Publications by authors named "Denis Malvy"

Background: The Bari-SolidAct randomized controlled trial compared baricitinib with placebo in patients with severe COVID-19. A post hoc analysis revealed a higher incidence of serious adverse events (SAEs) among SARS-CoV-2-vaccinated participants who had received baricitinib. This sub-study aimed to investigate whether vaccination influences the safety profile of baricitinib in patients with severe COVID-19.

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West Nile Virus (WNV) and Usutu virus (USUV) circulate through complex cryptic transmission cycles involving mosquitoes as vectors, birds as amplifying hosts and several mammal species as dead-end hosts. Both viruses can be transmitted to humans through mosquito bites, which can lead to neuroinvasive and potentially fatal disease. Notably, WNV can also be transmitted through blood donations and organ transplants.

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Background: Data on the presentation, management, and outcomes of Lassa fever (LF) in children are limited.

Methods: Description of the clinical and biological features, treatment, and outcomes of reverse transcriptase and polymerase chain reaction (RT-PCR)-confirmed LF in children aged under 15, enrolled in the LASsa fever clinical COurse and Prognostic factors in an Epidemic context (LASCOPE) prospective cohort study in Nigeria between April 2018 and February 2023.

Results: One hundred twenty-four children (aged under 12 months: 19; over 12 months: 105) were hospitalized with RT-PCR-confirmed LF.

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  • Dengue poses a significant health risk to international travelers, with 5,958 cases reported from 2007 to 2022 at GeoSentinel sites, where 81.6% were confirmed cases.
  • The study revealed that the median age of affected travelers was 33 years, with the majority traveling for tourism and acquiring the virus primarily in South East Asia.
  • Complicated cases of dengue were rare, with only 1.6% of travelers experiencing complications; however, there is a crucial need for awareness and preventive measures among travelers heading to endemic areas.
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Background: Thrombo-inflammation and neutrophil extracellular traps (NETs) are exacerbated in severe cases of COVID-19, potentially contributing to disease exacerbation. However, the mechanisms underpinning this dysregulation remain elusive. We hypothesised that lower DNase activity may be associated with higher NETosis and clinical worsening in patients with COVID-19.

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Background: Prolonged diarrhoea is common amongst returning travellers and is often caused by intestinal protozoa. However, the epidemiology of travel-associated illness caused by protozoal pathogens is not well described.

Methods: We analysed records of returning international travellers with illness caused by Giardia duodenalis, Cryptosporidium spp.

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  • Schistosomiasis is affecting more people in France, particularly children, due to cases acquired from endemic areas, leading to potential outbreaks.
  • A study collected data from 122 pediatric patients treated for urinary schistosomiasis between 2013 and 2019, revealing common symptoms like hematuria and complications, including chronic kidney disease.
  • The majority of patients responded well to treatment with praziquantel, highlighting the need for better awareness and systematic screening for schistosomiasis among practitioners, especially in non-endemic regions.
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In September 2023, a severe outbreak of type B botulism with fifteen cases was linked to consumption of canned sardines at a restaurant in Bordeaux, France, during the Rugby World Cup. The cases were from seven countries. One death was recorded.

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Background: Since 2021, 3 variants of concern (VOC) have spread to France, causing successive epidemic waves.

Objectives: To describe the features of Alpha, Delta and Omicron VOC circulation in the Nouvelle-Aquitaine region, France, between February 2021 and February 2022.

Study Design: Data from the three university hospitals (UH) of Nouvelle-Aquitaine were used to describe regional SARS-CoV-2 circulation (RT-PCR positive rates and identified VOC) as well as its consequences (total number of hospitalizations and admissions in intensive care unit).

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  • Researchers tested a cream containing paromomycin (with or without gentamicin) on travelers with cutaneous leishmaniasis (CL), achieving cure rates of 75-82%, comparable to clinical trials.
  • Two groups were studied: one treated under supervision (Group 1) and another using a locally produced paromomycin-only cream (Group 2), both showing similar medical outcomes despite some differences in cure rates.
  • Adverse effects were mostly mild, with common issues being itching and pain, and no serious complications or mucosal involvement occurred throughout the study.
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Patient experiences and perspectives on trial participation and follow-up may influence their compliance with research procedures or negatively impact their well-being. We aimed to explore the acceptability and feasibility of home-based and hospital-based follow-up modalities among COVID-19 patients enrolled in the ANTICOV ANRS COV33 Coverage-Africa trial in Burkina Faso and Guinea. The trial (2021-2022) evaluated the efficacy of treatments to prevent clinical worsening among COVID-19 patients with mild to moderate symptoms.

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  • Earlier research indicated distinct blood changes in African patients with schistosomiasis, suggesting that full blood counts (FBC) could aid in diagnosing the disease in travelers and migrants.
  • A study reviewed patient records from seven travel clinics in Europe, analyzing FBC data of 382 subjects, focusing on changes among returned travelers and migrants.
  • The findings revealed significant decreases in various blood cell counts for returned travelers, particularly in females, and although migrants had somewhat similar profiles, they exhibited notably lower platelet and white blood cell counts; thus, FBC is not reliable for diagnosing schistosomiasis.
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Objectives: To explore communities' perceptions about COVID-19 in the context of the ANRS COV33 Coverage-Africa clinical trial evaluating the efficacy of treatments in preventing clinical worsening of COVID-19.

Design: Descriptive qualitative study using semistructured in-depth individual interviews conducted by telephone in French and Soussou between May and September 2021. Data were transcribed, translated in French when applicable and analysed with the thematic analysis method.

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Background: The emergency set-up and implementation of outpatient clinical trials on epidemic emerging infectious diseases such as COVID-19 raise many issues in terms of research structuration, regulations, and health systems organization. We aimed to describe the experience and points of view of different stakeholders involved in a French home-based outpatient trial on COVID-19 and to identify the early barriers and facilitators to the trial implementation.

Methods: We conducted a mixed-methods study in July 2020.

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Background: Viral hemorrhagic fevers (VHFs) are a group of diseases, which can be endemo-epidemic in some areas of the world. Most of them are characterized by outbreaks, which occur irregularly and are hard to predict. Innovative medical countermeasures are to be evaluated but due to the field specificities of emerging VHF, challenges arise when implementing clinical studies.

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Background: As mortality remains high for patients with Ebola virus disease (EVD) despite new treatment options, the ability to level up the provided supportive care and to predict the risk of death is of major importance. This analysis of the EVISTA cohort aims to describe advanced supportive care provided to EVD patients in the Democratic Republic of the Congo (DRC) and to develop a simple risk score for predicting in-hospital death, called PREDS.

Methods: In this prospective cohort (NCT04815175), patients were recruited during the 10 EVD outbreak in the DRC across three Ebola Treatment Centers (ETCs).

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  • The COVID-19 pandemic highlights the importance of testing drugs in large animal models to ensure effective clinical applications after in vitro results.
  • This study investigates favipiravir, a drug shown to work against RNA viruses, and its effects on Zika and SARS-CoV-2 in cynomolgus macaques.
  • The findings indicate that favipiravir effectively reduces Zika viral load but has no beneficial effect on SARS-CoV-2, with some treated animals experiencing worsening conditions.
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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections initiate in the bronchi of the upper respiratory tract and are able to disseminate to the lower respiratory tract, where infections can cause an acute respiratory distress syndrome with a high degree of mortality in elderly patients. We used reconstituted primary bronchial epithelia from adult and child donors to follow the SARS-CoV-2 infection dynamics. We show that, in epithelia from adult donors, infections initiate in multiciliated cells and spread within 24 to 48 h throughout the whole epithelia.

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Introduction: Coronavirus disease 2019 (COVID-19) can cause life-threatening acute respiratory distress syndrome (ARDS). Recent data suggest a role for neutrophil extracellular traps (NETs) in COVID-19-related lung damage partly due to microthrombus formation. Besides, pulmonary embolism (PE) is frequent in severe COVID-19 patients, suggesting that immunothrombosis could also be responsible for increased PE occurrence in these patients.

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Ribavirin is currently the standard of care for treating Lassa fever. However, the human clinical trial data supporting its use suffer from several serious flaws that render the results and conclusions unreliable. We performed a systematic review of available pre-clinical data and human pharmacokinetic data on ribavirin in Lassa.

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  • A study was conducted in two nursing homes in southwestern France to investigate COVID-19 breakthrough infections among residents who were mostly vaccinated, during active COVID-19 clusters in early 2021.
  • Out of 152 residents, 31% had confirmed COVID-19 infections, including those who were fully vaccinated, with some experiencing severe illness and one fatality.
  • The study found that infected residents had significantly higher antibody levels compared to non-infected vaccinated residents, suggesting that additional vaccine doses may be beneficial for this vulnerable population.
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Objectives: To assess the efficacy of inhaled ciclesonide in reducing the risk of adverse outcomes in COVID-19 outpatients at risk of developing severe illness.

Methods: COVERAGE is an open-label, randomized controlled trial. Outpatients with documented COVID-19, risk factors for aggravation, symptoms for ≤7 days, and absence of criteria for hospitalization are randomly allocated to either a control arm or one of several experimental arms, including inhaled ciclesonide.

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