ABSTRACT
Résumé Les Centres hospitaliers universitaires (CHU) ont une triple mission de soins, d'enseignement et de recherche. Cette dernière a une place prépondérante car elle permet d'offrir aux malades des soins de pointe adaptés à toutes les pathologies, et elle est la garantie d'une formation de haut niveau pour les futurs médecins et personnels soignants. L'évolution des bases scientifiques, technologiques, sociales, culturelles de la médecine justifient une refondation de la médecine universitaire dont la crise de la Covid-19 a révélé le besoin. Force est de constater que l'évolution des CHU s'est progressivement éloignée des principes fondateurs qui avaient montré leur efficacité en offrant aux malades une médecine de haut niveau. Face à ce constat, un colloque a réuni plus de cent personnalités du monde scientifique, économique et politique, des représentants des ministères, des parlementaires, avec pour objectifs de : faire un état des lieux de la recherche et de l'innovation en santé ;produire des recommandations sur la nécessaire refondation des CHU et leur place dans une organisation simplifiée de la recherche en biologie-santé ;et identifier les points qui devront faire l'objet d'une réflexion approfondie. Summary The University-hospitals have a triple mission of care, teaching and research. The latter has a preponderant place because it makes it possible to offer patients advanced care adapted to all diseases, and it is the guarantee of high-level training for future physicians and nursing staff. The evolution of the scientific, technological, social and cultural bases of medicine justify an overhaul of university medicine for which the Covid-19 crisis has revealed the need. Indeed, the evolution of the university-hospitals has gradually moved away from the founding principles that had shown their effectiveness by offering patients high-level care. Faced with this observation, a symposium brought together more than a hundred of decision makers from the scientific, economic and political world, representatives of ministries and members of the Parliament. The objectives of the symposium included making a state of research and innovation in health;producing recommendations on the necessary overhaul of university hospitals and their place in a simplified organization of research in biology and health;and identifying the points that will need in-depth analyses.
ABSTRACT
Individuals with pre-existing chronic systemic low-grade inflammation are prone to develop severe COVID-19 and stronger anti-SARS-CoV-2 antibody responses. Whether this phenomenon reflects a differential expansion of antiviral B cells or a failure to regulate antibody synthesis remains unknown. Here, we compared the antiviral B cell repertoire of convalescent healthcare personnel to that of hospitalized patients with pre-existing comorbidities. Out of 277,500 immortalized B cell clones, antiviral B cell frequencies were determined by indirect immunofluorescence screening on SARS-CoV-2 infected cells. Surprisingly, frequencies of SARS-CoV-2 specific clones from the two groups were not statistically different, despite higher antibody levels in hospitalized patients. Moreover, functional analyses revealed that several B cell clones from healthcare personnel with low antibody levels had neutralizing properties. This study reveals for the first time a key qualitative defect of antibody synthesis in severe patients and calls for caution regarding estimated protective immunity based only on circulating antiviral antibodies.