : éviter.

Is it safe to attend large gatherings? Maybe not yet.

Mazagatos C, Monge S, Olmedo C, et al. Effectiveness of mRNA COVID-19 vaccines in preventing SARS-CoV-2 infections and COVID-19 hospitalisations and deaths in elderly long-term care facility residents, Spain, weeks 53 2020 to 13 2021. Euro Surveill. 2021 Jun;26(24):2100452. PubMed: https://pubmed.gov/34142647. Full-text: https://doi.org/10.2807/1560-7917.ES.2021.26.24.2100452

Un groupe de résidents âgés (65 ans et plus) en établissement de soins de longue durée en Espagne : efficacité vaccinale partielle (EV) de 50 % avec la première dose du vaccin BioNTech/Pfizer et du vaccin Moderna. Après la deuxième dose, l'EV était de 71% contre l'infection par le SRAS-CoV-2, 88% et 97% contre les hospitalisations et les décès COVID-19, respectivement.

The same message from a group of elderly residents (aged 65 years and older) in long-term care facilities: partial vaccine effectiveness (VE) of 50% with the first dose of the BioNTech/Pfizer and the Moderna vaccine. After the second dose, VE was 71% against SARS-CoV-2 infection, 88% and 97% against COVID-19 hospitalizations and deaths, respectively.

Mateo-Urdiales A, Spila Alegiani S, Fabiani M, et al. Risk of SARS-CoV-2 infection and subsequent hospital admission and death at different time intervals since first dose of COVID-19 vaccine administration, Italy, 27 December 2020 to mid-April 2021. Euro Surveill. 2021 Jun;26(25):2100507. PubMed: https://pubmed.gov/34169819. Full-text: https://doi.org/10.2807/1560-7917.ES.2021.26.25.2100507

Italie comme Israël : protection partielle dès la deuxième semaine après la première injection.

A report on 7,370,008 persons who had received their first dose of vaccine by 4 April 2021 in Italy. As in earlier studies from Israel, a partial protection can be seen as early as two weeks after the first dose.

Pas de modification du sperme retrouvée après deux injections de vaccins à ARNm.

Source :

24 juillet 2021

Wei J, Stoesser N, Matthews PC, et al. Antibody responses to SARS-CoV-2 vaccines in 45,965 adults from the general population of the United Kingdom. Nat Microbiol. 2021 Jul 21. PubMed: https://pubmed.gov/34290390. Full-text: https://doi.org/10.1038/s41564-021-00947-3

Dans cette cohorte britannique de 45 965 adultes, les taux de séroconversion et les taux d'anticorps après une seule dose de vaccin étaient plus faibles chez les personnes âgées, en particulier chez celles âgées de > 60 ans. Les faibles répondeurs étaient plus fréquents chez les personnes prenant des immunosuppresseurs ou des corticostéroïdes, ainsi que chez les patients atteints de polyarthrite rhumatoïde, de pathologie hépatique chronique, de cancer, de diabète de type 2, d'obésité et d'asthme.

In this UK cohort of 45,965 adults, seroconversion rates and antibody levels after a single vaccine dose were lower in older individuals, especially in those aged > 60 years. Low responders were more common among people taking immunosuppressants or corticosteroids, as well as in patients with rheumatoid arthritis, chronic liver disease, cancer, type 2 diabetes, obesity, and asthma.

Ito K, Piantham C, Nishiura H. Predicted dominance of variant Delta of SARS-CoV-2 before Tokyo Olympic Games, Japan, July 2021. Euro Surveill. 2021 Jul;26(27):2100570. PubMed: https://pubmed.gov/34240695. Full-text: https://doi.org/10.2807/1560-7917.ES.2021.26.27.2100570

Les participants aux JO vont-ils ramener le Delta ?

In many countries, the Delta variant (B.1.671.2) has already replaced other variants. The authors show that in Japan, the replacement is likely to happen mostly before the start of the Tokyo Olympic Games on 23 July 2021. A substantial number of international visitors might be exposed and help spread the Delta variant around the world.

23 juillet 2021

Lopez Bernal J, Andrews N, Gower C, et al. Effectiveness of Covid-19 Vaccines against the B.1.617.2 (Delta) Variant. N Engl J Med. 2021 Jul 21. PubMed: https://pubmed.gov/34289274. Full-text: https://doi.org/10.1056/NEJMoa2108891

L'efficacité après une dose de BioNTech/Pfizer ou d'AstraZeneca était plus faible chez les individus infectés par le variant Delta (B.1.671.2, « indien ») qu'avec le variant Alpha (B.1.1.7, « anglais»): Delta, 30,7% – Alpha, 48,7% (il n'y avait pas de différence entre les deux vaccins). Après deux doses, les différences d'efficacité du vaccin entre les deux variants étaient modestes, mais le vaccin BioNTech/Pfizer était supérieur au vaccin AstraZeneca (BioNTech/Pfizer : Delta, 88,0 % – Alpha, 93,7 % ; AstraZeneca : Delta, 67,0 % ; Alpha , 74,5%.

Effectiveness after one dose of the BioNTech/Pfizer or AstraZeneca was lower among individuals infected with the Delta variant (B.1.671.2, “India”) than with the Alpha variant (B.1.1.7, “England”): Delta, 30.7% – Alpha, 48.7% (there was no difference between the two vaccines). After two doses, differences in vaccine effectiveness with the two variants were modest, but the BioNTech/Pfizer vaccine was superior to the AstraZeneca vaccine (BioNTech/Pfizer: Delta, 88.0% – Alpha, 93.7%; AstraZeneca: Delta, 67.0%; Alpha, 74.5%).

García-Azorín D, Sierra Á, Trigo J, et al. Frequency and phenotype of headache in covid-19: a study of 2194 patients. Sci Rep. 2021 Jul 19;11(1):14674. PubMed: https://pubmed.gov/34282206. Full-text: https://doi.org/10.1038/s41598-021-94220-6

Les céphalées peuvent être le symptôme révélateur de la COVID-19. Dans cette étude, le délai médian d'apparition des céphalées était dans les 24 h, avec une durée médiane de 7 jours. Chez 13 % des patients, la céphalée persistait après 1 mois. La plupart des patients ont décrit une céphalée bilatérale à prédominance frontale, de qualité oppressante et d'intensité sévère.

Headache may be the presenting symptom of COVID-19. In this study, median headache onset was within 24 h, with a median duration of 7 days. In 13% of patients, the headache persisted after 1 month. Most patients described a bilateral headache with frontal predominance, an oppressive quality, and severe intensity.

Hillis SD, Unwin HJT, Chen Y, et al. Global minimum estimates of children affected by COVID-19-associated orphanhood and deaths of caregivers: a modelling study. Lancet 2021, published 20 July. Full text: https://doi.org/10.1016/S0140-6736(21)01253-8

Autre conséquence de la covid-19 : plus d'un million de nouveaux orphelins.

From March 1, 2020, to April 30, 2021, more than one million children lost at least one parent or custodial grandparent.

See also the comment by Kentor RA, Thompson AL. Answering the call to support youth orphaned by COVID-19. Lancet 2021, published 20 July. Full text: Lancet 2021, published 20 July. Full text: https://doi.org/10.1016/S0140-6736(21)01253-8

22 juillet 2021

Ledford H. Should children get COVID vaccines? What the science says. Nature 2021, published 20 July. Full text: https://www.nature.com/articles/d41586-021-01898-9

Pendant que l'on débat et se débat en France avec l'obligation vaccinale, d'autres pays se confrontent à la pénurie de vaccins. Se posent alors des questions dans une autre dimension : qui vacciner en premier ? Par exemple des personnes vulnérables ou des adolescents; les rares complications du vaccin Pfizer à type de myocardite et de péricardite chez les adolescents masculins de 12 à 17 ans (67 cas par million de secondes doses) et féminins (9 cas par million de secondes doses) vont elles être dissuasives alors que la covid, bien que peu fréquente, peut entrainer des complications graves chez les sujets de cette tranche d'âge ?

Vaccinating children. Is it necessary? Is it safe? And how will it affect the pandemic?

Mateus J, Dan JM, Zhang Z, et al. Low dose mRNA-1273 COVID-19 vaccine generates durable T cell memory and antibodies enhanced by pre-existing crossreactive T cell memory. medRxiv 2021, posted 5 July. Full text: https://doi.org/10.1101/2021.06.30.21259787

Moderna protecteur au quart de dose ? Et sans effet secondaire ?

At 25 µg (instead of the four-fold higher 100 µg standard dose), the Moderna vaccine mRNA-1273 vaccine induced a durable and functional T cell and antibody response comparable to natural infection. If these preliminary findings are confirmed, the lower dose could accelerate the global immunization campaign (and perhaps help with side effects?).

21 juillet 2021

Brosh-Nissimov T, Orenbuch-Harroch E, Chowers M, et al. BNT162b2 vaccine breakthrough: clinical characteristics of 152 fully-vaccinated hospitalized COVID-19 patients in Israel. Clin Microbiol Infect. 2021 Jul 7:S1198-743X(21)00367-0. PubMed: https://pubmed.gov/34245907. Full-text: https://doi.org/10.1016/j.cmi.2021.06.036

Après Pfizer chez 152 patients israéliens qui ont développé une covid au moins une semaine après la deuxième injection et qui ont été hospitalisés. Parmi eux, leurs comorbidités : HTA pour 71%, diabète pour 48%, insuffisance cardiaque congestive pour 27%, pathologies pulmonaires pour 24%, insuffisance rénale pour 24%, démence chez 19% et cancer pour 24%. 40% étaient immunodéprimés et 22% sont morts (soit 34 patients). 

Retrospective study of 152 individuals who developed COVID-19 more than 7 days after the second BioNTech/Pfizer vaccine dose and required hospitalization. High rate of existing co-morbidities: hypertension (71%), diabetes (48%), congestive heart failure (27%), lung diseases (24%), chronic kidney (24%), dementia (19%) and cancer (24%). Importantly, 60 (40%) patients were immunocompromised. Thirty-four (22%) patients died.

Lucas C, Vogels CBF, Yildirim I, et al. Impact of circulating SARS-CoV-2 variants on mRNA vaccine-induced immunity in uninfected and previously infected individuals. medRxiv 2021, posted 18 July. Full text: https://www.medrxiv.org/content/10.1101/2021.07.14.21260307v1

Meilleure immunité si infection préalable que si vaccination et réduction de la neutralisation pour le Béta, le Gamma suivis par le Delta et l'Alpha.

Analysis of plasma neutralization using 16 SARS-CoV-2 variants. The Beta (B.1.351, ‘South Africa’) and Gamma (P.1, ‘Brazil’) strains, showed the greatest reduction, followed by the Delta (B.1.617.2, ‘India’) and Alfa (B.1.1.7, ‘England’) strains. Plasma from previously infected vaccinated individuals had a better neutralization than plasma from uninfected vaccinated individuals.

Coleman KK, Tay DJW, Tan KS, et al. Viral Load of SARS-CoV-2 in Respiratory Aerosols Emitted by COVID-19 Patients while Breathing, Talking, and Singing. medRxiv 2021, posted 19 July. Full text: https://doi.org/10.1101/2021.07.15.21260561

Bon, on peut s'arrêter de chanter et de parler mais il est encore permis de respirer.

In this study, fine aerosols (≤ 5μm) produced by talking and singing contained more SARS-CoV-2 copies than coarse aerosols. “The largest proportion of SARS-CoV-2 RNA copies was emitted by singing (53%), followed by talking (41%) and breathing (6%).”

20 juillet 2021

Li B, Deng A, Li K, et al. Viral infection and transmission in a large well-traced outbreak caused by the Delta SARS-CoV-2 variant. medRxiv 2021, posted 12 July. Full-text: https://doi.org/10.1101/2021.07.07.21260122

Delta : charge virale 1000 fois plus élevée et réduction de 6 à 4 jours entre le premier cas et le second quand ils présentenet des symptômes.

Explaining the forces behind the Delta wave: 1) 1000 times higher viral load and 2) a reduced serial interval, 4 days instead of 6 (the serial interval is defined as the duration of time between a primary case patient having symptom onset and a secondary case patient having symptom onset).

Dougherty K, Mannell M, Naqvi O, Matson D, Stone J. SARS-CoV-2 B.1.617.2 (Delta) Variant COVID-19 Outbreak Associated with a Gymnastics Facility – Oklahoma, April-May 2021. MMWR Morb Mortal Wkly Rep. 2021 Jul 16;70(28):1004-1007. PubMed: https://pubmed.gov/34264910. Full-text: https://doi.org/10.15585/mmwr.mm7028e2

Delta : évitez la gymnastique encore davantage que... la maison.

In the coming months, avoid gyms. The Delta variant (B.1.617.2, first identified in India) is frighteningly transmissible (see article above) and will lead to increased attack rates, especially in households and in indoor sports settings. In this report, the attack rates at the gymnastics facility and in households were 20% and 53%, respectively.

Guimarães RM, Portela MC, Villela DAM, Matta GC, de Freitas CM. Younger Brazilians hit by COVID-19 – What are the implications? Lancet Regional Health 2021, published 14 July. Full text: https://doi.org/10.1016/j.lana.2021.100014

Chute de 13 ans de l'âge médian des décédés au Brésil depuis le début de 2021.

New variants and incomplete vaccination will lead to increasing numbers of young and middle-aged adults in intensive care units. In the months ahead, how far will the “youthening of the pandemic” go? In Brazil, among patients who died from COVID-19, the median age has dropped 13 years since the beginning of 2021.

19 juillet 2021

Said M, Davis P, Davis P, et al. A Rapid Olfactory Test as a Potential Screening Tool for COVID-19. JAMA Otolaryngol Head Neck Surg July 15, 2021. https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/2782044?resultClick=1

Un test olfactif pour dépistage : sensibilité de 75% and spécificité de 95.2% en utilisant un test PCR comme référence.

In this pilot study, a novel olfactory test alone had a sensitivity of 75% and specificity of 95.2% in detecting COVID-19 using PCR testing as the gold standard.

Drake TM, Riad AM, Fairfield CJ, et al. Characterisation of in-hospital complications associated with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol UK: a prospective, multicentre cohort study. Lancet July 17, 2021. Volume 398, ISSUE 10296, P223-237, July 17, 2021. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00799-6/fulltext

Des conséquences sévères esn sortie d'hospitalisation, y compris chez des jeunes en bonne santé, les complications neurologiques possédant le pronostic le plus défavorable.

Hospitalization with COVID-19 is associated with high rates of morbidity in adults. In this large prospective cohort study, almost half of the survivors had one or more complications. Rates were high even in young, previously healthy individuals. Acute complications were associated with reduced ability to self-care at discharge, with neurological complications being associated with the worst functional outcomes.

Yoshikawa Y, Kawachi I. Association of Socioeconomic Characteristics With Disparities in COVID-19 Outcomes in Japan. JAMA Netw Open July 14. 2021;4(7):e2117060. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2781935?resultClick=1

Inégalités face à la Covid-19 : au Japon aussi. Pas surprenant : revenus faibles, population recevant une assistance publique, un taux de chômage plus élevé, un nombre plus grand de travailleurs de la distribution, des transports et des postes ainsi que de la restauration. Davvantage si nombreux à la maison, tabagisme et obésité.

Disparities in COVID-19 outcomes are not unique to the US and Europe: in this cross-sectional study of the 47 prefectures in Japan, a higher burden of COVID-19 cases and deaths was observed in prefectures with lower household incomes; a higher proportion of the population receiving public assistance; a higher unemployment rate; higher numbers of retail, transportation and postal, and restaurant industry workers; more household crowding; and higher smoking and obesity rates.

Oldenburg CE, Pinsky BA, Brogdon J, et al. Effect of Oral Azithromycin vs Placebo on COVID-19 Symptoms in Outpatients With SARS-CoV-2 Infection – A Randomized Clinical Trial. JAMA July 16, 2021. doi:10.1001/jama.2021.11517

Encore un essai clinique défavorable à l'utilisation d'azithromycine.

In this randomized trial that included 263 outpatients with SARS-CoV-2 infection, treatment with a single oral dose of azithromycin, 1.2 g, vs placebo resulted in self-reported absence of COVID-19 symptoms at day 14 in 50% vs 50%.

18 juillet 2021

Barouch DH, Stephenson KE, Sadoff J, et al. Durable Humoral and Cellular Immune Responses 8 Months after Ad26.COV2.S Vaccination. NEJM July 14, 2021. https://www.nejm.org/doi/full/10.1056/NEJMc2108829?query=featured_home

Après Janssen, immunités cellulaire et humorale maintenues avec une décroissance minimale au bout de 8 mois. Développement des anticorps neutralisants y compris contre le Delta.

This small study indicates that the Ad26.COV2.S vaccine (J&J) elicited durable humoral and cellular immune responses with minimal decreases for at least 8 months. Moreover, there was an expansion of neutralizing antibody breadth associated with improved coverage of SARS-CoV-2 variants over time, including increased neutralizing antibody titers against Delta.

Ferreira I, Kemp S, Datir R, et al. SARS-CoV-2 B.1.617 mutations L452 and E484Q are not synergistic for antibody evasion. J Infect Dis July 14, 2021, jiab368. https://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiab368/6321359

Des modifications de la protéine Spike telles que vues sur le Delta ne diminuent que faiblement l'efficacité du Pfizer.

Spike bearing L452R and E484Q (as seen in Delta) confers modestly reduced sensitivity to BNT162b2 mRNA vaccine-elicited antibodies. The effect is similar in magnitude to the loss of sensitivity conferred by L452R or E484Q alone.

Bennett TD, Moffitt RA, Hajagos JG, et al. Clinical Characterization and Prediction of Clinical Severity of SARS-CoV-2 Infection Among US Adults Using Data From the US National COVID Cohort Collaborative. JAMA Netw Open Jul 13, 2021;4(7):e2116901. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2781923?resultClick=1

USA : facteurs indépendants de sévérité. L'âge, le sexe masculin, une affection hépatique, une démence, le fait d'être une personne de peau noire ou d'origine asiatique, l'obésité.

In this cohort study of 174,568 adults with SARS-CoV-2, 32,472 (18.6%) were hospitalized and 6565 (20.2%) got severely ill, and first-day machine learning models accurately predicted clinical severity. Mortality decreased from 16.4% in March to April 2020 to 8.6% in September to October 2020. In a separate multivariate logistic regression model built for inference, age (odds ratio, 1.03 per year), male sex (OR, 1.60), liver disease (OR, 1.20), dementia (OR, 1.26), African-American (OR, 1.12) and Asian (OR, 1.33) race, and obesity (OR, 1.36) were independently associated with higher clinical severity.

17 juillet 2021

Williamson EJ, McDonald HI, Bhaskaran K, et al. Risks of covid-19 hospital admission and death for people with learning disability: population based cohort study using the OpenSAFELY platform. BMJ July 14, 2021; 374. https://www.bmj.com/content/374/bmj.n1592

Trisomie 21 : davantage de Covid-19.

This large population-based cohort study from England indicates that people with learning disability have markedly increased risks of hospital admission and death from covid-19, over and above the risks observed for non-covid causes of death. Down’s syndrome and cerebral palsy were associated with increased hazards for both events; Down’s syndrome to a greater extent.

Williams SV, Vusirikala A, Ladhani SN, et al. An outbreak caused by the SARS-CoV-2 Delta (B.1.617.2) variant in a care home after partial vaccination with a single dose of the COVID-19 vaccine Vaxzevria, London, England, April 2021. Euro Surveill. 2021;26(27):pii=2100626. https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2021.26.27.2100626

Soignants et patients mal protégés contre le Delta par une seule dose d'AstraZeneca mais hospitalisation peu fréquente et pas de décès.

The Delta attack rate after the first dose of Astra Zeneca’s vaccine was 35.7% (5/14) for staff and 81.3% (13/16) for residents, indicating lower protection in people who had received only one dose of the Vaxzevria vaccine within 3 months. Reassuringly, though, hospitalisation was uncommon and there were no deaths, providing some evidence that a single dose of vaccine may be protective against severe disease following infection with the Delta variant.

Normark J, Vikström L, Gwon YD, et al. Heterologous ChAdOx1 nCoV-19 and mRNA-1273 Vaccination. NEJM July 14, 2021. https://www.nejm.org/doi/full/10.1056/NEJMc2110716?query=featured_home

Meilleure efficacité du MODERNA mais davantage d'effets secondaires que l'AstraZeneca : fièvre, céphalée, frissons, myalgies.

This relatively small cohort suggests that the mRNA-1273 vaccine (MODERNA) boost may provide better protection against the B.1.351 variant than a ChAdOx1 nCoV-19 boost. However, the mRNA-1273 boost led to more frequent reports of fever, headache, chills, and muscle aches than the ChAdOx1 nCoV-19 boost.

Kimihito I, Chayada P, NHiroshi N. Predicted dominance of variant Delta of SARS-CoV-2 before Tokyo Olympic Games, Japan, July 2021. Euro Surveill. 2021;26(27):pii=2100570. https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2021.26.27.2100570

Moins d'une semaine avant que le Delta ne remplace les autres variants au Japon.

It is just a matter of time for the Delta variant to replace other variants in Japan. This study shows that the replacement is likely to happen mostly before the start of the Tokyo Olympic Games on 23 July 2021.

16 juillet 2021

Rossi AH, Ojeda DS, Varese A, et al. Sputnik V Vaccine Elicits Seroconversion and Neutralizing Capacity to SARS CoV-2 after a Single Dose. Cell Rep Med July 13, 2021. https://www.cell.com/cell-reports-medicine/fulltext/S2666-3791(21)00208-1

Sputnik V plus efficace dès la première dose chez des soignants argentins déjà infectés.

Of 227 seronegative healthcare workers in Argentina, 94% developed spike-specific IgG antibodies at day 21 after the first dose. A single Sputnik V dose elicited higher antibody levels and virus neutralizing capacity in 67 previously infected individuals than in naïve ones receiving the full two-dose schedule.

Bui LT, Winters NI, Chung MIm et al. Chronic lung diseases are associated with gene expression programs favoring SARS-CoV-2 entry and severity. Nat Commun Jul 14, 2021, 12, 4314. https://www.nature.com/articles/s41467-021-24467-0

Pathologies respiratoires chroniques : un mécanisme génétique favorisant la sévérité de la covid.

Chronic lung disease AT2 cells express higher levels of genes linked directly to the efficiency of viral replication and the innate immune response.

Mura C, Preissner S, Nahles S, et al. Real-world evidence for improved outcomes with histamine antagonists and aspirin in 22,560 COVID-19 patients. Sig Transduct Target Ther July 14, 2021, 6, 267. https://www.nature.com/articles/s41392-021-00689-y

Association aspirine-famotidine (un anti-H2) : un espoir ?

In this analysis of 22,560 COVID-19 patients taking H1/H2 receptor antagonists, the combination of famotidine and aspirin did exhibit a significant synergistic survival benefit (OR 0.55, CI 0.39–0.78). The RR for death decreased by 32.5%—an immense benefit. The authors anticipate that at least three prospective RCTs that have been underway (NCT04504240, NCT04370262, and NCT04545008) will illuminate famotidine’s potential therapeutic profile.

15 juillet 2021

Barros-Martins J, Hammerschmidt SI, Cossmann A, et al. Immune responses against SARS-CoV-2 variants after heterologous and homologous ChAdOx1 nCoV-19/BNT162b2 vaccination. Nat Med Jul 14, 2021. https://www.nature.com/articles/s41591-021-01449-9

Pfizer vs AstraZeneca. meilleure immunisation par le premier au niveau cellulaire et humoral. Les auteurs déclarent qu'ils n'ont aucun conflit d'intérêt...

ChAdOx1 (Astra Zeneca)-primed immune responses before and 3 weeks after booster with ChAd (n=32) or BioNTech/Pfizer’s BNT162b2 (n=55): Although both vaccines boosted prime-induced immunity, BNT162b2 induced significantly higher frequencies of spike-specific CD4+ and CD8+ T cells and, in particular, high titers of neutralizing antibodies against the B.1.1.7, B.1.351 and P.1 variants.

Goldshtein I, Nevo D, Steinberg DM, et al. Association Between BNT162b2 Vaccination and Incidence of SARS-CoV-2 Infection in Pregnant Women. JAMA Jul 12, 2021; https://jamanetwork.com/journals/jama/fullarticle/2782047?resultClick=1

Efficacité de 78% pendant la grossesse avec Pfizer. Une efficacité atténuée par les autres mesures de prévention mieux suivies pendant la grossesse.

This cohort included 7,530 vaccinated and 7,530 matched unvaccinated women, 46% and 33% in the second and third trimester, respectively. Adjusted hazard ratio for infection of 0.22 (95% CI, 0.11-0.43), corresponding to an estimate of vaccine effectiveness of 78%. The authors argue that benefit from the vaccine may be somewhat attenuated because pregnant women were generally advised to take extra precautions during the pandemic.

14 juillet 2021

Koehler J, Ritzer B, Weidlich S, et al. Use of monoclonal antibody therapy for nosocomial SARS-CoV-2 infection in patients at high risk for severe COVID-19: experience from a tertiary-care hospital in Germany. Infection July 6, 2021. https://doi.org/10.1007/s15010-021-01657-y

Anticorps monoclonaux : les essais continuent.

Because of an in-house transmission of SARS-CoV-2 infection, 11 patients received monoclonal antibodies shortly after an infection (eight cases received bamlanivimab, three received the combination of casirivimab and imdevimab), and prior to symptoms. Despite many risk factors, none of these 11 patients were admitted to the intensive care unit or died from any causes.

Barizien N, Le Guen M, Russel S, et al. Clinical characterization of dysautonomia in long COVID-19 patients. Sci Rep July 7, 2021, 11, 14042. https://www.nature.com/articles/s41598-021-93546-5

Dysautonomie : une explication pour la longue covid ?

A small study, indicating that dysautonomia (the failure or the increase of the sympathetic or para-sympathetic components activities in the autonomic nervous system) may explain the persistent symptoms observed in long COVID-19 patients, such as fatigue and hypoxia.

COVID-19 Host Genetics Initiative. Mapping the human genetic architecture of COVID-19. Nature July 8, 2021. https://www.nature.com/articles/s41586-021-03767-x

Nous ne sommes pas tous génétiquement égaux face à la covid-19.

An individual’s genetics can influence their risk of infection and the severity of disease symptoms. This large international study has identified parts of the human genome that can affect the risk of severe COVID-19. Three genome-wide association meta-analyses comprised of up to 49,562 COVID-19 patients from 46 studies identified a total of 13 genome-wide significant loci associated with SARS-CoV-2 infection (n = 4) or severe manifestations of COVID-19 (n = 9). Several of these loci correspond to previously documented associations to lung or autoimmune and inflammatory diseases.

13 juillet 2021

Mahil SK, Bechman K, Raharja A, et al. The effect of methotrexate and targeted immunosuppression on humoral and cellular immune responses to the COVID-19 vaccine BNT162b2: a cohort study. Lancet Rheumatology July 08, 2021. https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(21)00212-5/fulltext

Immunité cellulaire préservée mais immunité humorale diminuée chez des patients sous méthotrexate.

Seroconversion alone might not adequately reflect vaccine immunogenicity in individuals with immune-mediated inflammatory diseases receiving therapeutic immunosuppression. In 84 patients with psoriasis receiving immunosuppressive drugs, seroconversion rates were lower in patients receiving immunosuppressants (78%), compared to 17 controls (100%), with the lowest rate in those receiving methotrexate (47%). However, cellular responses were preserved in almost all patients.

Hinks TS, Cureton L, Knight R, et al. Azithromycin versus standard care in patients with mild-to-moderate COVID-19 (ATOMIC2): an open-label, randomised trial. Lancet Resp Med July 09, 2021. https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(21)00263-0/fulltext

Inefficacité confirmée de l'azithromycine chez des patients souffrant de Covid-19 léger à modéré.

In patients with mild-to-moderate COVID-19, adding azithromycin to standard care treatment did not reduce the risk of subsequent hospital admission or death.

12 juillet 2021

Planas D, Veyer D, Baidaliuk A. et al. Reduced sensitivity of SARS-CoV-2 variant Delta to antibody neutralization. Nature July 8, 2021. https://www.nature.com/articles/s41586-021-03777-9

Le Delta échappe partiellement mais de manière significative aux anticorps monoclonaux neutralisants et aux anticorps polyclonaux provoqués par une infection ou une vaccination antérieure par le SRAS-CoV-2. Les sérums d'individus ayant reçu une dose des vaccins Pfizer ou AstraZeneca ont à peine inhibé le variant delta. L'administration de deux doses a généré une réponse neutralisante chez 95% des individus, avec des titres 3 à 5 fois inférieurs contre le delta que contre l'alpha.

Delta partially but significantly escapes neutralizing mAbs, and polyclonal antibodies elicited by previous SARS-CoV-2 infection or vaccination. Sera from individuals having received one dose of either the Pfizer or AstraZeneca vaccines barely inhibited the delta variant. Administration of two doses generated a neutralizing response in 95% of individuals, with titers 3-to-5-fold lower against delta than alpha.

Abdelnabi R, Foo CS, De Jonghe S, et al. Molnupiravir inhibits the replication of the emerging SARS-CoV-2 variants of concern (VoCs) in a hamster infection model. The Journal of Infectious Diseases Juily 9, 2021, jiab361, https://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiab361/6318434

Molnupiravir, un espoir contre le delta et l'alpha... chez le hamster.

Molnupiravir, currently in Phase II clinical trials, has worked well in hamsters infected with either Wuhan strain, with the delta or alpha variants.

Dougherty K, Mannell M, Naqvi O, Matson D, Stone J. SARS-CoV-2 B.1.617.2 (Delta) Variant COVID-19 Outbreak Associated with a Gymnastics Facility — Oklahoma, April–May 2021. MMWR Morb Mortal Wkly Rep. ePub: 9 July 2021. https://www.cdc.gov/mmwr/volumes/70/wr/mm7028e2.htm?s_cid=mm7028e2_w

L'épidémie de delta peut indiquer que le retour au gymnase en 2021 n'est probablement pas la meilleure idée. Du 15 avril au 3 mai 2021, 47 cas de COVID-19 (les 21 cas testés étaient delta) étaient liés à une salle de gymnastique. Les taux globaux de diffusion dans des établissements et des familles étaient de 20 % et 53 %, respectivement. Il est à noter que quatre personnes (9 %) avaient reçu 2 doses de Moderna ou de Pfizer-BioNTech ou une dose unique du vaccin Johnson & Johnson ≥ 14 jours avant un résultat de test positif. Plusieurs facteurs de risque potentiels de transmission ont été identifiés, notamment le fait de ne pas utiliser de masques chez les participants actifs, couplé à une respiration accrue pendant la participation sportive active (en outre, la politique de l'établissement était que toutes les personnes ne participant pas activement portent des masques, mais cette politique n'était pas toujours suivie) ; mauvaise ventilation de l'installation.

This delta outbreak may indicate that return to gym in 2021 is probably not the best idea. During April 15–May 3, 2021, 47 COVID-19 cases (all 21 tested cases were delta) were linked to a gymnastics facility. The overall facility and household attack rates were 20% and 53%, respectively. Of note, four persons (9%) had received 2 doses of either the Moderna or Pfizer-BioNTech or a single dose of the Johnson & Johnson vaccine ≥ 14 days before a positive test result. Several potential risk factors for transmission were identified, including not using masks among active participants, coupled with increased respiration during active sport participation (further, facility policy was that all persons not actively participating wear masks, but this policy was not always followed); poor facility ventilation; staff members training multiple cohorts, etc.

11 juillet 2021

Nehme M, Braillard O, Chappuis F, et al. Prevalence of Symptoms More Than Seven Months After Diagnosis of Symptomatic COVID-19 in an Outpatient Setting. Annals Int Med July 6, 2021. https://www.acpjournals.org/doi/10.7326/M21-0878

Des symptômes persistants après infection par le SRAS-CoV-2 sont courants chez les personnes jeunes et en bonne santé suivies en ambulatoire. Sur les 629 participants qui ont honoré les entretiens de base, 410 ont effectué le suivi 7 à 9 mois après le diagnostic de COVID-19 ; 39,0 % ont signalé des symptômes résiduels. La fatigue (20,7 %) était le symptôme le plus fréquemment signalé, suivi de la perte du goût ou de l'odorat (16,8 %) et de la dyspnée (11,7 %).

Residual symptoms after SARS-CoV-2 infection are common among otherwise young and healthy persons followed in an outpatient setting. Of the 629 participants who completed the baseline interviews, 410 completed follow-up at 7 to 9 months after COVID-19 diagnosis; 39.0% reported residual symptoms. Fatigue (20.7%) was the most common symptom reported, followed by loss of taste or smell (16.8%) and dyspnea (11.7%).

Kadri SS, Sun J, Lawandi A, et al. Association Between Caseload Surge and COVID-19 Survival in 558 U.S. Hospitals, March to August 2020. Ann Int Med July 6, 2021. https://www.acpjournals.org/doi/10.7326/M21-1213

USA : près d'un décès sur quatre dus au COVID-19 était potentiellement attribuable à la charge excessive des hôpitaux mis à rude épreuve par l'augmentation du nombre de cas. Le renforcement des mesures préventives et le soutien aux hôpitaux  permettraient de sauver de nombreuses vies.

Nearly 1 in 4 COVID-19 deaths was potentially attributable to hospitals strained by surging caseload. Bolstering preventive measures and supporting surging hospitals will save many lives.

10 juillet 2021

Tarke A, Sidney J, Methot N, et al. Impact of SARS-CoV-2 variants on the total CD4+ and CD8+ T cell reactivity in infected or vaccinated individuals. Cell Rep July 01, 2021. https://www.cell.com/cell-reports-medicine/fulltext/S2666-3791(21)00204-4

Contre les variants, pas seulement l'immunité humorale mais aussi l'immunité cellulaire. Les lymphocytes T reconnaissent les variants : anglais, sud-africain, brésilien, californien.

The SARS-CoV-2 variants B.1.1.7, B.1.351, P.1 and CAL.20C do not significantly disrupt the total SARS-CoV-2 T cell reactivity. T cells of exposed donors or vaccinees effectively recognized SARS-CoV-2 variants.

The WHO Rapid Evidence Appraisal for COVID-19 Therapies (REACT) Working Group. Association Between Administration of IL-6 Antagonists and Mortality Among Patients Hospitalized for COVID-19A Meta-analysis. JAMA July 6, 2021. https://jamanetwork.com/journals/jama/fullarticle/2781880?resultClick=1

Espoir dans les antagonistes de l'interleukine 6.

This prospective meta-analysis of 27 randomized trials included 10,930 patients. The 28-day all-cause mortality was lower among patients who received IL-6 antagonists compared with those who received usual care or placebo (summary odds ratio, 0.86). Administration of IL-6 antagonists was also associated with lower progression to IMV or death, cardiovascular support or death.

Vouga M, Favre G, Martinez-Perez O, et al. Maternal outcomes and risk factors for COVID-19 severity among pregnant women. Sci Rep Jul 6, 2021, 11, 13898. https://www.nature.com/articles/s41598-021-92357-y

Grossesse et covid : une association préoccupante.

In this large study, several risk factors for developing severe complications of SARS-CoV-2 infection among 926 pregnant women were identified including pulmonary co-morbidities, hypertensive disorders and diabetes. Obstetric and neonatal outcomes appear to be influenced by the severity of maternal disease.

Publié dans Covid-19, bibliographie

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