Severe hospital events following symptomatic infection with Sars-CoV-2 Omicron and Delta variants in France, December 2021-January 2022: A retrospective, population-based, matched cohort study.

Background: A rapid increase in incidence of the SARS-CoV-2 Omicron variant (sub-lineage BA.1) occurred in France in December 2021, while the Delta variant was prevailing since July 2021. We aimed to determine whether the risk of a severe hospital event following symptomatic SARS-CoV-2 infection differs for Omicron versus Delta. Methods: We conducted a retrospective cohort study to compare severe hospital events (admission to intensive care unit or death) between Omicron and Delta symptomatic cases matched according to week of virological diagnosis and age. The analysis was adjusted for age, sex, vaccination status, presence of comorbidities and region of residence, using Cox proportional hazards model. Findings: Between 06/12/2021-28/01/2022, 184 364 cases were included, of which 931 had a severe hospital event (822 Delta, 109 Omicron). The risk of severe event was lower among Omicron versus Delta cases; the difference in severity between the two variants decreased with age (adjusted Hazard Ratio (aHR)=0·13 95%CI: 0·08-0·20 among 40-64 years, aHR=0·50 95%CI: 0·26-0.98 among 80+ years). The risk of severe event increased with the presence of comorbidities (for very-high-risk comorbidity, aHR=4·15 95%CI: 2·86-6·01 among 40-64 years) and in males (aHR=2·28 95%CI: 1·82-2·85among 40-64 years) and was higher in unvaccinated compared to primo-vaccinated (aHR=7·29 95%CI: 5·58-9·54 among 40-64 years). A booster dose reduced the risk of severe hospital event in 80+ years infected with Omicron (aHR=0·29; 95%CI: 0·12-0·69). Interpretation: This study confirms the lower severity of Omicron compared to Delta. However, the difference in disease severity is less marked in the elderly. Further studies are needed to better understand the interactions between age and severity of variants. Funding: The study was performed as part of routine work at Public Health France.

A multi-state Markov model using notification data to estimate HIV incidence, number of undiagnosed individuals living with HIV, and delay between infection and diagnosis: Illustration in France, 2008-2018.

Thirty-five years since the discovery of the human immunodeficiency virus (HIV), the epidemic is still ongoing in France. To guide HIV prevention strategies and monitor their impact, it is essential to understand the dynamics of the HIV epidemic. The indicator for reporting the progress of new infections is the HIV incidence. Given that HIV is mainly transmitted by undiagnosed individuals and that earlier treatment leads to less HIV transmission, it is essential to know the number of infected people unaware of their HIV-positive status as well as the time between infection and diagnosis. Our approach is based on a non-homogeneous multi-state Markov model describing the progression of the HIV disease. We propose a penalized likelihood approach to estimate the HIV incidence curve as well as the diagnosis rates. The HIV incidence curve was approximated using cubic M-splines, while an approximation of the cross-validation criterion was used to estimate the smoothing parameter. In a simulation study, we evaluate the performance of the model for reconstructing the HIV incidence curve and diagnosis rates. The method is illustrated in the population of men who have sex with men using HIV surveillance data collected by the French Institute for Public Health Surveillance since 2004.

A traumatic life experience in childhood increases the risk of a psychiatric disorder in the offspring.

A traumatic life experience in childhood is a fundamental risk factor of numerous psychiatric disorders. Recently, studies try to evaluate the mental health consequences on victims' offspring, but few psychiatric disorders were examined, and whether these results apply to the general population remains unknown. In this study, we use the National Epidemiologic Survey on Alcohol and Related Conditions, a large representative sample of American population, in order to estimate the impact on the offspring of a traumatic experience in parents. Besides, we use a well-known risk factor for offspring's psychiatric disorder: a familial history of a psychiatric disorder, in order to compare and assess the importance of parental traumatism as a risk factor for the offspring. Our results show that the five psychiatric disorders studied, alcohol use disorder, substance use disorder, mood disorder, antisocial personality disorder and anxiety disorder, are more prevalent in the offspring, when at least one parent report a traumatic life event in his own childhood. Moreover, the magnitude of this risk factor is close to the magnitude of having a parental history of psychiatric disorder.

Developmental trajectories of pregnant and postpartum depression in an epidemiologic survey.

OBJECTIVE: To estimate the prevalence and determinants for the peripartum depression. METHODS: Data were extracted from the 2 waves of the National Epidemiologic Study of Alcohol and Related Conditions (NESARC), a representative sample of the US population corresponding to 34,653 participants. All women pregnant during the year before the second assessment were included. Peripartum depression was evaluated according a semi-structured interview at Wave 2. Risk factors covering life from childhood through adulthood, and including sexual abuse, family history of depression and psychiatric disorder lifetime were evaluated at wave 1. Stressful life event and obstetric factors were evaluated for the period of 12 months preceding the second interview. RESULTS: In the sample of 1085 participants pregnant at wave 2, the prevalence of peripartum depression was 10.8%. Women with a peripartum depression reported higher rates of sexual abuse in childhood (OR=3.07), family history of depression (OR=3.27). A history of mental disorder was associated with a higher rate of peripartum depression (OR=3.43) Four disorders were specifically associated with higher rate of peripartum depression including depression (OR=4.91), substance use disorder (OR=2.37), bipolar disorder (OR=2.39) and history of suicide attempt (OR=3.79). Peripartum depression was associated with stressful life event in the last year (OR=3.03), and complications during pregnancy (OR=2.10). LIMITATIONS: Not distinguish between depressed women during pregnancy from postpartum depressed women. CONCLUSION: Depression affects more than one in 10 women during peripartum. The factors associated with peripartum depression are traumatic, personal or family history of mental disorder, in a timeframe covering life from childhood through adulthood.