Herpesviridae lung reactivation and infection in patients with severe COVID-19 or influenza virus pneumonia: a comparative study.

BACKGROUND: Lung reactivations of Herpesviridae, herpes simplex virus (HSV) and cytomegalovirus (CMV) have been reported in COVID-19 patients. Whether or not those viral reactivations are more frequent than in other patients is not known. METHODS: Retrospective monocentric cohort study of 145 patients with severe COVID-19 pneumonia requiring invasive mechanical ventilation and who were tested for HSV and CMV in bronchoalveolar lavage performed during fiberoptic bronchoscopy for ventilator-associated pneumonia suspicion. Rates of HSV and CMV lung reactivations, and HSV bronchopneumonitis were assessed and compared with an historical cohort of 89 patients with severe influenza pneumonia requiring invasive mechanical ventilation. RESULTS: Among the 145 COVID-19 patients included, 50% and 42% had HSV and CMV lung reactivations, respectively, whereas among the 89 influenza patients, 63% and 28% had HSV and CMV lung reactivations, respectively. Cumulative incidence of HSV lung reactivation (taking into account extubation and death as competing events) was higher in influenza than in COVID-19 patients (p = 0.03), whereas the rate of HSV bronchopneumonitis was similar in both groups (31% and 25%, respectively). Cumulative incidence of CMV lung reactivation (taking into account extubation and death as competing events) was similar in COVID-19 and influenza patients (p = 0.07). Outcomes of patients with HSV or CMV lung reactivations were similar to that of patients without, whatever the underlying conditions, i.e., in COVID-19 patients, in influenza patients, or when all patients were grouped. CONCLUSIONS: HSV and CMV lung reactivations are frequent in COVID-19 patients, but not more frequent than in patients with influenza-associated severe pneumonia, despite a higher severity of illness at intensive care unit admission of the latter and a longer duration of mechanical ventilation of the former. Although no impact on outcome of HSV and CMV lung reactivations was detected, the effect of antiviral treatment against these Herpesviridae remains to be determined in these patients.

Cross-sectional study on COVID-19 vaccine hesitancy and determinants in healthcare students: interdisciplinary trainings on vaccination are needed.

BACKGROUND: To ensure the success of COVID-19 vaccination, public authorities need to have the support of the entire population and build vaccine confidence. Identifying and understanding the determinants of vaccine acceptance is essential for conducting vaccine strategy. The aim was to estimate vaccine hesitancy among healthcare students in France and to investigate the associated factors. METHODS: A web-based cross-sectional study was conducted in a large French University in greater Paris area, among 4927 healthcare students from the different training courses such as medicine studies, midwifery studies, physiotherapy studies, nurse studies and others health studies. The study was conducted between January 21 and February 8, 2021 based on a questionnaire including 25 single or multiple-choice questions, made using the free software Limesurvey. The link of the questionnaire was distributed to the students by the teachers and the student associations. The SAGE group definition of vaccine hesitancy was used. All estimates were weighted using the gender and training courses category of all healthcare students registered for the 2020-2021 year. Crude and adjusted weighted odds ratio (wOR) and 95% confidence interval (95%CI) were estimated using logistic regression. RESULTS: A total of 1465 healthcare students answered. A proportion of 44.5% (95%CI = [41.7-47.3]) of them were considered as hesitant. Women were more hesitant (50.9, 95%CI = [48.0-53.9]) than men (21.6, 95%CI = [15.2-28.0]). Vaccine hesitancy was significantly associated with gender (wOR = 0.27, 95%CI = [0.18-0.39]) and training courses: medical students were less likely to be hesitant than students in the common and first year of several health studies (wOR = 0.48, 95%CI = [0.33-0.70]) while nursing students were more than 5 times more likely to be hesitant (wOR = 5.20, 95%CI = [3.71-7.28]). Students who did an internship during the epidemic (wOR = 0.53, 95%CI = [0.41-0.69]) and who downloaded the mobile contact-tracing mobile app "TousAntiCovid" (wOR = 0.34, 95%CI = [0.26-0.44]) were significantly less likely to be hesitant. CONCLUSIONS: Overall vaccine hesitancy among healthcare students was high, substantial differences were found between training courses. To reduce these disparities, interdisciplinary lectures on vaccines for all healthcare students may be implemented and evaluated.

[Adolescents turning into smokers in France]. / Entrée des adolescents dans le tabagisme en France.

Adolescents turning into smokers in france .Tobacco kills more than 75,000 people in France each year. Among them, a large majority started their smoking history as an adolescent. More than half of 17-years-old have already tried tobacco and 25.1% of them report daily smoking. This is the lowest prevalence of daily smoking observed in France for 20 years. The daily consumption of 16-years-old decreased from 31% in 1995 to 12% in 2019, placing France in the European average. The initiation of regular tobacco consumption results from complex combinations of social (family, peers), environmental (passive exposure, accessibility, and marketing of products) and individual elements. Passive smoking in the family sphere and the influence of peers, which is most prevalent in adolescence, are two decisive determinants of future adolescent use of cigarette. The study of the entrance into smoking in adolescence should help to adapt preventive strategies to achieve a "tobacco-free generation".

"Entrée des adolescents dans le tabagisme en france. Le tabac tue en France chaque année plus de 75 000 personnes. Parmi elles, une très large majorité a commencé son histoire tabagique dès l'adolescence. Plus de la moitié des jeunes de 17 ans ont déjà essayé le tabac et 25,1 % d'entre eux déclarent fumer quotidiennement. Il s'agit de la prévalence de tabagisme quotidien la plus faible observée en France depuis 20 ans. La consommation quotidienne des jeunes de 16 ans est, quant à elle, passée de 31 % en 1995 à 12 % en 2019, plaçant la France dans la moyenne européenne. Le démarrage d'une consommation régulière de tabac résulte de combinaisons complexes entre des éléments sociaux (famille, pairs), environnementaux (exposition passive, accessibilité et marketing des produits) et individuels. Le tabagisme passif dans la sphère familiale et l'influence des pairs, majeure à l'adolescence, sont deux déterminants décisifs de la consommation future de l'adolescent. L'étude des modalités d'entrée dans le tabagisme à l'adolescence doit aider à adapter les stratégies préventives pour parvenir à une « génération sans tabac ¼."