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1.
Bulletin ..pid..miologique Hebdomadaire ; 2022.
Article in French | GIM | ID: covidwho-1743817

ABSTRACT

Background - In the context of the global COVID-19 pandemic and the expansion of the more transmissible 20J/501Y.V3 (P1) variant of concern (VOC), mRNA vaccines were made available in French Guiana, an overseas French territory in South America, from mid-January 2021. This study aimes to estimate the willingness to be vaccinated and the socio-demographic and motivational correlates among Health Care Workers (HCWs) in French Guiana. Methods - A cross-sectional survey was conducted from January 22 to March 26, 2021, among a sample of HCWs in French Guiana based on an anonymous online questionnaire. Results - A total of 579 HCWs were interviewed, including 220 physicians and 200 nurses most often working in hospital (54%) or in the liberal sector (22%). Overall, 65.6% of respondents reported that they were willing to be or had already been vaccinated against COVID-19, while 24.3% of respondents reported that they did not want to get vaccinated against COVID-19 and 11.2% were unsure. In multivariate analysis, factors associated with vaccination willingness were older age, level of concern about COVID-19, confidence in vaccine information, and having been vaccinated against influenza in the previous year. Conversely, reluctance to certain vaccinations in general (adjusted OR=0.23, CI95%: [0.13-0.41]) and being from the West Indies or French Guiana (aOR=0.39 [0.21-0.73]) were associated with greater vaccine distrust. Conclusion - Negative opinions and attitudes toward vaccines are a major public health concern among HCWs in French Guiana when considering the current active epidemic with P1 VOC. Territorial specificities, general vaccine hesitancy and concerns about future side effects in particular represent important barriers and/or issues. Low confidence in government and science are important for COVID-19 vaccine refusal among non-medical staff. Public health messages with information on vaccine safety should be tailored to address these concerns.

2.
Allergy: European Journal of Allergy and Clinical Immunology ; 76(SUPPL 110):649-650, 2021.
Article in English | EMBASE | ID: covidwho-1570431

ABSTRACT

Background: It is well accepted that specific micronutrients can enhance the immune response to improve resistance to viral respiratory tract infections (RTIs), such as COVID-19. The primary objective of this systematic review was to evaluate the evidence for primary prevention of any respiratory viral infection through supplementation with nutrients that already have a recognized role in immune function. Method: We conducted a systematic search in EMBASE, AMED, CAB International, MEDLINE, Scopus, and ISI Web of Science papers, published from the inception of these respective databases until 10th of April 2020. Our primary outcome was the incidence of RTIs with (potential) viral origins in subjects without increased risk of RTIs. Results: The search produced 15,163 records of which 93 papers (based on 115 studies) met the criteria to be included in the review. These studies included 199,055 study participants (191,636 children and 7,419 adults) in 37 countries around the world on supplementation with multiple micronutrients, vitamin A, folic acid, vitamin B12, C, D, E, beta-carotene, zinc, iron and long-chain polyunsaturated fatty acids. The overall ROB across all studies was moderate. Sixty-three studies were included in the meta-analyses, which was performed for children and adults separately. Supplementation with zinc in children showed a non-significant decreased risk of incidence of RTI (RR 0.91, 95%CI 0.82-1.01, I2 = 83.70% p = 0.000.) By stratifying the meta-analysis by regions of the world, only studies performed in Asia showed a significant (RR 0.86, 95%CI 0.7-0.96, I2 = 79.1%, p = 0.000) protective effect of zinc supplementation on RTI. Vitamin D supplementation in adults showed a significant decreased incidence of RTI (RR 0.89, 95%CI 0.79-0.99, I2 = 20.7%), p = 0.272). However, when subdivided by world regions, studies performed in North America showed a significant effect (RR 0.82 95%CI 0.68-0.97), but not those from Europe (RR 1.02, 95%CI 0.60-1.44) or Oceania (RR 0.97, (95%CI 0.84-1.10). Conclusion: Based on the systematic review and meta-analyses, supplementation of vitamins, multiple nutrients or fatty acids in the general population has no, or at least very limited, effect in the prevention of respiratory infections, such as COVID-19. However, there was some evidence that zinc supplementation among children in Asia, and vitamin D among adults in the USA and Canada might potentially confer protection.

3.
Allergy: European Journal of Allergy and Clinical Immunology ; 76(SUPPL 110):468-469, 2021.
Article in English | EMBASE | ID: covidwho-1570395

ABSTRACT

In 2012 a 25-year-old man presented to our outpatient clinic for severe atopic dermatitis (AD) and severe allergic eosinophilic asthma in polisensitivity (house dust mite, cat, gramineous plants, birch, milk protein and, in particular, Alternaria). His clinical history was also characterized by gastro-esophageal reflux disease and chronic rhinitis without polyposis, with septal deviation and turbinate hypertrophy, worthy of surgical intervention. History taking revealed egg and cow milk protein allergy and severe asthma since the first months of life, with frequent hospital admissions due to exacerbations. AD was severe and diffuse, involving especially face, neck, back and superior limbs, often complicated by impetigo. The esthetic, social and psychological impact led him to quit his job as a barman. At presentation, the Eczema Area and Severity Index (EASI) score was 72/72. Laboratory tests showed eosinophilic count ranging between 1.060 and 2.140/mm3, and high serum levels of total Immunoglobulin E (5.939 kUI/L). Tryptase levels were normal and autoantibody analysis was negative. Parasite stool examination was negative. Nasal swab tested positive for Staphylococcus aureus, which was treated with Sulfamethoxazole-Trimethoprim. Asthma Control Test was 15/25, pulmonary function tests (PFTs) showed mild obstruction (FEV1 4.43 L, 103%, FEV1/FVC 69%), with positive bronchodilator testing (FEV1 5.12 L, + 670 mL, + 16%). Firstly, he was treated with topical steroids and sometimes with oral corticosteroids, with poor response. Then, in July 2019, he initiated therapy with cyclosporine 3-5 mg/kg. Soon, the drug had to be discontinued due to adverse effects (gastrointestinal symptoms and infections). In November 2019, at the age of 32 years, he started therapy with monoclonal antibody anti-IL-5 receptor alpha (benralizumab 30 mg 1 subcutaneous vial every 4 weeks for the first three administrations and then every 8 weeks), with a terrific clinical improvement of AD since the first administrations and with benefit on asthma control (ACT after the first administration increased up to 25/25;PFTs could not be performed, due to SARS-CoV-2 pandemic). This therapy has always been well tolerated. The eosinophilic count decreased to 0/mm3 after the first administration. At the moment, after one year of therapy, AD is almost fully disappeared (EASI SCORE 4/72), despite being in free diet, and the quality of life of the patient has definitely improved.

4.
Allergy: European Journal of Allergy and Clinical Immunology ; 76(SUPPL 110):480, 2021.
Article in English | EMBASE | ID: covidwho-1570384

ABSTRACT

Background: During the ongoing pandemic of Coronavirus Disease 2019 (COVID-19) allergic patients need to continue their constant and proper treatment, including allergen-specific immunotherapy. These patients are expected to be at a higher risk for exacerbation of lung inflammation during viral infection. We investigated the putative interplay existing between allergen-specific immunotherapy and COVID-19 infection in Hymenoptera venom-allergic population. Method: We evaluated the frequency and severity of COVID-19 infection in a cohort of 211 Hymenoptera venom-allergic patients referring to our Center from the end of February till May 20th 2020 for the regular administration of venom immunotherapy (VIT). Each patient completed a form with information regarding symptoms (fever, cough, dyspnoea, sore throat, anosmia and/or ageusia) and eventual close COVID-19 contacts in the previous 14 days. Results: Our result showed that the median age of our cohort is similar to the one that in our region has been associated with a high incidence of COVID-19 infection, increased hospitalization and mortality rates. We reported only an isolated positivity of COVID-19 in the overall group, whereas none suffered from upper airway symptoms associated with COVID-19 (fever, cough, dyspnoea, sore throat, anosmia and/or ageusia). In our cohort 24 patients were in monotherapy with ACE-i, but none of these patients developed COVID-19 disease. In our cohort the median serum tryptase level at baseline was 8.13 ± 11.49: no correlations were found between tryptase levels and COVID-19 infection. Conclusion: Even though the demographic characteristics pose a substantial risk for such a population, we suggest that a regular administration of VIT may help to the development of an immunological milieu able to down modulate the Th1/Th17 environment that has been linked to inflammatory manifestations of COVID-19. To the best of our knowledge, this is the first description of the incidence of COVID-19 infection in Hymenoptera venom allergic patients treated with VIT, suggesting indirectly that venom immune tolerance-inducing treatment may be capable of reducing the aberrant inflammatory response induced by the virus in this specific population. (Table Presented).

5.
Infectious Diseases Now ; 51(5, Supplement):S65, 2021.
Article in French | ScienceDirect | ID: covidwho-1336495

ABSTRACT

Introduction La Guyane française a fait face à une première vague significative l’été 2020, quelques mois après la métropole. L’étude EpiCovid a révélé que 25 % des guyanais avaient été touchés par le COVID. Les soignants, comme ailleurs, ont fait partie des populations significativement impactées par l’épidémie. Après l’autorisation du vaccin à ARNm Comirnaty® par l’Agence européenne du médicament fin décembre, la métropole a commencé à vacciner dans les EHPAD. L’arrivée des vaccins a été retardée de 15 jours en Guyane du fait de l’attente de l’arrivée d’un congélateur à −80°C à l’hôpital de Cayenne. Dès le début de la campagne vaccinale dans les EHPAD et auprès des soignants, des réticences vis-à-vis du vaccin ont été exprimées. La vaccination était accessible à tous les soignants de plus de 50 ans ou avec comorbidités au moment de l’enquête. Dans le contexte de l’émergence du variant 20J/501Y.V3 en Amérique du Sud, une meilleure compréhension des attitudes et de l’intention vaccinale des professionnels de santé de ce territoire particulier est susceptible d’aider à l’ajustement de la campagne. Matériels et méthodes Une enquête épidémiologique transversale a été mis en place en février et mars 2021 à destination de l’ensembles des soignants de Guyane à l’aide d’un questionnaire en ligne sur le site wepi.org, diffusé par mailing larges en partenariat avec les structures de santé du territoire, les URPS et les ordres médecins et infirmiers, la lettre de l’ARS, les groupes What'sApp de professionnels, sous forme de QR code affichés et sur les fonds d’écran des ordinateurs professionnels et sur support papier dans les services du CH de Cayenne et les 17 centres délocalisés de prévention et de soins (CDPS) des communes de l’intérieur. Résultats Au total, 578 professionnels de santé ont répondu à l’enquête, dont 42 % de médecins ou sage femmes, 37 % d’infirmiers et 20 % d’autres professionnels de santé. Les médecins et les infirmiers exerçaient en libéral (30 % et 23 %), en milieu hospitalier (48 % et 51 %) et en CDPS (10 % et 18 %, respectivement). Dans l’ensemble, 91 % des soignants interrogés se déclaraient favorables aux vaccinations en général, mais 26 % défavorables à certains vaccins. Concernant la vaccination contre le COVID-19, 65 % étaient déjà vaccinés ou envisageaient probablement de se faire vacciner, 11 % étaient indécis et 24 % déclaraient ne pas vouloir se faire vacciner. L’intention vaccinale était plus élevée parmi les médecins (87 %) que parmi les infirmiers et les autres professions de santé (50 % et 46 %, p<0,001). Le refus du vaccin n’était pas différent selon le mode d’exercice, libéral ou hospitalier. L’opposition au vaccin était plus fréquente parmi les femmes (30 %), les moins de 35 ans (37 %) et parmi les professionnels de santé originaires de Guyane et des Antilles françaises (48 %). Ces facteurs restaient associés en analyse multivariée par régression logistique. À l’inverse, parmi les professionnels originaires de métropole ou de l’étranger, elle n’était pas différente en fonction de l’ancienneté d’arrivée en Guyane (qui était en médiane de 8 ans, IIQ [19–2]). Elle ne variait pas non plus en fonction du lieu d’exercice. Conclusion Les intentions vaccinales des professionnels de santé de Guyane française dans la période initiale de mise à disposition des vaccins sont assez contrastées, avec près d’un soignant sur quatre ne souhaitant pas se faire vacciner.

6.
Pharmaceuticals ; 14(4):06, 2021.
Article in English | MEDLINE | ID: covidwho-1210243

ABSTRACT

The Coronavirus Disease-19 (COVID-19) pandemic has caused more than 100,000,000 cases of coronavirus infection in the world in just a year, of which there were 2 million deaths. Its clinical picture is characterized by pulmonary involvement that culminates, in the most severe cases, in acute respiratory distress syndrome (ARDS). However, COVID-19 affects other organs and systems, including cardiovascular, urinary, gastrointestinal, and nervous systems. Currently, unique-drug therapy is not supported by international guidelines. In this context, it is important to resort to adjuvant therapies in combination with traditional pharmacological treatments. Among natural bioactive compounds, palmitoylethanolamide (PEA) seems to have potentially beneficial effects. In fact, the Food and Drug Administration (FDA) authorized an ongoing clinical trial with ultramicronized (um)-PEA as an add-on therapy in the treatment of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection. In support of this hypothesis, in vitro and in vivo studies have highlighted the immunomodulatory, anti-inflammatory, neuroprotective and pain-relieving effects of PEA, especially in its um form. The purpose of this review is to highlight the potential use of um-PEA as an adjuvant treatment in SARS-CoV-2 infection.

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