Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 2 de 2
Cytometry A ; 99(5): 435-445, 2021 05.
Article in English | MEDLINE | ID: covidwho-1046850


The identification of a bacterial, viral, or even noninfectious cause is essential in the management of febrile syndrome in the emergency department (ED), especially in epidemic contexts such as flu or CoVID-19. The aim was to assess discriminative performances of two biomarkers, CD64 on neutrophils (nCD64) and CD169 on monocytes (mCD169), using a new flow cytometry procedure, in patients presenting with fever to the ED during epidemics. Eighty five adult patients presenting with potential infection were included during the 2019 flu season in the ED of La Timone Hospital. They were divided into four diagnostic outcomes according to their clinical records: no-infection, bacterial infection, viral infection and co-infection. Seventy six patients with confirmed SARS-CoV-2 infection were also compared to 48 healthy volunteers. For the first cohort, 38 (45%) patients were diagnosed with bacterial infections, 11 (13%) with viral infections and 29 (34%) with co-infections. mCD169 was elevated in patients with viral infections, with a majority of Flu A virus or Respiratory Syncytial Virus, while nCD64 was elevated in subjects with bacterial infections, with a majority of Streptococcus pneumoniae and Escherichia coli. nCD64 and mCD169 showed 90% and 80% sensitivity, and 78% and 91% specificity, respectively, for identifying patients with bacterial or viral infections. When studied in a second cohort, mCD169 was elevated in 95% of patients with SARS-CoV-2 infections and remained at normal level in 100% of healthy volunteers. nCD64 and mCD169 have potential for accurately distinguishing bacterial and acute viral infections. Combined in an easy and rapid flow cytometry procedure, they constitute a potential improvement for infection management in the ED, and could even help for triage of patients during emerging epidemics.

Bacterial Infections/diagnosis , COVID-19/diagnosis , Emergency Service, Hospital , Flow Cytometry , Monocytes/immunology , Receptors, IgG/blood , Sialic Acid Binding Ig-like Lectin 1/blood , Adult , Aged , Bacterial Infections/blood , Bacterial Infections/immunology , Bacterial Infections/microbiology , Biomarkers/blood , COVID-19/blood , COVID-19/immunology , COVID-19/virology , Diagnosis, Differential , Female , Host-Pathogen Interactions , Humans , Male , Middle Aged , Monocytes/microbiology , Monocytes/virology , Predictive Value of Tests , Prospective Studies , Reproducibility of Results
Schizophr Bull ; 47(3): 624-634, 2021 04 29.
Article in English | MEDLINE | ID: covidwho-889592


Patients with schizophrenia (SCZ) represent a vulnerable population who have been understudied in COVID-19 research. We aimed to establish whether health outcomes and care differed between patients with SCZ and patients without a diagnosis of severe mental illness. We conducted a population-based cohort study of all patients with identified COVID-19 and respiratory symptoms who were hospitalized in France between February and June 2020. Cases were patients who had a diagnosis of SCZ. Controls were patients who did not have a diagnosis of severe mental illness. The outcomes were in-hospital mortality and intensive care unit (ICU) admission. A total of 50 750 patients were included, of whom 823 were SCZ patients (1.6%). The SCZ patients had an increased in-hospital mortality (25.6% vs 21.7%; adjusted OR 1.30 [95% CI, 1.08-1.56], P = .0093) and a decreased ICU admission rate (23.7% vs 28.4%; adjusted OR, 0.75 [95% CI, 0.62-0.91], P = .0062) compared with controls. Significant interactions between SCZ and age for mortality and ICU admission were observed (P = .0006 and P < .0001). SCZ patients between 65 and 80 years had a significantly higher risk of death than controls of the same age (+7.89%). SCZ patients younger than 55 years had more ICU admissions (+13.93%) and SCZ patients between 65 and 80 years and older than 80 years had less ICU admissions than controls of the same age (-15.44% and -5.93%, respectively). Our findings report the existence of disparities in health and health care between SCZ patients and patients without a diagnosis of severe mental illness. These disparities differed according to the age and clinical profile of SCZ patients, suggesting the importance of personalized COVID-19 clinical management and health care strategies before, during, and after hospitalization for reducing health disparities in this vulnerable population.

COVID-19/epidemiology , COVID-19/therapy , Healthcare Disparities/statistics & numerical data , Hospital Mortality , Intensive Care Units/statistics & numerical data , Patient Admission/statistics & numerical data , Schizophrenia/epidemiology , Schizophrenia/therapy , Adult , Aged , Aged, 80 and over , COVID-19/mortality , Cohort Studies , Critical Care , Female , France/epidemiology , Humans , Male , Middle Aged