Source : BMJ GH Auteur : Wim Van Damme and al.

ANALYSE

Commentateur

Dr Moitry Marie

Objectifs et Résultats

Un article qui tente de comprendre pourquoi les trajectoires de l’épidémie varient visiblement d’un contexte (pays) à l’autre
  • Il liste les différents facteurs qui pourraient expliquer ces disparités, à la fois liés aux caractéristiques du virus (infectiosité, potentiel mutagène, capacité à survivre en dehors de l’autre…), à l’hôte (susceptibilité au virus, voies de transmission, immunité post infectieuse…), à l’environnement physique (conditions climatiques et atmosphériques…).
  • Il évoque également les effets de l’environnement humain (démographie, conditions socio-économiques conditions d’hygiène, mobilité…), et des comportements : compliance aux mesures collectives (confinement) et individuelles (hygiène des mains, port du masque…).
  • Il rappelle que les effets propres de ces différents facteurs sont difficiles (voire impossible…) à quantifier, au moins pour le moment
  • Enfin, il fait également le point sur les connaissances actuelles sur l’épidémie et ses trajectoires potentielles.

Points intéressants 

  • il rappelle que des pandémies liées à des virus émergeants restent exceptionnelles…. Un effet (entre autres) de la circulation visiblement “continue” du virus quel que soit le contexte ? (Comme le HIV ?)



Source : Medrxiv (PRE-PRINT)

Auteur : Takahashi and al.


ABSTRACT

Vous A growing body of evidence indicates sex differences in the clinical outcomes of coronavirus disease 2019 (COVID-19)1-4. However, whether immune responses against SARS-CoV-2 differ between sexes, and whether such differences explain male susceptibility to COVID-19, is currently unknown. In this study, we examined sex differences in viral loads, SARS-CoV-2-specific antibody titers, plasma cytokines, as well as blood cell phenotyping in COVID-19 patients. By focusing our analysis on patients with mild to moderate disease who had not received immunomodulatory medications, our results revealed that male patients had higher plasma levels of innate immune cytokines and chemokines including IL-8, IL-18, and CCL5, along with more robust induction of non-classical monocytes. In contrast, female patients mounted significantly more robust T cell activation than male patients during SARS-CoV-2 infection, which was sustained in old age. Importantly, we found that a poor T cell response negatively correlated with patients age and was predictive of worse disease outcome in male patients, but not in female patients. Conversely, higher innate immune cytokines in female patients associated with worse disease progression, but not in male patients. These findings reveal a possible explanation underlying observed sex biases in COVID-19, and provide important basis for the development of sex-based approach to the treatment and care of men and women with COVID-19.

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Source : Clinical Infectious Diseases Auteur : Leolin Katsidzira et al

ANALYSE:

Commentateur : Dr David REY.

Voici un article très intéressant sur l’épidémiologie du COVID-19 au Zimbabwe proposé par le Dr David Rey, ses conséquences, et des éléments d’explication de l’impact très faible !

  • à la date du 1er mai 2020 : seulement 34 cas confirmés d’infections à SARS-CoV-2, le plus souvent asymptomatiques ou modérés, et 4 décès ; ce sont tous des cas importés d’Angleterre, des Etats-Unis et de Dubaï, mais aucun de Chine !
  • un confinement a été mis en place (21 jours, étendu avec 14 jours de plus)
  • les conséquences sont les mêmes que dans les pays occidentaux : moyens sanitaires dédiés au COVID, avec une réduction des activités médicales habituelles, et une crainte sur les programmes de lutte contre la tuberculose
  • particularités épidémiologiques expliquant le faible nombre de cas : 1. Le COVID a plutôt touché les communautés riches (voyageant vers l’Europe ou les Etats-Unis) ; 2. 63% des habitants vivent en zone rurale (donc plus de distanciation, et peu d’utilisation des transports en commun) ; 3. Peu de trafic aérien, contrairement à l’Afrique du Sud (pays le plus touché) ; 4. La population est jeune : 89% a moins de 50 ans, et 2,8% plus de 75 ans, par ailleurs les anciens sont très peu en institution.
  • L’infection VIH pourrait malheureusement aggraver la situation du COVID, mais il semble y avoir eu beaucoup de progrès dans la prise en charge des PVVIH (90% connaissent leur statut sérologique, 88% sont sous traitement et 73% en contrôle virologique, donc la crainte de départ n’est pas confirmée.
  • Les conséquences économiques, le dépistage, le « tracing », la protection des soignants, sont discutés.
  • Reste à savoir si les données sont fiables …
Mots-clés : COVID-19, SARS-CoV-2, tuberculose, VIH, Zimbabwe, Afrique sub-Saharienne


Source : The LANCET Auteurs :Lucio Verdoni and al.

ABSTRACT:

The Bergamo province, which is extensively affected by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic, is a natural observatory of virus manifestations in the general population. In the past month we recorded an outbreak of Kawasaki disease; we aimed to evaluate incidence and features of patients with Kawasaki-like disease diagnosed during the SARS-CoV-2 epidemic.


Source : JAMA Internal Medicine Auteurs :Wenhua Liang and al.
“Un article sur la mise au point d’un score de prédiction du risque de formes sévères de COVID-19 (disponible sur internet). Il est intéressant de constater que les auteurs n’ont pas proposé de classement de type bas/moyen/haut risque, considérant que ce niveau de gravité doit être laissé à l’appréciation du médecin, en fonction de l’état clinique du patient bien entendu, mais aussi des ressources matérielles disponibles et de la situation épidémiologique locale.  ” présenté par le Dr Marie MOITRY


Source : BMC Medical Research Methodology

Auteur : Martin Wolkewitz and Livia Puljak


ABSTRACT

On March 11, 2020, the World Health Organization (WHO) declared that COVID-19 can be characterized as a pandemic [1]. The disease is caused by the novel coronavirus SARS-CoV-2, which rapidly overwhelmed the entire world. The virus was first described in China in December 2019, in early January it was already characterized, and already on January 30, 2020, the outbreak was declared a Public Health Emergency of International Concern, which later evolved into a pandemic.


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Source : JAMA Internal Medicine

Auteur : Michael Liu and al.


Research Letter

There are no highly effective prescription drug therapies supported by any reliable evidence for the ongoing coronavirus disease 2019 (COVID-19) pandemic of severe acute respiratory syndrome coronavirus 2. However, fears among the public can lead to searches for unproven therapies. Therefore, when several high-profile figures, including entrepreneur Elon Musk and President Donald Trump, endorsed the use of chloroquine, amalarial prophylaxis drug, and hydroxychloroquine (with the antibiotic azithromycin), a lupus and rheumatoid arthritis treatment, to treat COVID-19, it drew massive public attention that could shape individual decision-making.


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Source : Journal of Clinical Medicine

Auteur : Israel Júnior Borges do Nascimento and al.


ABSTRACT

A growing body of literature on the 2019 novel coronavirus (SARS-CoV-2) is becoming available, but a synthesis of available data has not been conducted. We performed a scoping review of currently available clinical, epidemiological, laboratory, and chest imaging data related to the SARS-CoV-2 infection. We searched MEDLINE, Cochrane CENTRAL, EMBASE, Scopus and LILACS from 01 January 2019 to 24 February 2020. Study selection, data extraction and risk of bias assessment were performed by two independent reviewers. Qualitative synthesis and meta-analysis were conducted using the clinical and laboratory data, and random-effects models were applied to estimate pooled results. A total of 61 studies were included (59,254 patients). The most common disease-related symptoms were fever (82%, 95% confidence interval (CI) 56%–99%; n = 4410), cough (61%, 95% CI 39%–81%; n = 3985), muscle aches and/or fatigue (36%, 95% CI 18%–55%; n = 3778), dyspnea (26%, 95% CI 12%–41%; n = 3700), headache in 12% (95% CI 4%–23%, n = 3598 patients), sore throat in 10% (95% CI 5%–17%, n = 1387) and gastrointestinal symptoms in 9% (95% CI 3%–17%, n=1744). Laboratory findings were described in a lower number of patients and revealed lymphopenia (0.93 × 109 /L, 95% CI 0.83–1.03 × 109 /L, n = 464) and abnormal C-reactive protein (33.72 mg/dL, 95% CI 21.54–45.91 mg/dL; n = 1637). Radiological findings varied, but mostly described ground-glass opacities and consolidation. Data on treatment options were limited. All-cause mortality was 0.3% (95% CI 0.0%–1.0%; n = 53,631). Epidemiological studies showed that mortality was higher in males and elderly patients. The majority of reported clinical symptoms and laboratory findings related to SARS-CoV-2 infection are non-specific. Clinical suspicion, accompanied by a relevant epidemiological history, should be followed by early imaging and virological assay.

Keywords: novel coronavirus; SARS-CoV-2; COVID-19; scoping review; meta-analysis


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Source : Journal of Clinical Medicine

Auteur : Yosra A. Helmy and al.


ABSTRACT

A pneumonia outbreak with unknown etiology was reported in Wuhan, Hubei province, China, in December 2019, associated with the Huanan Seafood Wholesale Market. The causative agent of the outbreak was identified by the WHO as the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), producing the disease named coronavirus disease-2019 (COVID-19). The virus is closely related (96.3%) to bat coronavirus RaTG13, based on phylogenetic analysis. Human-to-human transmission has been confirmed even from asymptomatic carriers. The virus has spread to at least 200 countries, and more than 1,700,000 confirmed cases and 111,600 deaths have been recorded, with massive global increases in the number of cases daily. Therefore, the WHO has declared COVID-19 a pandemic. The disease is characterized by fever, dry cough, and chest pain with pneumonia in severe cases. In the beginning, the world public health authorities tried to eradicate the disease in China through quarantine but are now transitioning to prevention strategies worldwide to delay its spread. To date, there are no available vaccines or specific therapeutic drugs to treat the virus. There are many knowledge gaps about the newly emerged SARS-CoV-2, leading to misinformation. Therefore, in this review, we provide recent information about the COVID-19 pandemic. This review also provides insights for the control of pathogenic infections in humans such as SARS-CoV-2 infection and future spillovers.


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Source : AHA

Auteur : Poissy and al.


ABSTRACT

We report a case-series of COVID-19 patients with pulmonary embolism (PE) in our institution. Lille University Hospital is the tertiary care center for the North-of-France, the 2nd French region in population density (189 p/km2 ), also considered as a “metabolic” area with high number of overweight patients. The study was approved by the Institutional data protection authority of Lille University Hospital.


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