Feb 12, 2022

Covid-19: infection increases the risk of developing cardiovascular disease by 55%

Admin February 12, 2022 0 Comments

Being infected with Covid-19 increases the risk of developing cardiovascular disease by 55% in the year following contamination. This is the finding of a study published on February 7 by American researchers.

People with Covid-19 have an increased risk of cardiovascular disease

Researchers at Washington University in St. Louis, USA have been interested in the consequences of Covid-19 on the heart and blood circulation of Covid-19 infected patients. To carry out their research, they analyzed data from 153,760 infected people in the United States between March 2020 and January 15, 2021, which they compared to data from 5 million uninfected people.

According to the results published on February 7, 2022, in the journal Nature Medicine, people with Covid-19 have an increased risk of cardiovascular disease (cerebrovascular disorders, dysrhythmias, ischemic and non-ischemic heart disease, pericarditis, myocarditis, heart failure and thromboembolic disease).

In detail, Covid-19 infection increases the risk of cardiac arrest by 63% and stroke by 52%. In total and all cardiovascular diseases combined, the infection increases the risk of developing cardiovascular disease by 55%.

A risk that also concerns people without comorbidities

Although the risk of developing cardiovascular disease is greater in hospitalized people, it also increases in people infected without comorbidities, in those who have had mild forms and in those who have not been hospitalized.

According to University of Washington assistant professor of medicine and study author Ziyad Al-Aly, "Even people who have never had heart problems and are considered low risk can develop the cardiovascular disease after Covid. Our data show that the risk increases in young and old people, in those with diabetes and those without, in those who have had heart disease before and in those with no history of cardiovascular disease, in those who have been hospitalized for Covid-19 as well as in those with mild forms of Covid-19."

Covid has led to more than 15 million cardiovascular diseases worldwide

Researchers estimate that 15 million people are suffering from cardiovascular disease due to coronavirus infection. Indeed, the authors of the study note that cardiovascular diseases affected about 4% more people in the group of infected people. Given that there have been more than 380 million infected people worldwide, they conclude that Covid-19 may have caused more than 15 million cardiovascular diseases.

How to overcome fatigue after Covid?

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After an infectious disease, fatigue is common. In the case of Covid-19, it is sometimes intense and can last for several months. Some patients need to undergo exercise rehabilitation sessions.

After the acute phase of Covid-19, fatigue persists very frequently. It is logically found in patients who leave the hospital after having presented a severe form of the disease, but also in some people who have suffered only mild symptoms. "Six weeks after infection, half of the patients have not regained their full capacity," says Professor Pierre Tattevin, president of the French-language Society of Infectious Pathology.

Why this post-Covid fatigue?

All infectious diseases can put the body flat for several weeks, and this is especially true with Covid-19. "The disease puts a lot of strain on the immune system, which could explain why fatigue is so marked after infection, especially in young and initially healthy patients, whose immune system is very reactive. This fatigue does not surprise us in patients who have been ventilated (placed on respiratory assistance, Editor's note) and who is released from resuscitation. It is more surprising in young people who have presented with a non-severe form of Covid. We do not see such a situation after the flu, "observes the infectiologist.

Is this fatigue different?

The High Health Authority (HAS) delivered its recommendations on the management of Covid-long in February 2021. In this practical document for doctors, she describes fatigue as "one of the most prevalent symptoms that can persist during the initial episode of Covid-19 or reappear abruptly after a phase of improvement".

The HAS encourages not to neglect this seemingly banal symptom and to look for its cause as much as possible. "We must not put everything on the account of Covid-19," warns Professor Tattevin who invites patients to talk to their doctor.

Fatigue during exertion, persistent shortness of breath are common. They may reveal a breathing problem that has not been resolved or a heart defect.

But other factors can trigger, or aggravate, this feeling of exhaustion: non-restorative sleep, stress, anxiety, even depression...

Why do we need to fight this fatigue?

In consultation, patients tell their doctor that they "can't take it anymore". The risk, in this context, is to fall into a vicious circle. When you are exhausted, you sit or lie down, you limit your activities. However, the less you move, the more you lose your muscles and respiratory abilities.

After a Covid it is undeniable necessary to rest; but without, however, remaining inactive. On the contrary, it is important to regain a good physical condition as quickly as possible by strengthening your muscles and increasing your lung capacity. Another advantage is that by practising physical activity, you regain self-confidence and the body secretes endorphins, anti-stress hormones, which help overcome anxiety related to the disease.

What physical activity after Covid?

This physical activity must be progressive and adapted to the abilities of each person, for example walking or cycling. You have to train at your own pace, without trying to do too much.

It can be practised at home or under the supervision of a professional. On its website, the Aprèsj20 association, which brings together patients suffering from Covid-long, advises a gentle Aprèsj20, to be done at home, developed by the Pitié Salpêtrière Hospital (Paris).

For its part, the French Association of Chronic Fatigue Syndrome (a disease that has many points in common with Covid-long) offers practical advice to better recover.

For people who are particularly embarrassed about their respiratory level, exercise rehabilitation sessions, supervised by a sports doctor or a physiotherapist, are necessary. It is, at present, one of the few treatments for Covid-long validated by the High Authority of Health. "These rehabilitation programs, which start in the hospital, but can then be continued at home, are offered to patients à la carte, after assessing their difficulties: mainly muscle fatigue or breathing difficulties," explains Professor Tattevin.

Post-covid fatigue: getting out of the mental fog

Many patients come out of the Covid ordeal with a feeling of "mental fog". They complain of confusion, memory problems and lack of concentration. These different symptoms are often exacerbated by the stress and anxiety generated by the disease.

To overcome these difficulties, some people need real psychological support. But most will get by respecting simple rules of lifestyle: avoid stimulants such as tea or coffee, ban screens after 6 pm to fall asleep more easily, sleep in a cool room, relax or even meditate if possible...

Most patients who feel exhausted after Covid will recover within a few weeks. For others, it will be longer. Evolution is often jagged, with ups and downs, at a different rate depending on the individual. As such, Professor Tattevin wants to convey a message of optimism: "It's long, but it always ends up getting better. Don't get discouraged! »

Feb 11, 2022

How to keep fit in winter?

Admin February 11, 2022 0 Comments

The winter months can be a challenging time to stick to an exercise plan. The weather is colder, the daylight hours are shorter and other priorities can make it hard to establish a routine. While exercise in winter may be tough, it is very important for health.

Before having transplant surgery, exercise will help you to maintain strength and energy. After a transplant, exercise can help you return to your normal level of physical activity more quickly. Cardiovascular exercise is a type of exercise that focuses on increasing your heart rate and building your endurance. Resistive exercise uses resistance (body weight, bands, or weights) to build strength in your muscles. Both types of exercise have important benefits before and after transplant. An exercise program should include both cardiovascular and resistive exercises.

Pamper your sleep and vitality to be fit in winter

Having a good sleep is very important to be healthy because it allows our body to regenerate. Below 6 hours of sleep, the risk of catching a cold is multiplied by four. Winter is a season when we are more likely to feel tired and our sleep cycle is disrupted. Lack of sleep directly affects our vitality which is why it is important to sleep well to keep fit throughout the winter.

Take advantage of the morning light to get back in shape in winter

Do you want to sleep all the time? This is completely normal because the body produces more melatonin, the sleep hormone, in winter because the nights are longer. To regain energy, the solution is not to play groundhogs by staying in bed longer. On the contrary: enjoying the daylight in the morning by doing a little sport in front of a window or going out for a walk, recalibrates the biological clock.

Test light therapy if you feel a decrease in vitality in winter

Studies show that by delaying melatonin production, a cure with a light therapy device reduces difficulty falling asleep and waking up at dawn. The effects are rapid: after a week, you have more energy and better morale. It is necessary to choose a lamp with a power of 10,000 lux: half an hour of exposure each morning is enough, placing the face about 50 cm from the device (you must keep your eyes open but no need to look at the lamp directly). It takes between 90 and 150 € for the device. These appliances can be found in appliance stores and organic shops. It is a good habit to keep until spring, to overcome the winter serenely. It is also important to seek the advice of your doctor in case of eye problems such as glaucoma, cataracts ...

Follow a course of anti-stress Rhodiola to sleep better

Danielle Roux-Sitruk, the doctor of pharmacy, recommends this adaptogenic plant "which helps to better manage the physical and psychological fatigue of winter, so also to have a better sleep in the evening, and to face the cold". One capsule of dry extract (dosed at 200 mg) in the morning and at noon (never in the evening because it is stimulating), from Monday to Friday, for 15 days.

Dried fruits are the best foods to spend the winter in shape

"Chewing in a few oilseeds such as almonds or hazelnuts rich in tryptophan, a precursor of serotonin, helps to accompany the natural production of serotonin at the end of the day, which itself triggers the secretion of melatonin at night," says the phytotherapist. A Chrono nutrition reflex that helps to recalibrate the rhythms day/night and sleep better at night.

Eat a little more protein to be healthier

It is important not to neglect your protein intake, especially in winter! It is recommended to consume in particular red and white meat (at least twice a week), fish, and seafood (twice a week) that provide zinc and iron, because deficiencies cause immunity to fall. If you are a vegetarian, it is advisable to consume more lentils, eggs, wheat germ on soups and yogurts while keeping a balanced diet.

Taking vitamin D to stay in shape

Vitamin D is not only useful for bones, it is also the key vitamin for immunity. A recent review of studies confirms that taking 400 IU to 2,000 IU daily reduces the risk of respiratory infection. This vitamin is useful for almost everyone in winter, preferring vitamin D3 of animal origin, which is better assimilated.

Put on socks at night to fall asleep faster

A scientific experiment has shown that warming the hands and feet (by about 0.5 ° C) at bedtime causes a blood flow capable of lowering the heat of the center of the body. As a result, participants' time to fall asleep was reduced by 20%. Do not forget, however, to lower the temperature of the room to around 19 ° to promote better sleep.

How to face winter while taking care of your immune system?

The otolaryngologist (ENT) sphere should not be neglected during this season. In order to keep fit in winter you must take care of your immune system and this means avoiding infectious episodes as much as possible.

Alternating echinacea and elderberry, the best trick to boost your immune system

These two plants can reduce the number of infectious episodes during the winter and boost the immune system. "Echinacea is effective, but should not be taken continuously so as not to overstimulate the immune system. We take it four days a week for one to two months," advises Danielle Roux-Sitruk. It can be consumed as a standardized fresh plant extract (1 tbsp per day) or dry extract capsules (200 mg), and never in case of allergy to Asteraceae, autoimmune disease, or cancer. Alternate for one to two months with elderberry, in the form of herbal teas (1 tbsp per cup of water, infuse 10 minutes) or dry extract capsules (200 to 400 mg per day).

Wash your nose regularly to avoid infections

"It is in the evening that it is most useful, especially if you travel in the city, to rid the nasal mucosa of pollution particles that create microlesions and promote the penetration of viruses. It should not be done more than once a day so as not to irritate the nose, "advises Dr. Gilles Ayoun, ENT. The right move? Spray the solution, aiming not upwards, but towards the opposite ear (the head is tilted slightly) so that the liquid comes out through the other nostril.

Bet on thyme and propolis with anti-infectious properties

"An anti-infectious thyme tea is a good idea at the beginning of winter infection, but also on a daily basis in prevention against chronic sinusitis," says Dr. Ayoun. Propolis-based, anti-infectious, and anti-inflammatory lozenges or sprays are a good solution because they do good if you have an irritated nose and/or throat.

Unclog the nose with essential oils

Essential oils of Niaouli or radiated eucalyptus are preferred because they have decongestant properties. It is interesting to combine them with ravintsara, anti-viral, to stop the common cold. Just breathe them in, in dry inhalation: 1 drop of each on a handkerchief; or wet: 5 drops in a bowl of hot water, we breathe the vapors 10 minutes by covering the head. Never use in case of asthma.

The best tips for taking care of your joints in the winter

During the winter period, the joints are more likely to be painful. Especially when you are suffering from osteoarthritis, this season can be particularly difficult. However, it is possible to spend the winter well when our joints hurt, with the help of some sometimes amazing tricks.

Using the hairdryer to relieve osteoarthritis

Applying this dry heat from the hairdryer at least 15 cm from the skin on the knee or hand can do good when osteoarthritis is sensitive to wet and cold weather. Wearing a heated knee pad (at Gibaud for example) also helps to unlock, in the morning when you wake up, or if you have to walk in the cold, but you should not wear it for more than a few hours so as not to limit movements.

Massage with a heating oil

Wintergreen essential oil is anti-inflammatory but also has a slightly warming effect. It is ideal for massaging a painful joint and relaxing the muscles around it, as the cold tends to increase stiffening. How to use it? 1 to 2 drops diluted in 1 tbsp. Vegetable oil (if possible arnica or calophyll, which are the most effective anti-inflammatory products).

Doing finger gym to reduce osteoarthritis pain

The hands, very exposed to the cold, suffer particularly. In the case of osteoarthritis of the fingers, small daily exercises with elastics are effective in increasing mobility and reducing pain according to a Norwegian study. We surround each finger with it, then we spread the fingers well from each other, and we lift one finger after the other.

How to keep good joints in winter? Bet on anti-inflammatories

In case of an osteoarthritis flare-up, when the joint is red, warm, and swollen, do not hesitate to double for a few days the dose of turmeric or harpagophytum if you are already taking it as a background treatment. You can apply a local anti-inflammatory gel such as diclofenac or based on wintergreen essential oil and take an oral anti-inflammatory (prescribed by the doctor depending on the gastric or cardiac sensitivity of each) for 2 to 3 days if the pain is really intense.

What to do if you have your fingertips, all white?

If one suffers from Raynaud's syndrome, tingling and numbness can be very painful. Instead, wear two pairs of gloves on top of each other, one of which is silk, to keep the heat warm. You can also place heaters in your pockets and dip your hands in them when walking outside.

Make small movements regularly: open and loosen your fists, make reels with your arms. It is advisable to take as a background treatment, ginkgo Biloba which promotes vasodilation (Ginkor fort, Tanakan or their generics ...), as a cure throughout the winter.

Our selection of products to keep fit in winter

The vitamin solution: immuno + Propolis, Ladrôme, 19,95 € for 20 ampoules. Propolis + royal jelly + echinacea + acerola for vitamin C.

The stimulating solution: elderberry gummies, New Nordic, 26 € for 60 gummies (for a month). Two chewable gummies provide 300 mg of a concentrated extract of elderberries. Perfect for those who do not like to swallow capsules.

The anti-fatigue solution: phytostandard Rhodiole, PiLèJe, 13,70 € for 20 capsules. A standardized plant extract for a good concentration of active ingredients (and organic).

The solution to boosting immunity: vitamin D3 1,000 IU, Lescuyer, € 22.50 per 20 ml. Vitamin D is extracted from lanolin (the substance of sheep's wool).

some tips

Here are some tips to keep in shape over the winter (and year-round):

Go for the goals. Remind yourself of your goals for exercise and staying in shape. Do you want to be able to walk the dog farther? Do you want to be able to play with your grandchildren? Do you want to feel healthier? Do you want to be able to pick up a suitcase by yourself? By starting with goals in mind, you are more likely to succeed.
Bring fitness indoors. During the winter months, you may not be able to exercise outside, but there are many ways to stay active and warm. You can walk laps at the mall, take a fitness class at the gym, join a community dance class, lift weights, work out to a video at home, or even just dance. The most important component of an exercise program is finding something that you enjoy. If you’re having fun, you will be more likely to stick with exercise.
Make the most of winter. While it’s easy to bring fitness routines indoors, perhaps you want to get outside and enjoy the winter months. If you are in good health and your doctor is agreeable, try some more daring winter sports. You could sign up for ice skating lessons, cross-country ski, or snowshoe. If you are not feeling as adventurous, get outdoors and build a snowman with the younger members of your family. Even just shoveling the snow and other winter chores count as exercise. Be sure to bundle up!
Partner up! Enlist your friends and family as exercise partners. Set a date to meet a friend at the gym and you’re much more likely to follow through. Instead of meeting a friend for a meal or coffee, consider an exercise date. You could meet at the mall to walk briskly and window shop. Try stepping out of your comfort zone with a friend and take a dance or yoga class. Exercise can be social and fun.
Pencil it in. Be deliberate about scheduling exercise and fitting it in, even when you’re busy. Once you write down exercise in your calendar, it becomes part of your schedule for the day and this can help you achieve your fitness goal. Additionally, track your exercise in a log. Seeing your achievements and progress will be very motivating.
Don’t let a lack of time get you down. When your schedule is busy, remind yourself that exercise does not have to take long. There are many simple ways to increase your physical activity. Instead of using an escalator or elevator, take the stairs. Park your car farther away from the building to increase your steps. When your favorite song comes on the radio, dance for a minute or two. While you’re brushing your teeth, tighten the muscles in your bottom and thighs. Practice standing up from a chair without using your arms.

Throughout the winter months, there’s no need to hibernate! It’s possible to stay active and exercise. Experts recommend that you exercise for at least thirty minutes, five days a week. However, even five or ten minutes of movement a day can help with weight loss, improving your mood, and increasing your heart health. So, remember your goals for exercising, grab a partner, find an activity you enjoy and get moving!

Tyrosine: role, benefits, in which foods to find it?

Admin February 11, 2022 0 Comments

Tyrosine is an amino acid, non-essential, synthesized by the body and found in certain foods. It is involved in the production of dopamine, norepinephrine, and thyroid hormones. The point with Dr. Camille Le Quéré nutritionist, the doctor in Paris.

Definition: What is tyrosine?

Tyrosine is an amino acid, a small molecule that synthesizes proteins. It is mainly found in poultry, almonds, bananas, avocados, sesame seeds... The body also produces it on its own, from another amino acid.

What is its role?

Tyrosine allows the production of dopamine and norepinephrine, substances that help the body adapt to stress in particular. It is also involved in the production of thyroid hormones. "Tyrosine also has secondary roles in the production of growth hormone, the production of melanin (skin pigmentation) and helps prevent the aging of cells, with an antioxidant action," says Camille Le Quéré, a nutritionist doctor in Paris.

What are the benefits of depression?

"Tyrosine has a precursor role to certain neurotransmitters that circulate information in the brain, including dopamine and norepinephrine," continues our specialist. These neurotransmitters act on the patient's psychic state. 'Dopamine is involved in the patient's vital momentum, dynamism, concentration, cognition. Norepinephrine is involved in mood, alertness, and vigilance mechanisms," observes Camille Le Quéré.

What are the benefits of the thyroid?

"Tyrosine is a precursor to the thyroid hormones, thyroxine, and triiodothyronine," notes the nutritionist. Lacking tyrosine can cause hypothyroidism and the symptoms that go with it: fatigue, difficulty concentrating, bradycardia...

How to dose tyrosine?

Tyrosine, a complex practice that takes place in a hospital setting, is very rarely dosed. "We do not dose the amino acid in routine. In my opinion, this dosage is only done in the context of research. Rather, it is based on a bundle of clinical arguments and other associated deficiencies such as deficiencies in iron, magnesium, zinc, vitamin B ... In view of which we identify a very clear risk of tyrosine deficiencies', explains Camille Le Quéré. "We will rather dose dopamine and norepinephrine in routine, a urine or blood test depending on the laboratory. It is not reimbursed and there are many false results due to the patient's diet. For the result to be revealing, the patient must have a diet low in tyrosine for a few days," says the doctor.

Tyrosine levels too low: what are the dangers?

Our expert observes several risks related to a tyrosine level that is too low:

Difficulty concentrating
Anxiety
Stress
Depression, loss of vital momentum
Hypothyroidism
Stunting (in extreme cases)
Premature cell aging
Fatigue
Skin fragility

Tyrosine levels too high: what are the dangers?

"The risks associated with too high a tyrosine level will depend on the patient's history," says Camille Le Quéré. Thus tyrosine can contribute to:

→ An increase in blood pressure and consequences on the cardiovascular system

→ A thyroid disorder causing hyperthyroidism (tachycardia, hypertension)

→ A disruption of metabolism and in particular blood sugar

In which foods to find tyrosine?

"Tyrosine is mainly found in protein-rich foods," says the nutritionist. It can be found in:

Milk
Egg
Meat
Fish
Nut
Cashew nuts
Almond
Lawyer
Mushroom
French bean
Potato
Eggplant
Beet
Radish
Asparagus
Parsley
Cucumber
Red onion
Spinach
Rye

When to supplement with tyrosine?

As part of an omnivorous diet, there is little risk of suffering from tyrosine deficiency. 'If there is a need for tyrosine supplementation, supplementation is contraindicated in the case of hyperthyroidism, if the patient is on antidepressants or for patients with Parkinson's disease. It is, therefore, necessary to be careful with these food supplements because there can be risks if the food supplements are poorly dosed, "warns Camille Le Quéré.

The specialist is not used to supplementing her patients with tyrosine. "I prescribe co-factors that will make it possible to synthesize tyrosine. That is to say that I supplement with vitamin B9 and magnesium in particular. Tyrosine supplementation can be considered as a last resort if the co-factors have not been effective enough," she continues. It does, however, identify a group of people who may need tyrosine supplementation, 'vegans or even vegetarians whose diets are low in protein.'

Tyrosine and Parkinson's disease

Tyrosine as a dietary supplement is strongly discouraged in people treated for dopaminergic disorders such as Parkinson's disease.

In addition, high-dose tyrosine can interact with the action of thyroid hormones, so in case of the pathology of the thyroid gland, it is advisable to consult a doctor before taking L-tyrosine.

Chemical properties

The crude formula of tyrosine is C9H11NO3, its molar mass is 181.1885 g/Mol. Tyrosine is an amino acid that is said to be non-essential for the human body. Indeed, we know how to synthesize it. However, it can be produced in insufficient quantities, hence the need to provide enough via food.

Tyrosine is characterized by its phenol group, whose hydroxyl is acidic. This amino acid is synthesized from phenylalanine. It has a very important role since it participates in the synthesis of many essential substances: dopamine, norepinephrine, adrenaline, etc. In addition, it is a precursor of thyroid hormones and melanin.

Historical

History of the nutrient

An amino acid with many roles in the body, tyrosine was also for a long time a molecule of choice for the treatment of certain conditions. Indeed, several patents have been obtained for the use of tyrosine in a therapeutic setting and in particular to treat depression, Parkinson's disease, or shock states.

Even today, the combination of DOPA and tyrosine is used to treat certain attention disorders such as hyperactivity.

Feb 9, 2022

Iron: role, deficiency, blood test, food, cure

Admin February 09, 2022 0 Comments

Essential for the transport of oxygen and the formation of red blood cells in the blood, iron is a constituent of hemoglobin. When and how to do a dosage? A cure? What to do in case of deficiency? Overdose? What are the consequences? The point with Dr. Eric Atlani, the general practitioner.

Definition: What is iron?

"Iron is a trace element that circulates in plasma or can be stored in organs," says Dr. Eric Atlani, a general practitioner in Cannes. It is necessary to distinguish in the average patient serum iron, which refers to the level of iron, which is not fixed to red blood cells, but which is circulating in the plasma, and ferritin, a protein, allowing the storage of iron, and which corresponds to the iron reserves of the patient' Sometimes, when analyzing iron in a patient, "serum iron may be high, but the storage (iron reserves) is a bit low," he says.

► Heme iron is 'ferrous' iron from animal foods such as meat, poultry, offal, and fish. It is associated with hemoglobin and myoglobin, and represents about 70% of the iron present in the body;

► Non-heme iron is present in plants: cereals, fruits, vegetables, eggs, spirulina. Only 1 to 10% of this iron is absorbed by the body.

What is its role for the organization?

The human body does not naturally make iron.

Iron is a constituent of hemoglobin. It is used to transport oxygen through red blood cells in all the so-called 'noble' organs (brain, kidneys, heart, muscles ...). Its role is therefore essential. "You have to know that the human body does not naturally make iron. Its rate in the body, therefore, depends on the intake and use of iron. That's why there can be a lot of iron deficiencies," he says.

What are the daily needs?

"In general, iron requirements in men and women are between 10 and 20 mg of daily intake in men and women, and above 20 mg in pregnant women, women who have and in regular athletes," observes Dr. Atlani. In children, iron requirements are between 6 and 10 mg per day. In 2016, the nutritional references of the adult population were updated* and are estimated at exactly 11 mg/d for:

Man;
Women with low or normal menstrual losses (80% of the premenopausal female population);
Postmenopausal women and 16 mg/d for premenopausal women with high menstrual discharge.

How to dose iron?

"The determination of serum iron (circulating in plasma) is done through a blood test," says Dr. Atlani. It is also possible to perform a liver biopsy to have a notion of the iron level in the liver - or to perform a liver MRI. In everyday life, however, a blood test is the most common. 'The last two examinations are prescribed when there is a suspicion of hemochromatosis (a genetic disease characterized by intestinal iron hyperabsorption).'

When to do an iron dosage?

"We often start with a simple ferritin dosage to look at the iron reserves. If the reserves are low, as well as the hemoglobin too, there is a suspicion of iron deficiency anemia (decrease in the number of red blood cells in the blood or their hemoglobin content)', describes Dr. Atlani, In this case, we realize most of the time:

► A serum iron assay;

► A transferrin assay (to know the saturation coefficient, which gives a good idea of blood transport).

"I prefer to ask for a ferritin dosage in all my standard checkups. With diets such as vegetarianism or veganism, increasingly adopted by a part of the population, there may be iron deficiencies that must be monitored," observes our interlocutor.

Iron deficiency: consequences, what to do?

"Since iron is a constituent of hemoglobin, if iron is lacking, it cannot efficiently carry oxygen," notes the doctor. Iron deficiency can manifest as the following symptoms:

Fatigue (the first sign of lack of iron);
Ideatory slowness (feeling of losing intellectual abilities, lack of words, concentration ...);
Dyspnea (shortness of breath);
Pallor especially in iron deficiency anemia;
Orthostatic hypotension (when moving from sitting or lying down to standing);
Decreased libido in some patients;
More fragile dander (hair loss especially in women, nails that will break);
Pruritus: people scratch because they have dry skin, this is one of the consequences of an iron deficiency;
Regular bleeding is more abundant (hemorrhoids, menstruation ...) especially in the context of iron anemia.

Iron overload: consequences, what to do?

When there is an iron overload, it means that iron is too abundant in the blood. "The main cause sought is hemochromatosis - the main organ affected by this genetic disease being the liver, a liver biopsy or liver MRI is performed. It may be possible to spot iron overload through an abnormality in liver function, but otherwise, there are no particular symptoms as for an iron deficiency. The only treatments for iron overload in a carrier of the hemochromatosis gene consist of monitoring as well as bleeding. "Often, iron overload is a fortuitous discovery, or there is a family history of hemochromatosis that motivated ferritin testing," he adds.

When to do an iron cure?

An iron cure is performed when iron deficiency is diagnosed. Taking iron-based medications lasts between two and three months. "It takes at least a month for everything to fall into place, and well two months to do the iron refills," says Dr. Atlani. Note that iron-based drugs color the stool, so do not worry if you notice this phenomenon.

What foods are rich in iron?

Red meat, especially cooked black pudding, lamb liver...;
Poultry liver;
Fish and seafood;
Cereals (dry lentils, wheat germ, cooked or dried white beans...);
Spirulina;
Spices (rosemary, sage, curry ...).

'Some substances, on the contrary, reduce the transit of iron: we can mention coffee for example, or certain teas (green tea makes iron lose, black tea decreases its absorption). You should know that vitamin C improves iron absorption. It is therefore advisable to eat foods rich in vitamin C, such as blackcurrant, cabbage, parsley, lemon, pepper, broccoli ...', explains our interlocutor.

Iron during pregnancy

During pregnancy, the blood volume increases. The pregnant woman, therefore, needs more iron for her organs to function properly. "Serum iron consumption is higher in pregnant women," says Dr. Atlani. The slightest iron deficiency can aggravate phenomena of orthostatic hypotension, shortness of breath, dizziness, fatigue, etc.'. In case of iron deficiency during pregnancy, iron supplementation is prescribed by the doctor, often from the fifth month.

Phosphorus deficiency: cause, symptoms, treatments

Admin February 09, 2022 0 Comments

Phosphorus is an essential constituent of bones and teeth. Its deficiency is rare, but when it occurs, it is responsible for many health problems. What rate should be worried? What causes phosphorus deficiency? What are the symptoms? And how to overcome it? Explanations.

Definition: What is phosphorus deficiency?

Phosphorus deficiency occurs when the blood level of this mineral salt is less than 0.8 and 1.5 mmol/L in adults and between 1.5 and 2 mmol/L in children. "This dosage is only indicated in the presence of disorders suggestive of withdrawal: bone disorders in adults and growth retardation in children," says Florence Foucault, dietician-nutritionist.

Daily phosphorus intake

On average, the daily needs of a child up to 10 years of age amount to 500-600 mg. From the age of 10, they amount to between 700 and 800 mg per day. In athletes, the needs amount to 2.5 g / day (source: IRBMS). This mineral salt is present in almost all foods: meat, fish, eggs, cheese as well as seeds and oilseeds are the ones that contain the most.

What are the symptoms of phosphorus deficiency?

Symptoms include tingling in the extremities, muscle weakness, loss of appetite, fatigue, decreased bone mineralization, and bone pain.

What causes phosphorus deficiency?

Phosphorus deficiency can be due to severe malnutrition, anorexia, pregnancy or breastfeeding, digestive problems, or taking certain medications, especially antacids for stomach sourness. "Alcoholism can also cause hypophosphatemia as well as certain diseases, especially those affecting the kidneys," says Florence Foucault.

What are the health consequences?

Phosphorus deficiency causes anemia, a disorder responsible for great fatigue and shortness of breath. "It also leads to coordination disorders in walking, and bone disorders such as rickets; in children and osteomalacia in adults (bone demineralization, source of fractures)," says the expert.

What are the natural treatments and remedies for phosphorus deficiency?

Initially, the cause of the deficiency will be investigated: if it is related to the taking of certain drugs, their discontinuation or replacement may be considered. Then, a food rebalancing is necessary: it aims to include every day on your menu foods rich in this nutrient to cover your daily needs. "Depending on the extent of the deficiency, treatment may also be prescribed in parallel: it is the daily intake of phosphorus. It comes in the form of tablets or capsules, most often combined with calcium, to be taken for a month," recommends Florence Foucault.

Feb 7, 2022

All about the variants of the coronavirus: Omicron, Deltacron, Delta...

Admin February 07, 2022 0 Comments

Several variants (Alpha, Delta...) of the SARS-CoV-2 coronavirus have appeared since the beginning of the pandemic. Now, in France, it is the Omicron variant that is in the majority. How many cases? How effective are vaccines against this new variant?

Many variants of SARS-CoV-2 are circulating around the world. Some are referred to as 'variants of concern' (VOCs) or 'variants to be monitored' (VOI) because their impact (transmissibility, contagiousness, potential immune escape) justifies the implementation of special monitoring and specific management measures. Other variants remain classified as 'under evaluation', in the absence of virological, epidemiological, or clinical evidence in favour of a public health impact in France. In France, the Omicron variant became the majority only one month after the detection of the first case in metropolitan France.

The new variant "Deltacron", what is it?

The Delta and Omicron variants are the two strains that are currently circulating very actively in many countries. What if they combined? This is what a Cypriot researcher fears: he claims to have discovered a new strain of the coronavirus that combines Delta and Omicron, as reported by articles in the Cypriot press including the Cyprus Mail, taken up by the Bloomberg News agency. Leondios Kostrikis, professor of biological sciences at the University of Cyprus and head of the Laboratory of Biotechnology and Molecular Virology, says that the "Deltacron" strain, as he has nicknamed it, has already caused at least 25 cases on the island of Cyprus, where the incidence rate of COVID-19 cases is considered the highest in Europe.

Its particularity? The genetic signature of the Omicron variant and the genomes of the Delta variant. "There are currently Omicron and Delta co-infections and we have found this strain which is a combination of both," Said Leondios Kostrikis in an interview with Sigma TV. "We will see if this strain is more pathological or more contagious or if it will prevail over Delta and Omicron," he added. Not without estimating from a personal point of view that this possible new strain will be replaced by Omicron, much more contagious than other strains of SARS-CoV-2. It should be noted that the discovery of this new mutation is awaiting official confirmation since samples have been sent to the GISAID device of the Institut Pasteur for analysis.

The role of this international database is to list all the observed changes and mutations of Covid-19, which are subsequently made available to the global scientific community. The presence of "Deltacron" was updated following analyses of samples taken from both the general population and hospitalized patients. The results showed that its frequency is higher in patients hospitalized due to Covid-19 compared to non-hospitalized patients, which could mean that there is a correlation between Deltacron and hospitalizations. But other details are all the more expected on this subject as the analysis of the genetic sequences of the supposed 25 cases has led some scientists to pronounce themselves for a "false alarm".

The newspaper Libération reveals that the hypothesis of improper handling in a laboratory is evoked on Twitter by some scientists who have had access to Gisaid. This is the case of Tom Peacock, virologist at Imperial College London who explains that "the Cypriot Deltacron sequences seem to be quite clearly a contamination, they do not group on a phylogenetic tree". It would therefore be rather a "mixture" between several laboratory samples. The latter adds that "true recombinations appear a few weeks or even months after the simultaneous circulation of several variants. Omicron has only been circulating for a little over two weeks, I doubt that there could have already been recombinations... So cases to follow.

Variant Omicron (B.1.1.529): symptoms, severity...

This new variant of the coronavirus was detected on November 25 in South Africa, the African country officially most affected by the pandemic. Named 'Omicron' by the WHO (B.1.1.529), it has an extremely high number of mutations, according to South African scientists: no less than thirty, while the Delta variant has only two. This variant is now the majority among Covid-19 infections in France, two months after its appearance in metropolitan France.

What are the symptoms of the Omicron variant?

According to data collected by Public Health France, the most frequent symptoms that appear after Covid-19 contamination are:

cough;
fatigue;
fever;
Congestion or runny nose.

Cases of nausea, vomiting, shortness of breath, and diarrhea have also been reported, but to a lesser extent. During the weekly update of January 6 of Public Health France, the loss of smell and taste is cited by only 10% of the 338 people interviewed by Public Health France.

In France, more than half of covid-19 deaths in hospitals are now linked to this variant

Between 17 and 23 January 2022, the Directorate of Research, Studies, Evaluation, and Statistics (Drees) estimates that the Omicron variant concerns 57% of deaths occurring in hospitals with Covid-19.

The results, published on Friday, Jan. 28, and updated weekly, also indicate that Omicron is responsible for 99 percent of positive PCR tests, 88 percent of conventional hospital admissions, and 79 percent of critical care admissions.

"The lower representation of the Omicron variant in hospitalized people than in those who tested positive therefore remains, even if this difference in prevalence is decreasing week after week," reports Drees. It would be the fact of the 'temporality of these events (which) differs since infections precede hospitalizations by about a week, themselves preceding deaths by about a week'.

A lower hospitalization rate with the Omicron variant than with Delta

According to a study published on January 10, 2022, by the Assistance Publique-hôpitaux de Paris (AP-HP), the probability of using critical care is "three times higher in patients infected with the Delta variant than with the Omicron variant". The AP-HP studied the share of the Delta variant and the Omicron variant in new patients hospitalized in its departments for Covid-19 between December 1, 2021, and January 4, 2022, in critical care and conventional hospitalization.

"On average over the last week of 2021, about 19% of daily entrants with Omicron in critical care and 54% in conventional hospitalization," notes the AP-HP.
Conventional hospitalizations that correspond to stays of less than one day represent '19% of stays for incoming patients infected with Delta and 43% for incoming patients infected with Omicron'.

According to two British studies published on December 22, the risk of hospitalization related to an infection with the Omicron variant is 70% lower than during infection with the Delta variant.

Their results also showed that the Omicron variant would be less dangerous for the elderly than the Delta variant. "First of all, more of them have made their recall. But also for anatomical reasons. The Hong Kong researchers showed that with the Delta variant we had a lot of variants and viruses that went down into the lungs and it makes serious forms. While with Omicron it goes down less into the lungs, there are fewer serious forms," explained Dr. Damien Mascret on the set of France 2 on December 23.

Is the booster dose needed to protect against the Omicron variant?

In an opinion published on 16 December 2021, the Scientific Council confirms that a booster dose of vaccine would increase vaccine efficacy against Covid-19 and the development of a severe form of the disease. The booster dose (3rd dose) restores an immune response to the Omicron variant. It protects, probably at a good level, against the occurrence of severe and severe forms, but only partially protects against infection with the Omicron variant. According to the researchers, vaccine efficacy would remain at 70% after a booster dose.

Getting out of the pandemic phase?

On Tuesday 11 January, the European Medicines Agency estimated that Omicron would transform Covid-19 into an endemic disease. From now on, we will have to learn to live with it.

"Nobody knows exactly when we will be at the end of the tunnel, but we will get there," said Marco Cavaleri, head of vaccine strategy at the Amsterdam-based European Medicines Agency (EMA). "With the increase in immunity in the population – and with Omicron, there will be a lot of natural immunity in addition to vaccination – we will move quickly towards a scenario that will be closer to endemicity." This is encouraging news that should not make us forget that the world is still in a pandemic.

A higher reinfection rate for the Omicron variant?

WHO Director-General Tedros Adhanom Ghebreyesus had announced that the reinfection rate of the Omicron variant would be much higher than other variants of Covid-19. "Preliminary data from South Africa suggest a higher risk of reinfection with Omicron, but more data are needed to draw firmer conclusions.

A data confirmed by the Scientific Council (opinion published on December 16, 2021): 'The transmission is significantly increased compared to the Delta variant.'

What is known about the Subvariant of Omicron, BA.2, detected in France?

The BA.2 sublineage of the Omicron variant has been detected in several countries, including France. Already the majority in India and Denmark, it has several mutations that could modify the characteristics of the virus. Most of them are found in the Spike protein, the key to the virus' entry into cells.

"We know neither its origin, nor its virulence, nor its ability to escape immunity, including that conferred by Omicron. On the other hand, it seems to be more contagious," explained Antoine Flahaut, epidemiologist and director of the Institute of Global Health at the University of Geneva.

In France, in mid-January, only about fifteen cases of BA.2 subvariants have been sequenced for the moment. The authorities remain cautious: the subvariant BA.2 'corresponds to the characteristics we know of Omicron (...) It does not change the situation," assured the Minister of Health, Olivier Véran, Thursday, January 20. For its part, the WHO confirms to CheckNews "a trend of increase in BA.2 in recent weeks" and says "monitor the progression of BA.2 and its possible implications".

Effectiveness of vaccines against Omicron: what data are available?

In a new risk analysis of Covid-19 variants published on Friday 7 January, Santé Publique, France reported on the available data on the effectiveness of vaccines against the Omicron variant. 'Vaccine efficacy against infection (37 to 86%), hospitalization (70 to 88%), and severe forms (98%) appear to be maintained against Omicron after administration of a booster dose. Preliminary analyses conclude that Omicron has a reduced risk of hospitalization compared to other variants (up to 81%).' The agency recalls that these data should be interpreted with caution because cases of Omicron infection are still mostly identified in a young population, which is, therefore, less at risk.

According to a study conducted by the Institut Pasteur and published on December 20, 2021, the Omicron variant would be resistant to the antibodies of a person who received his complete vaccination regimen five months ago with the Pfizer or AstraZeneca vaccine. Scientists find that blood from patients who have had COVID-19, collected up to 12 months after symptoms, as well as from people who have received both doses of the Pfizer vaccine or the AstraZeneca vaccine, almost no longer neutralize the Omicron variant, five months after vaccination. On the other hand, the sera of individuals who received the 3rd dose of Pfizer booster, analyzed one month after injection, remain effective against Omicron', reads the statement.

A few days later, it is Danish researchers who provide more details about the higher ability of the Omicron variant to circumvent the immunity of vaccinated people compared to the Delta variant. By surveying nearly 12,000 Danish households, the researchers found that Omicron was 2.7 to 3.7 times more infectious than the Delta variant is fully vaccinated Danes. This variant would therefore spread mainly faster because it better escapes the immunity obtained through vaccines.

In this study published in the journal "medRxiv" (a version of a scientific article that has not yet been validated by peers), and relayed by the Reuters agency, the researchers say that Omicron is not so much characterized by greater transmissibility, but by a greater ability to "escape" vaccine immunity. "Our results confirm that the rapid spread of the Omicron variant can mainly be attributed to immune evasion rather than an inherent increase in basic transmissibility," they say. Their study also shows that the effectiveness of the vaccine was reduced to about 40% against symptoms and 80% against a severe form of the disease when it came to the Omicron variant.

It also found that people who received a booster dose are less likely to transmit the virus, regardless of the variant, than people who were not vaccinated.

Finally, although more transmissible, Omicron seems to induce a less serious disease, ISS technical director Tyra Grove Krause told local media. "While Omicron will still be able to put pressure on our health care system, all indications are that it is milder than the Delta variant," she said, adding that the risk of being hospitalized with Omicron was halved compared to the Delta variant. "Maybe that's what will get us out of the pandemic so that it becomes the latest wave of COVID-19," she concludes.

Variant Omicron: are laboratories developing new vaccines?

Since the discovery, at the end of November, of the variant 'Omicron', it is the swing of combat on the side of the laboratories. Contacted by BFMTV, the Pfizer-BioNTech laboratory had explained that it was waiting for complete data from South African analysis laboratories before deciding on the possibility of developing a new vaccine.

For its part, "Moderna will rapidly develop a vaccine candidate for a booster dose specific to the Omicron variant," the U.S. company said in a statement on November 26. This announcement is part of a strategy to work on specific recall doses for variants of concern, according to the laboratory. "From the beginning, we have said that to fight the pandemic, it is imperative to be proactive in the face of the evolution of the virus," said Moderna boss Stéphane Bancel, quoted in the statement.

Oxford and AstraZeneca also say they can develop a new serum "very quickly", especially against the Omicron variant. In a statement, AstraZeneca also said it has "developed, in close collaboration with the University of Oxford, a vaccine platform that allows us to respond quickly to new variants that may appear." The British pharmaceutical company announced that it was "already conducting research in places where the variant has been identified".

Despite some claims widely relayed on social networks, variants are not created by vaccines. It is enough to take the example of the British variant that spread long before the vaccination campaign in the United Kingdom began, recalls Inserm.

Delta variant: contagion, diffusion, dangerousness?

The Delta variant was first identified in the fall of 2020, in the Nagpur region of India. To date, all the countries of Europe are confronted with it. According to the latest GISAID data, the majority of B.1.617 cases are identified in India, the United Kingdom, the United States, Germany and Singapore.

This lineage includes three sublineages, characterized by the L452R and P681R mutations:

B.1.617.1 (Kappa, VOI),
B.1.617.2 (Delta, VOC), the most frequent in France,
and B.1.617.3.

What are the differences between the three main Indian variants?

Each of the Indian variants involves a different risk, according to the Scientific Council (opinion of 24 May 2021):

Subline B.1.617.2 (Delta variant), which does not have the E484Q mutation (contrary to what was initially announced), is the most frequently detected lineage in France and Europe. Note that it also has additional specific mutations that can give it a superior transmissibility advantage to the other two lineages (L452R associated with T478K in the absence of E484Q mutation). It has been classified as VOC since May 12 by the WHO.

Subline B.1.617.1, (Kappa variant) which also has the combination of the two mutations, was detected in Europe and France, but at a low frequency compared to lineage B.1.617.2. Of the three viruses, it is the one that has the largest antigenic difference compared to the historical strain 'Wuhan' and therefore a risk of immune escape. It is classified as VOI.

Subline B.1.617.3, which exhibits the combination of the L452R (which may be associated with an increase in virus transmissibility) and E484Q (responsible for post-infectious and post-vaccine partial immune escape) mutations, has spread very little in and out of India.

The Delta variant '40 to 60% more transmissible' than the Alpha variant

'This variant is characterized by increased competitiveness compared to other variants, including the Alpha variant. It is more transmissible than historical viruses (about 2 times more) and the VOC Alpha (about 40 to 60% more transmissible), Beta (about 60%) and Gamma (about 30%)', indicated Public Health France is a risk analysis published on July 28. And before adding: "Among the possible factors that may explain this increase in Delta's transmissibility, several different data sources indicate an increase in viral load in the nasopharynx in infected people compared to Alpha and other reference viral strains."

'A recent study conducted on a small number of people suggests a shortening of the Delta generational interval compared to the reference strains (4 days versus 6). Data from the UK, Canada, and Singapore indicate an increased risk of hospitalization and severe forms related to this variant compared to VOC Alpha and other reference strains," the organization said.

This variant is characterized by increased competitiveness compared to other variants, including the VOC Alpha. It is more transmissible than historical viruses (about 2 times more) and that THE VOC Alpha (about 40 to 60% more transmissible), Beta (about 60%), and Gamma (about 30%), confirms the risk analysis of Public Health France (August 25).

"The Delta variant is so contagious that it crushes the competition between variants, there is none that has managed to supplant it," explained Yannick Simonin, virologist specializing in emerging viruses, interviewed by Ouest France, October 18, 2021.

Are vaccines effective against the Delta variant?

The effectiveness of mRNA vaccines (Moderna and Pfizer/BioNTech) and Vaxzevria® vaccine (AstraZeneca) on the prevention of severe forms of Covid-19 is established. However, "vaccines save lives, but they do not completely prevent the transmission of Covid-19," said boss Tedros Adhanom Ghebreyesus on Wednesday 24 November.

Since August, the Pfizer-BioNTech laboratory has been working on an updated version of its vaccine that targets the peak protein of the Delta variant, reports BFMTV: "We took measures months ago to be able to adapt the mRNA vaccine within 6 weeks and ship the first batches within 100 days in case of the variant that escapes immunity, says the Pfizer spokesman. To this end, the companies have begun clinical trials with alpha and Delta variant-specific vaccines to collect safety and tolerability data that can be provided to regulators as part of baseline studies if a specific vaccine is needed."

Having been infected with the coronavirus before being vaccinated would guarantee better protection against variants

Researchers at Imperial College London (study published on April 30 in the journal Science) had compared the immunity of patients who had contracted Covid-19 in the nine months before the injection, and the immunity of patients who had never contracted Covid-19, after administration of a single dose of vaccine.

Their conclusions? Patients who have already had Covid-19 have significantly improved protection against the English and South African variants after a single dose of the mRNA vaccine. The scientists found that after the first dose of vaccine, a previous infection was associated with an enhanced response of T cells, B cells, and neutralizing antibodies, which could provide effective protection against SARS-CoV-2, as well as against the Kent and South African variants. However, since individuals contracted a moderate form of covid-19 before the first dose of vaccine, the antibody response was much less important vis-à-vis the English or South African variant.

Conversely, in patients who have never had Covid-19, the immune response is less after the first dose of vaccine, potentially making them more at risk of being infected with a variant. The data collected indicate that 90% of vaccinated people who have not previously been infected with the coronavirus have 'not developed detectable neutralizing antibodies against the English variant B.1.1.7 (after the first vaccine injection)'. This observation underlines the importance of deploying second doses of messenger RNA vaccine.

"Our study is reassuring and a warning. We show that current vaccines offer some protection against variants of concern. However, people who have only received the first cycle of a double-dose vaccine have a more attenuated immune response," warns Professor Áine McKnight, of the Queen Mary University of London.

Delta variant has reduced the effectiveness of vaccines against disease transmission to 40%, warns WHO

The Highly Contagious Delta variant has reduced the effectiveness of vaccines against the transmission of Covid-19 to 40%, the head of the World Health Organization (WHO) announced on Wednesday (November 24th). At a press briefing, Tedros Adhanom Ghebreyesus called on people to continue wearing masks and other barrier measures.

"There is evidence to suggest that before the arrival of the Delta variant, vaccines reduced transmission by about 60%. With the Delta, it dropped to 40 percent," he said. "In many countries and communities, we are concerned that there is this misconception that vaccines have ended the pandemic and that people who are vaccinated no longer need to take further precautions."

What protective measures against omicron and Delta variants?

In order to protect against the Delta variant and other variants of the coronavirus, it is important to maintain barrier gestures and respect the protocol if you are considered a contact case.

What to do when you are a contact case, but already vaccinated?

If a person has a complete vaccination schedule and is not considered immunocompromised, there is no obligation to self-isolate. On the other hand, the contact case person must respect certain health rules to break the chains of transmission of Covid-19:

immediately perform a screening test (RT-PCR or antigen test);
inform the people we have met within 48 hours after meeting the sick person and recommend that they limit their social and family contacts;
respect barrier gestures for 1 week after the last contact with the patient and in particular:
limit social interactions, especially in establishments open to the public were wearing a mask is not possible;
avoid contact with people at risk of severe illness, even if they are vaccinated;
wear a category 1 mask in public spaces;
if you live with a person who tests positive: wear a mask at home;
carry out self-monitoring of temperature and the possible onset of symptoms, with immediate screening in case of symptoms, regardless of age;
Perform a second self-test on Day 2 and Day 4 after the last contact with the positive person.

What to do when you are a contact case and you are not vaccinated?

If the contact case has an incomplete vaccination schedule or if he is immunocompromised it will be necessary to immediately carry out a screening test, RT-PCR, or antigenic (for children under 6 years, a salivary sample may be taken if the nasopharyngeal swab is difficult or impossible).

if the test is positive, the person becomes a confirmed case of Covid-19;
If the screening test is negative, it is necessary to respect isolation at the home of 7 days, from the date of the last contact at risk with the person positive for Covid-19.

How long should I self-isolate if I am positive for Covid-19?

Faced with the extremely active circulation of the Omicron variant and therefore the fear of disorganization of society, the government has set a new isolation deadline for patients and contact cases regardless of the variant. In order to limit the circulation of the virus as much as possible, the Ministry of Health recommends early isolation.

From 3 January 2022, all people with a complete covid-19 positive vaccination schedule (symptoms or not) must remain isolated for 7 days.

However, after 5 days, the positive person can be released from isolation under two conditions:

- if it performs an antigenic test or RT-PCR and it is negative;
- if she has had no clinical signs of infection since 48.

For anyone with an incomplete vaccination schedule or if they are not vaccinated, isolation is 10 days (full) after the date of onset of the signs or the date of collection of the positive test. Nevertheless, after 7 days, the positive person can be released from isolation under two conditions:

she performs an antigen test or RTPCR and it is negative
she has had no clinical signs of infection for 48 hours

If the test is positive or the person does not perform a test, isolation is 10 days.

'Contact persons at risk and persons suspected or confirmed to have been infected by a variant should be monitored more closely. Home visits by nurses are systematically offered and the people concerned whose personal situation suggests a high risk of spread must be systematically offered a specific offer of accommodation, "says the Minister of Health.

What behavior to adopt at the end of isolation?

For a positive person who had symptoms:

- In case of temperature on the 7th day, it is advisable to wait another 48 hours after the disappearance of the fever to finish its isolation.

- If you have difficulty breathing, you should call 15 immediately (or 114 for people who are deaf or hard of hearing).

For a positive person who did not have symptoms:

- If no symptoms appear after 7 days, the isolation ends;

- If symptoms persist or appear after 7 days, the person contacts his doctor. In case of temperature (fever) on the 7th day, the person isolates himself for another 48 hours after the fever has disappeared.

For a person contact cases immunocompromised or with an incomplete vaccination schedule, in case of temperature on the 7th day, it is advisable to wait another 48 hours after the disappearance of the fever to complete its isolation.

At the end of the isolation period, everyone must again respect barrier gestures, such as wearing a mask and physical distancing, and avoid gatherings and contact with vulnerable people for a week.

Reminder: what is a variant?

By definition, viruses mutate constantly to adapt to the hosts they contaminate. The more viruses spread, the more they must mutate in order to always remain 'efficient'. But when viruses multiply in cells, their 'copying' can induce changes in their genetic sequence. We then speak of 'variants' or 'variant strains' to designate viral strains on which several mutations have been fixed.

While these mutations are not affected most of the time, some can make it easier for viruses to enter cells, multiply faster and become more contagious. Still poorly known by the scientific community, these variant strains of the coronavirus could undermine the immunity developed by patients who have already been contaminated by Covid-19 and impact the effectiveness of vaccines placed on the market.

VOC, VOI, VUM: how are variants classified?

Variants of the coronavirus are classified into three categories, according to the consequences they can cause:

Variants of Concern (VOCs). These are variants for which it has been demonstrated by comparing with one or more reference viruses:

- an increase in transmissibility or an adverse impact on the epidemiology of Covid-19;

- an increase in severity or a change in clinical presentation;

- a decrease in the effectiveness of the control measures put in place (preventive measures, diagnostic tests, vaccines, therapeutic molecules) OR

Variants to follow, or VOI ('variant under investigation' or 'variant of interest' in English). These are variants characterized by genetic modifications, which are known to affect (or are expected to affect) the characteristics of the virus such as transmissibility, disease severity, immune escape, ability to evade diagnosis or treatment. To be classified as ANI, a variant must also be responsible for significant community transmission in several countries, leading to increasing relative prevalence as well as an increase in the number of cases over time, or other observable epidemiological consequences that raise concerns about an emerging risk to global public health.

Variants under monitoring (VUM). These are variants for which researchers do not yet have virological, epidemiological, or clinical evidence in favor of an impact in public health, despite the presence of mutations found in one or more VOCs or VOIs.

Other variants of Covid-19, where do we stand?

All about the Alpha variant (20I/501Y. V1)

Reported on December 14, 2020, to the World Health Organization (WHO), the variant 20I/501Y. V1 (Variant Alpha), appeared in England in September 2020. To date in metropolitan France, its prevalence is almost zero. It was replaced by the Delta variant.

The Alpha variant is more contagious and deadly. "This variant is associated with increased transmissibility (from 43 to 90%) and possibly a more severe form of the disease, a higher risk of hospitalization (40-64%) and higher mortality (30-70%)," said Public Health France in its weekly report of April 29. In addition, this variant can contaminate dogs and cats. The British variant of Sars-CoV-2, called B.1.1.7 was first detected in February 2021 in a dog and a cat from the same household, in Brazos County, Texas (USA). In contrast, the risk of coronavirus transmission from pets to humans is considered low.

All about the Beta variant (20H/501Y. V2)

The beta variant, 20h/501y. V2 was detected in South Africa in December 2020. The results of genetic sequencing indicate its presence since November 2020. However, its presence has been a minority in France and is now almost nil.

Public Health France considered that the Beta variant was of concern because of its high contagion. "Preliminary studies suggest that this variant is associated with a 50% higher transmissibility and a higher risk of immune escape and reinfection. Some research indicates a 20% increased risk of death in hospitals. This variant would have the ability to evade the post-infection and post-vaccination immune response, and could therefore increase the risk of reinfection."

All about the Gamma variant (20J/501Y. V3)

Identified in early February 2021 in France, the Gamma variant, 20J/501Y. V3 would have emerged in December 2020 in Manaus (Brazil). Like the South African variant, it has the E484K mutation that could allow it to partially escape the body's immune response. This variant has remained a minority in France.

'Several studies show greater transmissibility compared to strains other than variants (from 40 to 120%). In addition, this variant would have the ability to escape the immune response induced by the first contact with strains of origin, and could therefore increase the risk of reinfection, "says Public Health France.

The impact of vaccination on this variant is still being studied. According to initial data, this Brazilian variant has two mutations E484K and N501Y on the Spike protein. The first would allow viruses to escape antibodies during reinfection or after vaccination.

Screening tests: how do you know if you are contaminated by a variant?

To combat the spread of variants, any test (antigenic or PCR) giving rise to a positive result must be subject to a second-line screening RT-PCR. "This second test makes it possible to determine if it is a variant," notes the DGS (Directorate General of Health).

The laboratories use a specific RT-PCR kit, capable of distinguishing mutations from the classic strain and variants of the coronavirus. They must transmit the results within less than 36 hours to the laboratories that carried out the first PCR test.

Note: if you have performed an antigen test and it turns out to be positive, you will need to perform a second PCR test so that it can be screened.