French Lockdown Research Articles

Household transmission and incidence of positive SARS-CoV-2 RT-PCR in symptomatic healthcare workers, clinical course and outcome: a French hospital experience

ObjectivesAlthough healthcare workers (HCWs) have been particularly affected by SARS-CoV-2, detailed data remain scarce. In this study, we investigated infection rates, clinical characteristics, occupational exposure and household transmission among all...

Increased susceptibility to SARS-CoV-2 infection in patients with reduced left ventricular ejection fraction.

AimsCardiovascular disease has been recognized as a major determinant of coronavirus disease 2019 (COVID‐19) vulnerability and severity. Angiotensin‐converting enzyme (ACE) 2 is a functional receptor for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) and is up‐regulated in patients with heart failure. We sought to examine the potential association between reduced left ventricular ejection fraction (LVEF) and the susceptibility to SARS‐CoV‐2 infection.Methods and resultsOf the 1162 patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention between February 2014 and October 2018, we enrolled 889 patients with available clinical follow‐up data. Follow‐up was conducted by telephone interviews 1 month after the start of the French lockdown which began on 17 March 2020. Patients were divided into two groups according to LVEF <40% (reduced LVEF) (n = 91) or ≥40% (moderately reduced + preserved LVEF) (n = 798). The incidence of COVID‐19‐related hospitalization or death was significantly higher in the reduced LVEF group as compared with the moderately reduced + preserved LVEF group (9% vs. 1%, P < 0.001). No association was found between discontinuation of ACE‐inhibitor or angiotensin‐receptor blockers and COVID‐19 test positivity. By multivariate logistic regression analysis, reduced LVEF was an independent predictor of COVID‐19 hospitalization or death (odds ratio: 6.91, 95% confidence interval: 2.60 to 18.35, P < 0.001).ConclusionsIn a large cohort of patients with previous ACS, reduced LVEF was associated with increased susceptibility to COVID‐19. Aggressive COVID‐19 testing and therapeutic strategies may be considered for patient with impaired heart function.

Long-term effects of treatment for chronic nightmares: is imagery rehearsal therapy robust in the COVID-19 pandemic?

Citation:Sierro C, Leslie W, Putois B. Long-term effects of treatment for chronic nightmares: is imagery rehearsal therapy robust in the COVID-19 pandemic? J Clin Sleep Med. 2020;16(11):1993.

Post lockdown COVID-19 seroprevalence and circulation at the time of delivery, France.

To fight the COVID-19 pandemic, lockdown has been decreed in many countries worldwide. The impact of pregnancy as a severity risk factor is still debated, but strict lockdown measures have been recommended for pregnant women. To evaluate the impact of the COVID-19 pandemic and lockdown on the seroprevalence and circulation of SARS-CoV-2 in a maternity ward in an area that has been significantly affected by the virus. Prospective study at the Antoine Béclère Hospital maternity ward (Paris area, France) from May 4 (one week before the end of lockdown) to May 31, 2020 (three weeks after the end of lockdown). All patients admitted to the delivery room during this period were offered a SARS-CoV-2 serology test as well concomitant SARS-CoV-2 RT-PCR on one nasopharyngeal sample. A total of 249 women were included. Seroprevalence of SARS-CoV-2 was 8%. The RT-PCR positive rate was 0.5%. 47.4% of the SARS-CoV-2-IgG-positive pregnant women never experienced any symptoms. A history of symptoms during the epidemic, such as fever (15.8%), myalgia (36.8%) and anosmia (31.6%), was suggestive of previous infection. Three weeks after the end of French lockdown, SARS-CoV-2 infections were scarce in our region. A very high proportion of SARS-CoV-2-IgG-negative pregnant women, which is comparable to that of the general population, must be taken into consideration in the event of a resurgence of the pandemic. The traces of a past active circulation of the virus in this fragile population during the spring wave should encourage public health authorities to take specific measures for this independent at-risk group, in order to reduce viral circulation in pregnant patients.

1691P Evaluation of practice variation for cancer patients care in a French cancer center during the COVID-19 outbreak

The COVID-19 pandemic rapidly spread in Europe and France. Cancer patients were identified at higher risk of infection and evolution to severe forms, especially those undergoing active treatment. Academic and experts’ recommendations proposed to protect cancer units and prioritize cancer treatment. In the same time, French authorities implemented a national lockdown from march 16, 2020. Most anti-cancer institutions have modified their organization, trying to combine cancer units COVID-free sanctuarization, continuity in priority care and precautionary principle. The impact of COVID-19 outbreak on global cancer care has not been formally evaluated. Data of oncological practice at the Antoine Lacassagne Center (mild-COVID-19 incidence rate area) were recorded (per week) for 3 periods, based on the timing of french lockdown: before (Jan-1 to Mar-15), during (Mar-16 to May-10) and after the end of lockdown (May-11 to Jul-12). We collected the number of chemotherapy and radiotherapy sessions, surgery procedures (senology and gynecology), blood products transfusions, on-site / telemedicine visits and inclusions in clinical trials. Preliminary results compare period 1 (Jan-1 to Mar-15) to interim period 2 (Mar-16 to Apr-19, available data at the time of submission). Variation of practice is detailed in the table. Activities were negatively impacted by the lockdown, mostly reconstructive surgery (-90%), on-site oncology visits (-73%) and clinical research (-69%). In parallel, telemedicine visits were multiplied by 100.Table: 1691PMean number of sessions or procedures (per week)Variation (%)Period 1 (Jan-1 to Mar-15)Period 2 (Mar-16 to Apr-19)Chemotherapy396351-11%Radiotherapy914631-31%Surgery (oncological)2112-43%Surgery (onco-plastic)80.8-90%Blood products transfusions8973-18%Inclusions in clinical trials3511-69%Visits (total)986546-45%On-site visits983233-76%Telemedicine visits3313+10 333% Open table in a new tab . The evaluation of practice variation for cancer care is essential to understand the real impact of COVID-19 outbreak on global cancer management, so as to get prepared to further epidemic waves (for ex. implementation of telehealth innovations) or long-term consequences on cancer outcome.

Impact of COVID-19 lockdown on lifestyle adherence in stay-at-home patients with chronic coronary syndromes: Towards a time bomb

BackgroundWe aimed to evaluate the impact of coronavirus disease 2019 (COVID-19)-related lockdown on adherence to lifestyle and drug regimens in stay-at-home chronic coronary syndromes patients living in urban and rural areas. MethodsA cross-sectional population-based study was perfomed in patients with chronic coronary syndromes. A sample of 205 patients was randomly drawn from the RICO (Observatoire des infarctus de Côte d'Or) cohort. Eight trained interviewers collected data by phone interview during week 16 (April 13 to April 19), i.e. 4 weeks after implementation of the French lockdown (start March 17, 2020). ResultsAmong the 195 patients interviewed (of the 205, 3 had died, 1 declined, 6 lost), mean age was 65.5 ± 11.1 years. Only six patients (3%) reported drug discontinuation, mainly driven by media influence or family members. All 166 (85%) patients taking aspirin continued their prescribed daily intake. Lifestyle rules were less respected since almost half (45%) declared >25% reduction in physical activity, 26% of smokers increased their tobacco consumption by >25%, and 24% of patients increased their body weight > 2 kg. The decrease in physical activity and the increase in smoking were significantly greater in urban patients (P < .05). ConclusionsThe COVID-19-related lockdown had a negative impact on lifestyle in a representative sample of stay-at-home CCS patients.

SARS-CoV2 positive RT-PCR incidence in symptomatic healthcare workers, clinical evolution, outcome and household transmission, experience from a French hospital

Although healthcare workers (HCW) have been particularly affected with the SARS-CoV2 all around the world, detailed data is still rare. Here, we explored rates of infection, clinical characteristics, occupational exposure and household transmission among all symptomatic HCW screened with PCR SARS-CoV2 between March 17th (the beginning French lockdown) and April 20th. This period coincides with the French highest epidemic period. SARS-CoV2 detection by nasopharyngeal swab using RT-PCR assay was proposed to symptomatic (new cough or dyspnea) HCW. Constants were gathered by a trained nurse. The survey together with clinical exam was performed by a physician. All patients with positive PCR were followed by phone call at D5, D7, D10, and D14 after illness onset. Data on occupational profile, living situation, household together with self-isolation and mask use at home were gathered as well as cases in the household. The epidemic curve was compared with the curve in general population during the same period. Factors associated with a positive PCR were explored by univariate and multivariate analyses. The incidence rate of symptomatic SARS-CoV2 was estimated of 5.5% (110/2000). A total of 110 (35%) symptomatic HCW of the 314 were tested positive, of them 9 (8%) were hospitalized. The local epidemic curve was similar with the one in general population with a peak around March 31st. ROC curve AUC was 0.65 for the presence of anosmia at screening, and 70% of positive HCW declared anosmia 7 days after onset versus 45% of HCW positive at screening ( P < 0.001). Factors independently associated in multivariate analysis with a positive PCR were occupational profile with direct patient facing (OR: 3.1 [1.1–8.8], P < 0.03), and presence of anosmia (OR: 5.7 [IC 3.1–10.6], P < 0.0001). Being a current smoker was associated with a negative PCR (0.3 [0.1–0.7], P = 0.005). Transmission from HCW to household members was reported in 9 (14%) cases, and 2 deaths occurred. Overall, self-isolation (a separate room) was possible in 52% of positive HCW and only 31% had the possibility to wear a mask. This is the first French study to report rates of infection in HCW during the peak of the SARS-CoV2 epidemic in France and the lockdown period underlying the risk related to occupational profile. Furthermore, this highlights the risk for HCW to household transmission and the lack of protection in the households during the peak of the epidemic.