Publications by authors named "Jean Sebastien Casalegno"

Background: Respiratory Syncytial Virus (RSV) is a major health concern, particularly for infants. In France, Nirsevimab, a long-acting monoclonal antibody to prevent RSV-associated lower respiratory tract infections (LRTI) was available from September 2023. We described RSV-associated LRTI hospitalisations during the 2023-2024 season among infants younger than six months born at the Hospices Civils de Lyon (HCL), and evaluated the effectiveness of Nirsevimab against RSV-LRTI hospitalisation.

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Objective: To use a pre-COVID-19 birth cohort database to describe the clinical heterogeneity of severe acute respiratory infections (SARI) cases of the past seasons as a basis to investigate further distribution of clinical phenotypes in the era of immunization for respiratory syncytial virus (RSV).

Study Design: Infants with RSV-SARI were identified from a 2014 through 2019 birth cohort in a tertiary care center in Lyon, France, and their medical records extensively reviewed. Using the criteria of the World Health Organization severity definitions, we classified SARI as having nutritional (inability to feed), respiratory (SpO<93%), or neurological (failure to respond, apneas) impairments.

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Pathogen-pathogen interactions represent a critical but little-understood feature of infectious disease dynamics. In particular, experimental evidence suggests that influenza virus and respiratory syncytial virus (RSV) compete with each other, such that infection with one confers temporary protection against the other. However, such interactions are challenging to study using common epidemiologic methods.

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Article Synopsis
  • A study conducted in France during the 2023-24 RSV season analyzed the effectiveness of nirsevimab, a monoclonal antibody, in preventing RSV infections in infants, focusing on breakthrough cases.
  • Out of 695 RSV-infected infants, researchers sequenced the full-length RSV genome of 545 infants, identifying that 48% had breakthrough infections despite receiving nirsevimab.
  • While no resistance was found in RSV-A infections from nirsevimab-treated infants, two cases of RSV-B showed substitutions linked to resistance, indicating a potential concern for the antibody's effectiveness against this variant.
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Article Synopsis
  • Respiratory syncytial virus (RSV) is a significant cause of hospitalizations and fatalities in infants globally, prompting France to start a national program administering nirsevimab, a monoclonal antibody treatment, to protect infants from RSV infections.
  • A modeling study was conducted to evaluate the effectiveness of nirsevimab and estimate the number of RSV-related hospitalizations avoided in infants under 24 months during the 2023-24 season in France.
  • The findings indicated that nirsevimab prevented approximately 5,800 RSV-associated hospitalizations for bronchiolitis in children under 24 months, with around 4,200 of these cases in infants aged 0-2 months.
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Nonpharmaceutical interventions (NPIs) implemented during the COVID-19 pandemic have disrupted the dynamics of respiratory syncytial virus (RSV) on a global scale; however, the cycling of RSV subtypes in the pre- and post-pandemic period remains poorly understood. Here, we used a two subtype RSV model supplemented with epidemiological data to study the impact of NPIs on the two circulating subtypes, RSV-A and RSV-B. The model is calibrated to historic RSV subtype data from the United Kingdom and Finland and predicts a tendency for RSV-A dominance over RSV-B immediately following the implementation of NPIs.

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Background: Respiratory syncytial virus (RSV) poses a substantial threat to infants, often leading to challenges in hospital capacity. With recent pharmaceutical developments to be used during the prenatal and perinatal periods aimed at decreasing the RSV burden, there is a pressing need to identify infants at risk of severe disease. We aimed to stratify the risk of developing a clinically severe RSV infection in infants under 1 year of age.

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Objectives: We aimed to study whether the percentwise age distribution of RSV cases changes over time during annual epidemics.

Methods: We used surveillance data (2008-2019) from the Netherlands, Lyon (France), Portugal, Singapore, Ecuador, South Africa, and New Zealand. In each country, every season was divided into "epidemic quarters", i.

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The H274Y substitution (N2 numbering) in neuraminidase (NA) N1 confers oseltamivir resistance to A(H1N1) influenza viruses. This resistance has been associated with reduced N1 expression using transfected cells, but the effect of this substitution on the enzymatic properties and on the expression of other group-1-NA subtypes is unknown. The aim of the present study was to evaluate the antiviral resistance, enzymatic properties, and expression of wild-type (WT) and H274Y-substituted NA for each group-1-NA.

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Article Synopsis
  • - The study compared mortality rates and patient burden among adult ICU patients with respiratory failure due to RSV, COVID-19, seasonal influenza, and H1N1, involving a total of 807 patients.
  • - Patients with RSV had more comorbidities, while those with COVID-19 presented with less severe conditions at admission, indicated by lower SAPS-II and SOFA scores.
  • - Results showed that COVID-19 and H1N1 were linked to higher mortality rates compared to RSV, despite patients with RSV being more severely ill, suggesting a better overall outcome for those affected by RSV and seasonal influenza.
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BackgroundThere is currently no standardised approach to estimate respiratory syncytial virus (RSV) epidemics' timing (or seasonality), a critical information for their effective prevention and control.AimWe aimed to provide an overview of methods to define RSV seasonality and identify factors supporting method choice or interpretation/comparison of seasonal estimates.MethodsWe systematically searched PubMed and Embase (2016-2021) for studies using quantitative approaches to determine the start and end of RSV epidemics.

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We initiated a nationwide prospective study to monitor respiratory syncytial virus (RSV)-related pediatric hospitalizations in 46 hospitals throughout the Netherlands between May 2021 and August 2022. We showed year-round RSV transmission in the Netherlands after an initial 2021 summer outbreak. The pattern was unprecedented and distinct from neighboring countries.

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Background: Preventive measures applied during the COVID-19 pandemic have modified the age distribution, the clinical severity and the incidence of Respiratory Syncytial Virus (RSV) hospitalisations during the 2020/21 RSV season. The aim of the present study was to estimate the impact of these aspects on RSV-associated hospitalisations (RSVH) costs stratified by age group between pre-COVID-19 seasons and 2020/21 RSV season.

Methods: We compared the incidence, the median costs, and total RSVH costs from the national health insurance perspective in children < 24 months of age during the COVID-19 period (2020/21 RSV season) with a pre-COVID-19 period (2014/17 RSV seasons).

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Background: National Influenza Centers (NICs) have played a crucial role in the surveillance of SARS-CoV-2. The FluCov project, covering 22 countries, was initiated to monitor the impact of the SARS-CoV-2 pandemic on influenza activity.

Methods: This project consisted of an epidemiological bulletin and NIC survey.

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Article Synopsis
  • * Researchers used a time-series susceptible-infected-recovered (TSIR) model to predict the 2021/2022 RSV epidemic in Lyon, successfully aligning their predictions with actual hospital data on RSV cases.
  • * The study emphasizes the importance of collaboration between modelers and hospital management to improve resource allocation and preparedness for future RSV outbreaks.
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Article Synopsis
  • Respiratory syncytial virus (RSV) can reinfect individuals, even those who are immunized, due to its viral proteins interfering with the immune response rather than significant genetic changes.* -
  • After a 3 to 8-day incubation, RSV primarily causes nasopharyngitis and leads to excessive mucus production and damage to respiratory cells, impairing mucociliary transport.* -
  • The most common clinical consequence of RSV, especially in infants, is bronchiolitis, often requiring hospitalization, while acute otitis media is a frequent secondary complication that results in antibiotic prescriptions.*
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Background: The nucleoprotein (N protein) of respiratory syncytial virus (RSV) is a candidate antigen for new RSV vaccine development. The aim of the present study was to investigate the association between maternal antibody titers against the RSV N protein at birth and the newborns' risk of developing very severe lower respiratory tract infection (VS-LRTI).

Methods: In this single-center prospective cohort study, 578 infants born during the RSV epidemic season in France were included.

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Autoantibodies neutralizing type I interferons (IFNs) can underlie critical COVID-19 pneumonia and yellow fever vaccine disease. We report here on 13 patients harboring autoantibodies neutralizing IFN-α2 alone (five patients) or with IFN-ω (eight patients) from a cohort of 279 patients (4.7%) aged 6-73 yr with critical influenza pneumonia.

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Article Synopsis
  • Preterm infants are vulnerable to lower respiratory tract infections, particularly severe cases of RSV, and the study aimed to identify risk factors for severe RSV disease in infants born before 34 weeks of gestation.
  • Among 2,101 preterm infants studied, 86 were hospitalized due to RSV, and 31 of those experienced very severe lower respiratory tract infections requiring ventilation support.
  • The key finding was that a younger corrected age for prematurity at the time of infection was strongly associated with a higher risk of severe RSV disease, suggesting that targeting prophylaxis and interventions for these infants could help reduce the severity of their condition.
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Background: Respiratory syncytial virus (RSV) is the leading cause of acute respiratory infection- related hospitalisations in infants (RSVh). Most of these infants are younger than 6 months old with no known risk factors. An efficient RSVh prevention program should address both mothers and infants, relying on Non-Pharmaceutical (NPI) and Pharmaceutical Interventions (PI).

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Background: Respiratory syncytial virus (RSV) is the most common cause of acute lower respiratory infection in young children. We previously estimated that in 2015, 33·1 million episodes of RSV-associated acute lower respiratory infection occurred in children aged 0-60 months, resulting in a total of 118 200 deaths worldwide. Since then, several community surveillance studies have been done to obtain a more precise estimation of RSV associated community deaths.

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Background: In critically ill COVID-19 patients, the initial response to SARS-CoV-2 infection is characterized by major immune dysfunctions. The capacity of these severe patients to mount a robust and persistent SARS-CoV-2 specific T cell response despite the presence of severe immune alterations during the ICU stay is unknown.

Methods: Critically ill COVID-19 patients were sampled five times during the ICU stay and 9 and 13 months afterwards.

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