Comparison of SARS-CoV-2 Variants of Concern Alpha (B.1.1.7) vs. Beta (B.1.351) in Critically Ill Patients: A Multicenter Cohort Study.

Objectives: The clinical outcomes of the Beta (B.1.351) variant of concern (VOC) of the SARS-CoV-2 virus remain poorly understood. In early 2021, northeastern France experienced an outbreak of Beta that was not observed elsewhere. This outbreak slightly preceded and then overlapped with a second outbreak of the better understood VOC Alpha (B.1.1.7) in the region. This situation allowed us to contemporaneously compare Alpha and Beta in terms of the characteristics, management, and outcomes of critically ill patients. Methods: A multicenter prospective cohort study was conducted on all consecutive adult patients who had laboratory confirmed SARS CoV-2 infection, underwent variant screening, and were admitted to one of four intensive care units (ICU) for acute respiratory failure between January 9th and May 15th, 2021. Primary outcome was 60-day mortality. Differences between Alpha and Beta in terms of other outcomes, patient variables, management, and vaccination characteristics were also explored by univariate analysis. The factors that associated with 60-day death in Alpha- and Beta-infected patients were examined with logistic regression analysis. Results: In total, 333 patients (median age, 63 years; 68% male) were enrolled. Of these, 174 and 159 had Alpha and Beta, respectively. The two groups did not differ significantly in terms of 60-day mortality (19 vs. 23%), 28-day mortality (17 vs. 20%), need for mechanical ventilation (60 vs. 61%), mechanical ventilation duration (14 vs. 15 days), other management variables, patient demographic variables, comorbidities, or clinical variables on ICU admission. The vast majority of patients were unvaccinated (94%). The remaining 18 patients had received a partial vaccine course and 2 were fully vaccinated. The vaccinated patients were equally likely to have Alpha and Beta. Conclusions: Beta did not differ from Alpha in terms of patient characteristics, management, or outcomes in critically ill patients. Trial Registration: ClinicalTrials.gov, identifier: NCT04906850.

[Hygiene as a weapon in the fight against SARS-Cov-2. All experts in taking care!] / Hygiène en campagne face au Sars-CoV-2 : tous experts du prendre soin.

To combat SARS-Cov-2, hygiene is essential for the safety of caregivers and saves lives. In hospital as well as in everyday social and professional environments, everyone is concerned by hygiene and distancing rules. It is an opportunity for us to reinvent ourselves, protect ourselves and protect the most vulnerable. In hospital, at the heart of the crisis, the action of the infection control team, which includes the infection control nurse, is one of the cornerstones of the fight against COVID-19.

[In-house PCR practical knowledge: a sufficient validation according to NF EN ISO 15189?]. / Bilan d'utilisation d'une PCR « maison ¼ qualitative : une validation acceptable en regard de la norme NF EN ISO 15189 ?

As far as molecular biology is concerned, numerous are laboratories using in-house method. Used since many years, medical biologists have often a good practical knowledge about them. According to ISO 15189 accreditation, is this knowledge sufficient for the validation of these methods? We have asked this question ourselves about our in-house Leishmaniasis PCR.

[High risk of strongyloïdes hyperinfection in a patient with sarcoidosis]. / Risque d'anguillulose maligne chez un patient présentant une sarcoïdose.

Strongyloïdes stercoralis infection is a polymorphic and non specific clinical presentation. Often asymptomatic, it can be not seen. However, in patients with immunodeficiency, high parasite load can be observed, consequence of self-infestation cycle, and can spread throughout the body. This presentation of malignant strongyloidiasis presents a mortality rate of 70%. The case report presents a 45 years old patient of Caribbean origin, long time treated with corticosteroids for sarcoidosis, and hospitalized for Strongyloïdes stercoralis colitis with high parasite load, raising fears an evolution to hyperinfection. His last visit to endemic area was in 2002. In conclusion, the potential severity of strongyloidiasis is strongly increased by immunosuppression, including corticosteroids. This risk should be notified prior to initiation of any treatment with corticosteroids, firstly by looking at a stay in endemic areas. The case of our patient illustrates the fact that a long time between risk of contamination and clinical manifestations is not a sufficient criterion for excluding an asymptomatic chronic infection with Strongyloïdes stercoralis. It is therefore recommended for patients who have lived in endemic areas to search the parasite in stool by a sensitive method.

[Automatic platelets numbering with citrate as anticoagulant: is the result valid?]. / Numération automatique des plaquettes sur citrate de sodium : le résultat est-il exact ?

Platelets count is usually realised on EDTA anticoagulant. This one is sometimes able to generate platelets agregats. That is the reason why the first thing to do encountering thrombopenia is to check for agregats on blood thin smear. In case of positive result, a control can be asked using another anticoagulant. The most used is sodium citrate. A correction has to be applied to the automat result because blood is diluted in anticoagulant. But no one says those haematological automats are exact on citrate as they are on EDTA. That's what we wanted to check.

[Apport de l'immunocapture-Elisa au diagnostic de l'infection à virus grippal A(H1N1)pdm09 : une alternative à la RT-PCR ?] / Apport de l'immunocapture-Elisa au diagnostic de l'infection à virus grippal A(H1N1)pdm09 : une alternative à la RT-PCR ?

AIM OF THE STUDY: To evaluate immunocapture-Elisa (ICE) sensitivity versus RT-PCR in diagnosis of influenza A(H1N1)pdm09 virus infection. METHODS: Sixty-seven RT-PCR-negative and 282 RT-PCR-positive nasopharyngeal swabs collected during winter 2009-2010 have been analyzed using ICE. RESULTS: Among all the samples tested, a sensitivity of 31.3% was found for ICE. The sensitivity of ICE was directly correlated to the virus load determined through the number of cycling reactions necessary to reach detection by RT-PCR. CONCLUSION: ICE can be a suitable method compared to RT-PCR when RT-PCR cannot be used for economical or epidemiological reasons. Its sensitivity is largely dependent of the nasopharyngeal sampling quality.