ABSTRACT
La crise sanitaire de la Covid-19 du printemps 2020 a peu touché les enfants avec peu d'hospitalisations dans les hôpitaux pédiatriques. Le défi a été d'apporter une aide aux hôpitaux adultes avec un personnel principalement formé à la pédiatrie tout en maintenant la permanence des soins urgents pour les enfants atteints ou non de la Covid-19. À l'hôpital universitaire Armand-Trousseau, nous avons créé des unités dédiées pour les enfants atteints de la Covid-19, identifié les spécificités des enfants atteints de la Covid-19 et notamment les formes de Kawasaki like ou PIMS (paediatric multisystem inflammatory syndrome), créé une unité de réanimation adulte au pic de l'épidémie pour augmenter les capacités en lits de réanimation dans notre région, mutualisé notre centre de dépistage pour le personnel d'hôpitaux adultes. Enfin, nous avons envoyé plus de 140 personnels médicaux et paramédicaux dans les hôpitaux adultes de notre groupe hospitalier. Cette aide a pu être organisée grâce aux liens étroits établis par des cellules de crises communes avec les hôpitaux adultes de notre groupe hospitalier. Nous rapportons ainsi un retour d'expérience d'un hôpital pédiatrique au cours de la crise de la Covid-19 en Île-de-France.Alternate : Children were relatively spared by the COVID-19 health crisis during spring 2020, with few hospitalizations in pediatric hospitals. For that reason, one of themain challenges for pediatric hospitals was to provide staff support to adult hospitals with health workers mainly trained in pediatrics. In our hospital, we created dedicated units for children with COVID-19, identified the specificities of children with COVID-19 and more specifically of children with "Kawasaki like” or PIMS-TS (Pediatric Multisystem Inflammatory Syndrome temporally associated with COVID-19), created an adult intensive care unit at the peak of the outbreak to increase adult resuscitation capacity in our region and pooled our staff screening center with the other adult hospitals. Finally, we have sent more than 140 health workers to other adult hospitals. This support was provided thanks to the close links established between our pediatric hospital crisis unit and those from the other adult hospitals included in our Hospital Group. We report here a feedback from a pediatric hospital during the COVID-19 crisis in the region of Ile-de-France.
ABSTRACT
Introduction: One of the major challenges of the SARS-CoV2 pandemic is to identify people most at risk of developing severe COVID-19. Patients with cystic fibrosis (CF) and COPD are at higher risk as alteration of their bronchial epithelium is a major target of SARS-CoV2 in triggering excessive inflammation. Aims and objectives: We aim to know whether the pathophysiological status of bronchial epithelium from CF and COPD patients could lead to specific responses to SARS-CoV2 infection. Method(s): Differentiated bronchial epithelium from controls, CF and COPD patients (N=4/group) were infected with SARS-CoV2 (24, 48 and 72h) as we previously described (Pizzorno, A. et al. Cell Rep Med, 2020). We compared its effect on epithelial integrity (transepithelial resistance), global gene expression (RNA sequencing) and inflammation (multiplex analysis). Result(s): SARS-CoV2 induces a stronger impairment of bronchial epithelial integrity and a greater number of deregulated genes in controls, compared to CF or COPD subjects. We identified specific transcriptomic signatures for each group, further characterized using in silico functional enrichment approaches. Although the magnitude of the responses differed, we identified common genes induced 72h post infection, including SOCS1, ZBP1 and CXCL10 (IP-10). Differential induction of CXCL10 was further validated at the protein level. Conclusion(s): We defined a common core signature of the bronchial epithelium response to SARS-CoV2, as well as specific differences according to the pathological context. This study may allow a better understanding of the underlying mechanisms related to COVID-19 severity and for identifying potential markers of interest.
ABSTRACT
Children were relatively spared by the COVID-19 health crisis during spring 2020, with few hospitalizations in pediatric hospitals. For that reason, one of the main challenges for pediatric hospitals was to provide staff support to adult hospitals with health workers mainly trained in pediatrics. In our hospital, we created dedicated units for children with COVID-19, identified the specificities of children with COVID-19 and more specifically of children with "Kawasaki like" or PIMS-TS (Pediatric Multisystem Inflammatory Syndrome temporally associated with COVID-19), created an adult intensive care unit at the peak of the outbreak to increase adult resuscitation capacity in our region and pooled our staff screening center with the other adult hospitals. Finally, we have sent more than 140 health workers to other adult hospitals. This support was provided thanks to the close links established between our pediatric hospital crisis unit and those from the other adult hospitals included in our Hospital Group. We report here a feedback from a pediatric hospital during the COVID-19 crisis in the region of Ile-de-France. Copyright © SFMU et Lavoisier SAS 2020
ABSTRACT
Objectives: As the novel coronavirus (SARS-CoV-2) pandemic continues, people with cystic fibrosis (CF) have been identified as being a vulnerable group. It is essential that people with CF, their families and their clinical teams have the most up-to-date information on the impact of SARS-CoV-2 on their health. This study aims to characterise the impact of SARS-CoV-2 infection in people with CF throughout 2020, identify factors that predict clinical progression of COVID-19, and to describe medium-term follow-up of people who have been infected. Methods: The ‘Cystic Fibrosis Registry Global Harmonization Group’ is a worldwide network of CF Registries that each contributed data on people with CF diagnosed with SARS-CoV-2 infection. In this analysis, we will report on cases contributed from 22 countries diagnosed between 1st February and 13th December 2020. We will present demographic, pre-infection clinical characteristics, symptoms, infection management and outcomes. We will use multivariable logistic regression to assess predictors for hospitalisation with respiratory support and intensive care admission as the outcomes of interest representing clinical progression of COVID-19. Descriptive analysis of medium-term follow-up BMI and FEV1% predicted values will also be undertaken. Results: Results pending. Expected cohort size >1,000, including the 181 previously reported in our paper “The global impact of SARS-CoV-2 in 181 people with cystic fibrosis.” Conclusion: It is expected that the findings of this study will have important implications for shielding advice, clinical care and vaccine prioritisation for people with CF.