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A longitudinal study of SARS-CoV-2-infected patients reveals a high correlation between neutralizing antibodies and COVID-19 severity

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Cellular & Molecular Immunology 2021年第2期18卷 318-327页

作者： Vincent Legros Solène Denolly Manon Vogrig Bertrand Boson Eglantine Siret Josselin Rigaill Sylvie Pillet Florence Grattard Sylvie Gonzalo Paul Verhoeven Omran Allatif Philippe Berthelot Carole Pélissier guillaume thiery Elisabeth Botelho-Nevers guillaume Millet Jérôme Morel Stéphane Paul Thierry Walzer François-Loïc Cosset Thomas Bourlet Bruno Pozzetto CIRI–Centre International de Recherche en Infectiologie Team EVIRUniv LyonUniversitéClaude Bernard Lyon 1InsermU1111CNRSUMR5308ENS Lyon46 allée d’ItalieF-69007LyonFrance Universitéde Lyon VetAgro SupMarcy-l’ÉtoileFrance Department of Infectious Agents and Hygiene University-Hospital of Saint-EtienneSaint-EtienneFrance Department of Immunology University-Hospital of Saint-EtienneSaint-EtienneFrance CIRI–Centre International de Recherche en Infectiologie Team GIMAPUniv LyonUniversitéClaude Bernard Lyon 1InsermU1111CNRSUMR5308ENS Lyon46 allée d’ItalieF-69007LyonFrance Department of Infectious Diseases University-Hospital of Saint-EtienneSaint-EtienneFrance Department of Occupational Medicine University-Hospital of Saint-EtienneSaint-EtienneFrance Department of Intensive Care and Resuscitation(Réanimation G) University-Hospital of Saint-EtienneSaint-EtienneFrance Laboratoire Interuniversitaire de Biologie de la Motricité Universitéde LyonUniversitéJean MonnetSaint-EtienneFrance Department of Anesthesiology and Critical Care University-Hospital of Saint-EtienneSaint-EtienneFrance

Understanding the immune responses elicited by SARS-CoV-2 infection is critical in terms of protection against reinfection and,thus,for public health policy and vaccine development for *** this study,using either live SARS-CoV-2 particles or retroviruses pseudotyped with the SARS-CoV-2 S viral surface protein(Spike),we studied the neutralizing antibody(nAb)response in serum samples from a cohort of 140 SARS-CoV-2 qPCR-confirmed infections,including patients with mild symptoms and also more severe forms,including those that required intensive *** show that nAb titers correlated strongly with disease severity and with anti-spike IgG ***,patients from intensive care units exhibited high nAb titers;conversely,patients with milder disease symptoms had heterogeneous nAb titers,and asymptomatic or exclusive outpatient-care patients had no or low *** found that nAb activity in SARS-CoV-2-infected patients displayed a relatively rapid decline after recovery compared to individuals infected with other ***,we found an absence of cross-neutralization between endemic coronaviruses and SARS-CoV-2,indicating that previous infection by human coronaviruses may not generate protective nAbs against ***,we found that the D614G mutation in the spike protein,which has recently been identified as the current major variant in Europe,does not allow neutralization ***,our results contribute to our understanding of the immune correlates of SARS-CoV-2-induced disease,and rapid evaluation of the role of the humoral response in the pathogenesis of SARS-CoV-2 is warranted.

关键词： Antibody Pathogenesis Humoral response COVID-19 SARS-CoV-2v

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Cost effectiveness of intensive care in a low resource setting: A prospective cohort of medical critically ill patients

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World Journal of Critical Care Medicine 2016年第2期5卷 150-164页

作者： Hajrunisa Cubro Rabija Somun-Kapetanovic guillaume thiery Daniel Talmor Ognjen Gajic Medical Intensive Care Unit Sarajevo University Clinical Center Department of Quantitative Ec-onomics Faculty of Economics Department of Anesthesia Critical Care and Pain Medicine Beth Israel Deaconess Medical Center and Harvard Medical School Division of Pulmonary and Critical Care Mayo Clinic

AIM: To calculate cost effectiveness of the treatment of critically ill patients in a medical intensive care unit(ICU) of a middle income country with limited access to ICU resources. METHODS: A prospective cohort study and economic evaluation of consecutive patients treated in a recently established medical ICU in Sarajevo, Bosnia and Herzegovina. A cost utility analysis of the intensive care of critically ill patients compared to the hospital ward treatment from the perspective of the health care system was subsequently performed. Incremental cost effectiveness was calculated using estimates of ICU vs non-ICU treatment effectiveness based on a formal systematic review of published studies. Decision analytic modeling was used to compare treatment alternatives. Sensitivity analyses of the key model parameters were ***: Out of 148 patients, seventy patients(47.2%) survived to one year after critical illness with a median quality of life index 0.64 [interquartile range(IQR)0.49-0.76]. Median number of life years gained per patient was 30(IQR 16-40) or 18 quality adjusted life years(QALYs)(IQR 7-28). The cost of treatment of critically ill patients varied between 1820 dollar and20109 dollar per hospital survivor and between 100 dollar and 2514 dollar per QALY saved. Mean factors that influenced costs were: Age, diagnostic category,ICU and hospital length of stay and number and type of diagnostic and therapeutic interventions. The incremental cost effectiveness ratio for ICU treatment was estimated at 3254 dollar per QALY corresponding to35% of per capita GDP or a Very Cost Effective category according to World Health Organization ***: The ICU treatment of critically ill medica patients in a resource poor country is cost effective and compares favorably with other medical *** health authorities in low and middle income countries should encourage development of critical care services.

关键词： Cost benefit analysis Intensive care Quality of life Intensive care unit Mortality Decision analysis Economics

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