For the first time, the cerebral reality of the long form of the Covid-19 is demonstrated in children. Seven young patients suffering from persistent symptoms were explored by functional imaging (PET-scan) in the nuclear medicine department of the Timone hospital, headed by Pr Guedj. “The complaints of these children can not simply be explained by psychological and psychiatric disorders”, believes the specialist who has already identified, identically, this brain damage in adult patients, and who today favors the ‘hypothesis of inflammation of the brain, at the time of infection with SARS-CoV-2, to explain, in a subgroup of patients, the very long-lasting symptoms: “There is real brain damage. We cannot sum it up to something purely functional. “
“During the first wave, 17% of children and Covid-positive adolescents have developed a long Covid”
Paris Match report (in French)
There have been a large number of reports of Covid-19 infections in French nursing homes over the past week. Most of the nursing home residents and staff will have been fully vaccinated.
18th August 2021
37 cases of Covid-19 at the Montfort-sur-Meu hospital center. Link
18th August 2021
51 cases of Covid in a nursing home in Perpignan, Link
18th August 2021
19 cases of covid-19 were detected in the Plonévez-du-Faou nursing home. Link
18th August 2021
COVID-19: the virus is back at the Rosemontoise nursing home in Valdoie. Link
18th August 2021
In Landerneau, two residents and an agent of the Ty-Sklaër unit tested positive for covid-19 Link
18th August 2021
At the Louis Morel residence in Plœuc-L’Hermitage, 17 residents and three officers have tested positive. Link
17th August 2021
Belfort: ten cases of Covid-19 detected in a nursing home. All vaccinated except one. Link
17th August 2021
A cluster identified at the Villars-les-Dombes nursing home Eleven residents of the public facility tested positive for the coronavirus last week. Link
16th August 2021
Loire Atlantique. Five establishments for dependent elderly people are affected by grouped cases of Covid 19 in the department. Despite the vaccination. Link
16th August 2021
A dozen nursing homes in Pays de la Loire, the majority of which are located in Loire-Atlantique and Vendée, are struck by clusters. Link
15th August 2021
Nineteen residents in the Donzère establishment have tested positive for the coronavirus. The nursing home deplored the deaths of two residents. Link
15th August 2021
Several cases of covid-19 have been detected at the Brisants residence in Concarneau. The establishment has been temporarily closed to visits. Link
14th August 2021
In Loperhet, an employee of the Accommodation facility for dependent elderly people (Ehpad), Les Trois Sources, in Loperhet, tested positive for Covid-19 on Friday. Link
13th August 2021
Côtes d’Armor: 1 infected in nursing home. Finistère: 1 infected in nursing home. Ille-et-Vilaine: 3 infected in nursing home. Morbihan: 3 infected in nursing home Link
12th August 2021
22 infected people, residents and nursing staff alike, in the “Les Pervenches” nursing home in Biéville-Beuville, near Caen. Link
11th August 2021
Eleven cases of covid were detected among residents and staff at the Foyer d’Argoat nursing home in Ploufragan. Link
The Brittany Regional Health Agency announced on Friday that this recall (booster jab) campaign was preparing at a time when the pressure in nursing homes is increasing: among the 83 clusters currently monitored in Brittany, 19 concern nursing homes, affecting 332 cases including 229 residents. “In almost all of these situations, the elderly who declare covid do not have a serious form of the disease, the vaccination protecting them from complications”, specifies the ARS.
“We have entered a fourth wave of the virus,” said government spokesman Gabriel Attal on leaving the Council of Ministers on Monday, July 19, explaining that “the dynamics of the epidemic are extremely strong, with a wave faster and a steeper slope than all the previous ones”. In one week, the incidence rate increased by nearly 125% he announced, while revealing that the Delta variant represented, according to the latest screening, 80% of contaminations in France.
Gabriel Attal also mentioned the mandatory isolation of people positive for Covid.
Le Figaro report (in French)
Europe has seen major changes in coronavirus case rates over the last two months. In many areas of Europe covid case rates have dropped sufficiently to allow restrictions to be eased, but there are notable exceptions. The Covid-19 rate in Spain now appears to be as bad, if not worse, than two months ago, and the Netherlands has seen a dramatic increase in numbers recently.
In the case of both Spain and the Netherlands, the rates increased following the decision to unlock their countries too quickly, and in both cases those decisions have had to reversed within weeks. Greece too appears to be seeing a new wave, and these areas now represent the largest threat to Europe’s strategy to keeping infection rates down.
Loss of smell, or anosmia, is one of the earliest and most commonly reported symptoms of COVID-19. Scientists from the Institut Pasteur, the CNRS, Inserm, Université de Paris and the Paris Public Hospital Network (AP-HP) determined the mechanisms involved in the loss of smell in patients infected with SARS-CoV-2 at different stages of the disease. They discovered that SARS-CoV-2 infects sensory neurons and causes persistent epithelial and olfactory nervous system inflammation. Furthermore, in some patients with persistent clinical signs, anosmia is associated with prolonged epithelial and olfactory nervous system inflammation and lasting presence of the virus in the olfactory epithelium.
This study unexpectedly demonstrates that nasopharyngeal swabs may test negative by standard RT-qPCR even if the virus is still present at the back of the nasal cavities, in the olfactory epithelium.
Research paper – COVID-19-related anosmia is associated with viral persistence and inflammation in human olfactory epithelium and brain infection in hamsters
The French city of Bordeaux is to fast-track vaccinations for residents in one neighbourhood, opening access the jab for all adults after nearly 50 people tested positive for a “very rare” variant of Covid-19. Labelled VOC 20I/484Q, the strain is related to the British variant B.1.1.7 but with an additional mutation E484Q. The variant has already been identified on a national level in France but it has reportedly been very rare until now. At least 46 people have been infected with the variant in Bordeaux, with mass testing launched on Friday to track down further cases.
“There has never been a cluster like that in the general population,” said Professor Patrick Dehail of the The National Reference Center in Lyon
UPDATE 1: There’s nothing in the latest Epidemiological Update from French Health Department about 20I/E484Q, but 20I/E484K gets a mention:
Le VOC 20I/484K, identifié pour la première fois en Grande-Bretagne suite à l’acquisition par le VOC 20I/501Y.V1 de la mutation E484K, était peu détecté en France jusqu’à la mi-mars. Une transmission communautaire a été rapportée depuis début avril dans plusieurs régions : Bretagne (en particulier à Brest), Ile-de-France et Hauts-de-France. Toutefois, le variant 20I/484K restait très nettement minoritaire par rapport au variant 20I/501Y. Dans les autres régions, aucune évolution notable dans les détections de cas du variant 20I/E484K n’a été observée et le nombre de cas restait faible.
UPDATE 2: The European CDC, which still lists all B.1.617 sub-lineages as Variants of Interest (VOI), not Variants of Concern (VOC), shows the E484Q mutation appears in both B.1.617.1 and B.1.617.3, but NOT B.1.617.2
The VOI 20C / H655Y (lineage B.1.616) initially detected in Lannion, in Brittany, was classified as variant to follow on 03/14/2021. Among the mutations and deletions carried by this VOI, several are found in one or more VOCs and VOIs, and could lead to increased transmissibility (H655Y in particular), post-vaccination or post-infection immune escape or even lower efficacy monoclonal antibody treatments (Y144- deletion, D215G and V483A mutations).
However, according to analyzes carried out by the CNR using sera from vaccinated subjects, infected subjects, or antibodies monoclonal, the data available at this stage do not show significant escape of the variant 20C / 655Y on neutralization. As of 05/04/2021, 42 confirmed cases of infection with the 20C / 655Y variant have been reported in France, including 39 in Brittany and 3 in other regions in people linked to the zone of circulation of the virus in Brittany (made up of several urban communities around Lannion, Guingamp, Saint- Brieuc, Paimpol). Eighteen deaths (43%) were reported, mostly in the elderly (age median 84 years) or with co-morbidities.
The high lethality associated with this variant is probably related to a bias in the identification of cases in which this variant was detected, most often from deep samples (generally more serious), but additional investigations are carried out to characterize the impact of this variant in terms of severity. The majority of confirmed cases are related to transmission chains in healthcare establishments in this geographical area (CH de Guingamp, de Lannion, de Paimpol).
“Last month, Gytis Dudas was tracking a concerning new coronavirus variant that had triggered an outbreak of COVID-19 in his native Lithuania and appeared sporadically elsewhere in Europe and in the United States. Exploring an international database of coronavirus genomes, Dudas found a crucial clue: One sample of the new variant came from a person who had recently flown to France from Cameroon. A collaborator, Guy Baele of KU Leuven, soon identified six more sequences from people in Europe who had traveled in Cameroon. But then their quest to pinpoint the variant’s origins hit a wall: Cameroon had uploaded a total of only 48 genomes to the global sequence repository, called GISAID. None included the variant”
B.1.620 is also listed as a Variant of Interest by the ECDC:
We report a nosocomial outbreak of COVID-19 cases related to a new variant, B.1.616, characterized by poor detection by RT-PCR tests on nasopharyngeal samples despite typical clinical, radiological, and biological features of COVID-19. We also noted high case fatality rate in our sampled population. This work also highlights the difficulties to manage nosocomial cases when the gold-standard test fails to confirm the diagnosis. With constantly emerging new variants, one should remain attentive to any unusual clinical situation that could be linked to such emergence.
In our study, among patients with a positive RT-PCR assay in the B.1.616 group, the sensitivity of one, two, three, and four tests on nasopharyngeal samples were, respectively, 5/34 (15%), 13/34 (38%), 14/34 (45%), and 17/34 (55%). RT-PCR tests on sputum, or broncho-alveolar lavage (BAL), were positive in 8/34 (24%) B.1.616-related COVID-19 cases with previous negative nasopharyngeal RT-PCR tests.
As samples from the lower respiratory tract are more difficult to obtain in frail patients, the real extent of the B.1.616-related COVID-19 outbreak in our institution has probably been underestimated. A large surveillance study, with sequencing of a representative sample of 15% of all RT-PCR-positive COVID-19 cases during the study period found no community-acquired B.1.616-related COVID-19 (Flash study#5, SpF, Paris, France, unpublished data), but the low detection in standard sampling may have contributed to this result.”
MedrXiv preprint – A new SARS-CoV-2 variant poorly detected by RT-PCR on nasopharyngeal samples, with high lethality
As of April 28, 40 cases of infection with the 20C/655Y (B.1.616) variant have been confirmed (37 in Brittany, three in other regions). The diagnosis was made on a first positive RT-PCR from a sample nasopharyngeal in 13% of them, and from a deep sample in 68% of cases. All cases have a direct or indirect link with the enhanced surveillance zone in Brittany. The majority of cases are linked to transmissions within hospital clusters in the area. A few cases have been reported in link with a chain of transmission in the community but, to date, the monitoring indicators do not suggest a significant community diffusion of this variant in the population, whether in Brittany or elsewhere. Epidemiological investigations are continuing to characterize the episode and monitor the diffusion of this variant.
The 19B / 501Y Henri Mondor variant (lineage A.27) has been detected in France since January 2021 infrequently but overall stable, with fluctuations from one week to the next: it represented 1% of sequences interpretable in the Flash # 6 survey (03/30/2021) versus 0.2% in the Flash # 5 survey (03/16/2021). In week 13, 18 detections of this variant were reported by the EMERGEN consortium. The clusters of large size that have been detected in connection with this variant have been closed to date, although strings of intrafamily transmission continue to be detected, particularly in the PACA region.
However, several points of attention should be noted and justify continuing the reinforced surveillance of this variant. First of all, it was detected in several large clusters, affecting school establishments, care (including hospitals, SSR and nursing homes) or military, especially in Ile-de-France (hospital and intra-family clusters), Pays de la Loire (3 clusters mainly affecting school establishments and military), Brittany (1 cluster in nursing homes in Morbihan) and Nouvelle-Aquitaine (6 clusters affecting healthcare establishments in Dordogne).
Maintaining sporadic detection of this variant on the national territory indicates a community transmission with low noise. At this point it seems less competitive than VOC 20I / 501Y.V1, since its prevalence remains much lower than the latter, including in geographic areas where it appears to have disseminated more extensively than nationally during of the 1st quarter of 2021 (Dordogne and Ile-de-France in particular).
In addition, three cases considered to be probable reinfections were identified 9 with confirmation of infection with this variant during the second episode, without it being possible to date to estimate the frequency of re-infections with this variant, nor to compare it with that of other viral strains circulating in France.
Data is still lacking at this stage on the clinical features of infection with this variant, but we did not detect a signal in favor of a significant impact on its transmissibility or an increased severity of the infection caused by this variant compared to the reference viral strains or variants of concern.
As of 04/21, 37 confirmed cases of infection with the 20C / 655Y [B.1.616] variant have been reported in France, including 34 in Brittany and 3 in other regions in people linked to the area of circulation of the virus in Brittany (made up of several urban communities around Lannion, Guingamp, Saint-Brieuc, Paimpol). The cases mainly occurred in elderly patients with co-morbidities. Sixteen deaths have been reported, mainly in the elderly (median age 84 years) or with comorbidities. The majority of confirmed cases are linked to chains of transmission in health facilities in this area.
Two cases have also been reported in connection with a chain of transmission in the community but to date this variant does not seem to spread widely in the population. However, given the difficulties associated with the diagnosis from nasopharyngeal samples, it is possible that community cases have not been identified. Confirmed cases linked to clusters hospitals for which deep samples are taken would only be a fraction of the cases. The diagnosis of SARS-CoV-2 infection was not made on a first positive nasopharyngeal swab than for 3 (9%) cases. For the majority (22/33, 67%), the virological diagnosis by RT-PCR was made only to from a deep sample: sputum (15/22, 68%) or bronchoalveolar lavage (7/22, 32%). For 7 cases, virological diagnosis by RT-PCR required the taking of nasopharyngeal swabs iterative (median 3, min: 2 – max: 7) or stool (1 case).
At this stage, this VOI is characterized mainly by detection in the upper respiratory tract more difficult than for other viral strains of SARS-CoV-2 currently circulating in France. The origin of this phenomenon is not yet known with certainty, several hypotheses currently being investigated, including shorter and / or weaker viral shedding in the nasopharynx, or tropism increase of this variant for the lower respiratory system.
The difficulty in detecting cases of infection with this varying in nasopharyngeal swabs could result in decreased efficacy current control measures for the transmission of SARS-CoV-2, based on patient isolation having a positive diagnostic test and contact-tracing. In addition, the occurrence of several clusters shows the transmission potential of this variant. These two elements therefore encourage us to maintain vigilance vis-à-vis this VOI. Epidemiological investigations are continuing in order to describe the characteristics of the cases and follow the geographical spread of this variant.
French Health Department Document: Analyse de risque liée aux variants émergents de SARS-CoV-2 réalisée conjointement par le CNR des virus des infections respiratoires et Santé publique France
On April 14, 32 cases of infection with the 20C / 655Y (B.1.616) variant were confirmed (29 in Brittany, three in other regions). All cases have a direct or indirect link with the enhanced surveillance zone by Brittany. The majority of the cases relies on the transmissions within the hospital clusters in the zone.
A few cases have been reported in connection with a chain of transmission in the community but, to date, there are significant dissemination of this variant in the population has not been documented, whether in Brittany or elsewhere. Epidemiological investigations are continuing to characterize the episode and monitor the spread of this variant.
Nine new cases of atypical thrombosis (clots) and two cases of coagulation disorders associated with AstraZeneca’s Covid-19 vaccine, with four additional deaths, occurred in France between April 2 and April 8, according to French health authorities. The nine new cases of rare thrombosis concern people who present “a profile different from that” of the cases declared previously, notes the ANSM. The age of the patients is “higher”: “It is about four women and five men, older (average age of 62 years) who presented more digestive thromboses.
Marie-Antoinette Sevestre-Pietri, French Society of Vascular Medicine President: “”In the long term, it will probably be necessary to do without adenovirus vaccines”