Publications by authors named "Francois Goehringer"
Article Synopsis
- The 2023 Duke-ISCVID criteria for diagnosing infective endocarditis (IE) were tested against the previous 2000 Modified Duke and 2015 ESC criteria using a large patient cohort treated for the condition.
- A total of 1194 patients were analyzed, revealing that the 2023 criteria had the highest sensitivity (97.6%) but the lowest specificity (46.0%) compared to the other criteria.
- The lower specificity in the 2023 criteria was largely due to the inclusion of patients with cardiac implanted electronic devices (CIED), highlighting the need for cautious interpretation in this group.
Article Synopsis
- The study aimed to assess how well the AEPEI surgical score predicts outcomes in patients undergoing surgery for infective endocarditis (IE), compared to other risk scores like EuroSCORE and De Feo.
- It enrolled patients from two hospitals in France over various years, excluding those with IE from certain procedures, and evaluated the scores using different statistical methods.
- Results showed that the AEPEI score had superior predictive performance and calibration for in-hospital mortality, indicating it may be a valuable tool for clinicians managing IE surgery.
Effect of weight-adjusted intermediate-dose versus fixed-dose prophylactic anticoagulation with low-molecular-weight heparin on venous thromboembolism among noncritically and critically ill patients with COVID-19: the COVI-DOSE trial, a multicenter, randomised, open-label, phase 4 trial.
EClinicalMedicine
June 2023
Background: Venous thromboembolism is a major complication of coronavirus disease 2019 (COVID-19). We hypothesized that a weight-adjusted intermediate dose of anticoagulation may decrease the risk of venous thromboembolism COVID-19 patients.
Methods: In this multicenter, randomised, open-label, phase 4, superiority trial with blinded adjudication of outcomes, we randomly assigned adult patients hospitalised in 20 French centers and presenting with acute respiratory SARS-CoV-2.
Article Synopsis
- The study aimed to identify new prognostic factors that could predict outcomes in Staphylococcus aureus infective endocarditis (SaIE), which has a high mortality rate.
- Researchers reviewed medical records of 30 patients and found 56 candidate prognostic factors, ultimately narrowing it down to three significant factors: prior use of NSAIDs, non-performance of valve surgery when needed, and decrease in vegetation size on antibiotic treatment.
- If confirmed in further studies, these factors could enhance patient management and potentially lower the lethality associated with SaIE.
Background: Given the rapidly evolving pandemic of COVID-19 in 2020, authorities focused on the repurposing of available drugs to develop timely and cost-effective therapeutic strategies. Evidence suggested the potential utility of remdesivir in the framework of an early access program. REMDECO-19 is a multicenter national cohort study assessing the ability of remdesivir to improve the outcome of patients hospitalized with COVID-19.
View Article and Find Full Text PDFBackground: Brain F-FDG PET imaging has the potential to provide an objective assessment of brain involvement in post-COVID-19 conditions but previous studies of heterogeneous patient series yield inconsistent results. The current study aimed to investigate brain F-FDG PET findings in a homogeneous series of outpatients with post-COVID-19 conditions and to identify associations with clinical patient characteristics.
Methods: We retrospectively included 28 consecutive outpatients who presented with post-COVID-19 conditions between September 2020 and May 2022 and who satisfied the WHO definition, and had a brain F-FDG PET for suspected brain involvement but had not been hospitalized for COVID-19.
Prevalence of post-acute coronavirus disease 2019 symptoms twelve months after hospitalization in participants retained in follow-up: analyses stratified by gender from a large prospective cohort.
Clin Microbiol Infect
February 2023
Article Synopsis
- A study examined the long-term symptoms of COVID-19 in patients 12 months after hospitalization, finding that 27% experienced three or more persistent symptoms, mainly fatigue, dyspnoea, and joint pain.
- The research included 737 participants, with a notable difference in outcomes based on gender; women reported more persistent symptoms, anxiety, and depression compared to men.
- Despite recovery progress, many who were employed before hospitalization still faced challenges, as 27% remained on sick leave at the 12-month mark, highlighting the ongoing impact of COVID-19 on quality of life.
Article Synopsis
- The study looked at how infective endocarditis (IE) affects pregnant women who don’t use drugs and included cases from 14 hospitals over many years.
- Most women in the study were around 33 years old and had their babies about 30 weeks along; many had no prior heart issues.
- Most women faced serious problems, like heart failure and complications with their pregnancies, including some that resulted in surgery or even loss of the baby; one woman sadly died from the illness.
Article Synopsis
- A study on infective endocarditis (IE) highlighted significant differences between patients with and without underlying cardiac conditions (UCC), finding that those without UCC were generally younger and had distinct comorbidities like malignancy and immune deficiency.
- Patients without UCC experienced more severe complications, such as larger vegetations, higher rates of valve issues, and a greater likelihood of requiring valve surgery.
- Despite the increased severity of their condition, in-hospital mortality rates were similar between both groups, suggesting that age and specific health conditions influenced the disease course rather than mortality outcomes.
Background: Duration of post-vaccination protection against COVID-19 in nursing home (NH) residents is a critical issue. The objective of this study was to estimate the duration of the IgG(S) response to the mRNA BNT162b2 vaccine in NH residents with (COV-Yes) or without (COV-No) history of SARS-CoV-2 infection.
Methods: A 574 COV-Yes and COV-No NH residents were included in 2 cohorts: Main (n = 115, median age 87 years) or Confirmatory (n = 459, median age 89 years).
Introduction: This observational CMR study aims to characterize left-ventricular (LV) damage, which may be specifically attributed to COVID-19 and is distant in time from the acute phase, through serial CMR performed during the first year in patients with no prior cardiac disease.
Methods: This study included consecutive patients without any prior history of cardiac disease but with a peak troponin-Ic > 50 ng/ml at the time of the first COVID-wave. All had a CMR in the first months after the acute phase, and some had an additional CMR at the end of the first year to monitor LV function, remodeling, and abnormalities evocative of myositis and myocarditis - i.
Background: This multicentre study aimed to provide a qualitative and consensual description of brain hypometabolism observed through the visual analysis of F-FDG PET images of patients with suspected neurological long COVID, regarding the previously reported long-COVID hypometabolic pattern involving hypometabolism in the olfactory bulbs and other limbic/paralimbic regions, as well as in the brainstem and cerebellum.
Methods: From the beginning of August 2021 to the end of October 2021, the brain F-FDG PET scans of patients referred for suspected neurological long COVID with positive reverse transcription polymerase chain reaction (RT-PCR) and/or serology tests for SARS-CoV-2 infection were retrospectively reviewed in three French nuclear medicine departments (143 patients; 47.4 years old ± 13.
Background: This study aims to determine whether the suppression of myocardial FDG uptake and detection of infectious endocarditis (IE) may be enhanced when FDG-PET is repeated on the next day while maintaining patients on a ketogenic diet in the interim.
Methods: Seventeen patients with definite IE underwent FDG-PET investigations both after a conventional metabolic preparation (> 12-hour fast after a low-carbohydrate evening meal) and a subsequent 12-hour extension of the low-carbohydrate diet followed by an additional > 12-hour fast.
Results: Plasma biomarkers showed increased ketogenic metabolism between the two FDG-PET scans.
Background: Despite guidelines describing the optimal diagnostic and therapeutic procedures for patients with suspected cardiac implantable electronic device (CIED) infections, their management is often challenging.
Aims: To describe our diagnostic and therapeutic practices for suspected CIED infection, and to compare them with European Heart Rhythm Association (EHRA) guidelines.
Methods: Patients hospitalized in the tertiary care Nancy University Hospital for suspected CIED infection from 2014 to 2019 were included retrospectively.
Objectives: Few studies have reported clinical COVID-19 sequelae six months (M6) after hospital discharge, but none has studied symptom severity.
Methods: Prevalence and severity of 7 symptoms were estimated until M6 using the self-administered influenza severity scale in COVID-19 hospitalized patients enrolled in the French COVID cohort. Factors associated with severity were assessed by logistic regression.
An open-label randomized controlled trial of the effect of lopinavir/ritonavir, lopinavir/ritonavir plus IFN-β-1a and hydroxychloroquine in hospitalized patients with COVID-19.
Clin Microbiol Infect
December 2021
Objectives: We evaluated the clinical, virological and safety outcomes of lopinavir/ritonavir, lopinavir/ritonavir-interferon (IFN)-β-1a, hydroxychloroquine or remdesivir in comparison to standard of care (control) in coronavirus 2019 disease (COVID-19) inpatients requiring oxygen and/or ventilatory support.
Methods: We conducted a phase III multicentre, open-label, randomized 1:1:1:1:1, adaptive, controlled trial (DisCoVeRy), an add-on to the Solidarity trial (NCT04315948, EudraCT2020-000936-23). The primary outcome was the clinical status at day 15, measured by the WHO seven-point ordinal scale.
Background: This study aimed to analyze the rates of tracheobronchitis signs observed on the ventilation scans of COVID-19 patients with shortness of breath, with comparisons to a non-COVID population.
Methods: Lung scintigraphy was collected in 10 such COVID patients, as well as from a non-COVID population investigated outside the epidemic wave period, on a CZT-SPECT/CT system, with ventilation images recorded with Tc-labeled Technegas® and perfusion images with Tc-labeled albumin macroaggregates.
Results: A diffuse tracheobronchial uptake was observed on the ventilation scans from 3 COVID patients (30%), whereas this rate was 3% (3/90) in the non-COVID group (P = 0.
Objective: To assess the effectiveness of corticosteroids on outcomes of patients with coronavirus disease 2019 (COVID-19) pneumonia requiring oxygen without mechanical ventilation.
Methods: We used routine care data from 51 hospitals in France and Luxembourg to assess the effectiveness of corticosteroids at 0.8 mg/kg/day eq.
Article Synopsis
- The article discusses supplementary tables and figures related to a research paper that analyzes referral bias in patients with infective endocarditis, using data from a population-based cohort study.
- It includes 497 patients diagnosed in 2008, categorized into three groups based on their hospital admissions, to examine the effects of referral bias on patient outcomes.
- The findings suggest that referral bias—favoring patients from tertiary hospitals—can significantly alter survival estimates and the identification of prognostic factors, as depicted in the six tables that compare selection impacts.
Article Synopsis
- This study examines referral bias in prognostic research for infective endocarditis by comparing characteristics and outcomes of patients from different hospital admission types.
- It analyzed data from 497 patients, categorizing them into three groups based on how they were admitted to hospitals: directly to a tertiary hospital, referred from a non-tertiary hospital, or admitted to a non-tertiary hospital.
- The findings revealed significant differences in patient demographics, surgical needs, and survival rates among the groups, indicating that referral bias can impact the accuracy of clinical characteristics and prognostic estimates.
Objectives: To assess changes in characteristics and management among ST-elevation myocardial infarction (STEMI) patients with coronavirus disease (COVID-19) who underwent primary percutaneous coronary intervention.
Methods: Our prospective, monocentric study enrolled all STEMI patients who underwent PPCI during the COVID-19 outbreak (n = 83). This cohort was first compared with a previous cohort of STEMI patients (2008-2017, n = 1,552 patients) and was then dichotomized into a non-COVID-19 group (n = 72) and COVID-19 group (n = 11).
For the first 3 months of COVID-19 pandemic, COVID-19 was expected to be an immunizing non-relapsing disease. We report a national case series of 11 virologically-confirmed COVID-19 patients having experienced a second clinically- and virologically-confirmed acute COVID-19 episode. According to the clinical history, we discuss either re-infection or reactivation hypothesis.
View Article and Find Full Text PDFImpact of Systematic Whole-body 18F-Fluorodeoxyglucose PET/CT on the Management of Patients Suspected of Infective Endocarditis: The Prospective Multicenter TEPvENDO Study.
Clin Infect Dis
August 2021
Article Synopsis
- A study evaluated the impact of 18F-FDG-PET/CT imaging on diagnosing and managing infective endocarditis (IE) in patients with prosthetic (PV) and native valves (NV), involving 140 patients from 8 hospitals.
- Before and after the imaging, experts assessed the patients' statuses using the modified Duke criteria, revealing that the imaging influenced the diagnosis, modifying classifications in 24.3% of PV and 5.7% of NV patients.
- The management of care for some patients was also adjusted based on imaging findings, affecting 40% of cases, particularly benefiting those with inconclusive echocardiograms or classified as possible IE.