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1. Parents’ depression and anxiety associated with hyperactivity-inattention and emotional symptoms in children during school closure due to COVID-19 in France

Author

Maëva Monnier, Flore Moulin, Marion Bailhache, Xavier Thierry, Stéphanie Vandentorren, Sylvana Côté, Bruno Falissard, Thierry Simeon, Bertrand Geay, Laetitia Marchand-Martin, Marie-Noelle Dufourg, Marie-Aline Charles, Pierre-Yves Ancel, Maria Melchior, Alexandra Rouquette, Cédric Galera, The SAPRIS Study Group, and The ELFE Joint Unit

Subjects
Medicine, Science
Abstract

Abstract Several risk factors of children’s mental health issues have been identified during the pandemic of COronaVIrus Disease first appeared in 2019 (COVID-19). This study aims to fill the knowledge gap regarding the association between parents’ and children’s mental health issues during the COVID-19 school closure in France. We conducted a cross-sectional analysis of data collected in the SAPRIS-ELFE study during the COVID-19 pandemic in France. Using multinomial logistic regressions, we estimated associations between parents’ and children’s mental health issues. Symptoms of anxiety were assessed by the General Anxiety Disorder-7 (GAD-7) and depression by the Patient Health Questionnaire-9 (PHQ-9) for the parents. Hyperactivity/inattention and emotional symptoms in children were assessed by the Strengths and Difficulties Questionnaire (SDQ). The sample included 3496 children aged 8 to 9 years, of whom 50.0% were girls. During the school closure, 7.1% of responding parents had moderate to severe levels of anxiety and 6.7% had moderate to severe levels of depression. A total of 11.8% of the children had an abnormal hyperactivity/inattention score and 6.6% had an abnormal emotional symptoms score. In multivariate regression models, parental moderate to severe level of anxiety and moderate to severe level of depression were associated with abnormal hyperactivity-inattention score (adjusted Odds Ratio (aOR) 3.31; 95% Confidence Interval (CI) 2.33–4.70 and aOR 4.65; 95% CI 3.27–6.59, respectively) and abnormal emotional symptoms score in children (aOR 3.58; 95% CI 2.33–5.49 and aOR 3.78; 95 CI 2.47–5.78 respectively). Children whose parents have symptoms of anxiety and/or depression have an increased likelihood of symptoms of hyperactivity/inattention and emotional symptoms during school closures in France due to COVID-19. Our findings suggest that public health initiatives should target parents and children to limit the impact of such crises on their mental health issues.

Published
2023
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2. Children's mental and behavioral health, schooling, and socioeconomic characteristics during school closure in France due to COVID-19: the SAPRIS project

Author

Maëva Monnier, Flore Moulin, Xavier Thierry, Stéphanie Vandentorren, Sylvana Côté, Susana Barbosa, Bruno Falissard, Sabine Plancoulaine, Marie-Aline Charles, Thierry Simeon, Bertrand Geay, Laetitia Marchand, Pierre-Yves Ancel, Maria Melchior, Alexandra Rouquette, the SAPRIS study group, and Cédric Galera

Subjects
Medicine, Science
Abstract

Abstract COVID-19 limitation strategies have led to widespread school closures around the world. The present study reports children’s mental health and associated factors during the COVID-19 school closure in France in the spring of 2020. We conducted a cross-sectional analysis using data from the SAPRIS project set up during the COVID-19 pandemic in France. Using multinomial logistic regression models, we estimated associations between children’s mental health, children’s health behaviors, schooling, and socioeconomic characteristics of the children’s families. The sample consisted of 5702 children aged 8–9 years, including 50.2% girls. In multivariate logistic regression models, children’s sleeping difficulties were associated with children’s abnormal symptoms of both hyperactivity-inattention (adjusted Odds Ratio (aOR) 2.05; 95% Confidence Interval 1.70–2.47) and emotional symptoms (aOR 5.34; 95% CI 4.16–6.86). Factors specifically associated with abnormal hyperactivity/inattention were: male sex (aOR 2.29; 95% CI 1.90–2.76), access to specialized care prior to the pandemic and its suspension during school closure (aOR 1.51; 95% CI 1.21–1.88), abnormal emotional symptoms (aOR 4.06; 95% CI 3.11–5.29), being unschooled or schooled with assistance before lockdown (aOR 2.13; 95% CI 1.43–3.17), and tutoring with difficulties or absence of a tutor (aOR 3.25; 95% CI 2.64–3.99; aOR 2.47; 95% CI 1.48–4.11, respectively). Factors associated with children’s emotional symptoms were the following: being born pre-term (aOR 1.34; 95% CI 1.03–1.73), COVID-19 cases among household members (aOR 1.72; 95% CI 1.08–2.73), abnormal symptoms of hyperactivity/inattention (aOR 4.18; 95% CI 3.27–5.34) and modest income (aOR 1.45; 95% CI 1.07–1.96; aOR 1.36; 95% CI 1.01–1.84). Multiple characteristics were associated with elevated levels of symptoms of hyperactivity-inattention and emotional symptoms in children during the period of school closure due to COVID-19. Further studies are needed to help policymakers to balance the pros and cons of closing schools, taking into consideration the educational and psychological consequences for children.

Published
2021
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3. Children's mental and behavioral health, schooling, and socioeconomic characteristics during school closure in France due to COVID-19: the SAPRIS project

Author

Marie-Aline Charles, Cédric Galéra, Sabine Plancoulaine, Thierry Siméon, Maëva Monnier, Stéphanie Vandentorren, Bertrand Geay, Maria Melchior, Laetitia Marchand, Bruno Falissard, Pierre-Yves Ancel, Susana Barbosa, Sylvana M. Côté, Flore Moulin, Alexandra Rouquette, Xavier Thierry, Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre hospitalier Charles Perrens [Bordeaux], Etude longitudinale française depuis l'enfance (UMS : Ined-Inserm-EFS) (ELFE), Institut national d'études démographiques (INED)-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de Biotechnologie et Microbiologie Appliquée (LBMA), Université Bordeaux Segalen - Bordeaux 2-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Santé publique France - French National Public Health Agency [Saint-Maurice, France], Université du Québec à Montréal = University of Québec in Montréal (UQAM), Research Unit on Children's Psychosocial Maladjustment [Montréal, QC, Canada], Université de Montréal (UdeM), Institut de pharmacologie moléculaire et cellulaire (IPMC), Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Centre National de la Recherche Scientifique (CNRS)-Université Côte d'Azur (UCA), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Equipe de Recherche en Epidémiologie Sociale [iPLesp] (ERES), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Fondation pour la Recherche Médicale, Direction Générale de la Recherche et de l’Innovation, Institut Gustave Roussy, the New-Aquitaine region. Mrs Maeva Monnier has been funded by the New-Aquitaine region (AMI Flash Recherche et Innovations COVID), SAPRIS study group: Nathalie Bajos, Fabrice Carrat, Pierre-Yves Ancel, Marie-Aline Charles, Florence Jusot, Claude Martin, Laurence Meyer, Ariane Pailhé, Alexandra Rouquette, Gianluca Severi, Alexis Spire, Mathilde Touvier, Marie Zins, HAL-SU, Gestionnaire, Hôpital Charles Perrens, Institut national d'études démographiques (INED), Centre National de la Recherche Scientifique (CNRS)-Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Université Côte d'Azur (UCA), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Montréal. École de santé publique. Département de médecine sociale et préventive

Subjects
Male, Health Behavior, EPIDEMICS, CHILDREN, Logistic regression, 0302 clinical medicine, Surveys and Questionnaires, Medicine, Psychology, 030212 general & internal medicine, Child, Multinomial logistic regression, Multidisciplinary, Schools, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Child Health, 3. Good health, Mental Health, Educational Status, Female, Sleeping difficulties, Coronavirus disease 2019 (COVID-19), Science, Physical Distancing, FRANCE, Article, Education, Distance, 03 medical and health sciences, Medical research, 030225 pediatrics, Humans, Socioeconomic status, Pandemics, business.industry, SARS-CoV-2, COVID-19, Odds ratio, MENTAL_HEALTH, Mental health, Confidence interval, RISK_FACTOR, Cross-Sectional Studies, Risk factors, Communicable Disease Control, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Demography
Abstract

COVID-19 limitation strategies have led to widespread school closures around the world. The present study reports children’s mental health and associated factors during the COVID-19 school closure in France in the spring of 2020. We conducted a cross-sectional analysis using data from the SAPRIS project set up during the COVID-19 pandemic in France. Using multinomial logistic regression models, we estimated associations between children’s mental health, children’s health behaviors, schooling, and socioeconomic characteristics of the children’s families. The sample consisted of 5702 children aged 8–9 years, including 50.2% girls. In multivariate logistic regression models, children’s sleeping difficulties were associated with children’s abnormal symptoms of both hyperactivity-inattention (adjusted Odds Ratio (aOR) 2.05; 95% Confidence Interval 1.70–2.47) and emotional symptoms (aOR 5.34; 95% CI 4.16–6.86). Factors specifically associated with abnormal hyperactivity/inattention were: male sex (aOR 2.29; 95% CI 1.90–2.76), access to specialized care prior to the pandemic and its suspension during school closure (aOR 1.51; 95% CI 1.21–1.88), abnormal emotional symptoms (aOR 4.06; 95% CI 3.11–5.29), being unschooled or schooled with assistance before lockdown (aOR 2.13; 95% CI 1.43–3.17), and tutoring with difficulties or absence of a tutor (aOR 3.25; 95% CI 2.64–3.99; aOR 2.47; 95% CI 1.48–4.11, respectively). Factors associated with children’s emotional symptoms were the following: being born pre-term (aOR 1.34; 95% CI 1.03–1.73), COVID-19 cases among household members (aOR 1.72; 95% CI 1.08–2.73), abnormal symptoms of hyperactivity/inattention (aOR 4.18; 95% CI 3.27–5.34) and modest income (aOR 1.45; 95% CI 1.07–1.96; aOR 1.36; 95% CI 1.01–1.84). Multiple characteristics were associated with elevated levels of symptoms of hyperactivity-inattention and emotional symptoms in children during the period of school closure due to COVID-19. Further studies are needed to help policymakers to balance the pros and cons of closing schools, taking into consideration the educational and psychological consequences for children.

Published
2021
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4. Cohort Profile: The French National cohort of children ELFE: birth to 5 years

Author

Cécile Zaros, Xavier Thierry, Ruxandra Popa, Marie-Noëlle Dufourg, Marie Cheminat, Bertrand Geay, Marie-Aline Charles, Corinne Bois, Jean-Louis Lanoë, and Institut national d'études démographiques (INED)

Subjects
0301 basic medicine, Epidemiology, Day care, [SHS.DEMO]Humanities and Social Sciences/Demography, [SHS]Humanities and Social Sciences, National cohort, Cohort Studies, ELFE survey, 03 medical and health sciences, 0302 clinical medicine, Humans, Medicine, 030212 general & internal medicine, Cohort Profiles, business.industry, 4. Education, Socialization, Infant, Newborn, Infant, General Medicine, Child development, Family life, 030104 developmental biology, Child, Preschool, longitudinal survey on childhood, Cohort, Pre school, France, business, Birth cohort, Demography
Abstract

International audience; ELFE is the first French national birth cohort. Its objective is to study determinants of the development, health and socialization of children from birth to adulthood through a multidisciplinary approach. A total of 18 329 children were recruited at birth in a random sample of maternity units in metropolitan France during 25 selected days of 2011 spread over the year. Follow-up in the first 5 years consisted of telephone interviews of both parents of the child at age 2 months and 1 year and 2 years, and of one parent at age 3.5 years; a home visit at age 3.5 years; questionnaires to the child’s physician at age 2 years, the child’s nursery school doctor at age 3 to 4 years, and the child’s nursery schoolteacher at age 4 years. Participation rates at the age 2-month, 1- and 2-year and 3.5-year parental interviews were 92%, 86%, 82% and 80%, espectively, of contacted participants. The main categories of data collected concern: sociodemographic characteristics; family life; parental health, behaviour and life values; child development and health; child school performance, behaviour, and socialization; day care and school; and childhood environmental exposures. The ELFE has an open-data policy after an 18-month exclusivity period following each release of new data. The data-access policy, study protocols, questionnaires and data catalogue can be found online: [https://www.ELFE-france.fr/en/]

Published
2020
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6. Association of Self-reported COVID-19 Infection and SARS-CoV-2 Serology Test Results with Persistent Physical Symptoms among French Adults during the COVID-19 Pandemic

Author

Gianluca Severi, Fabrice Carrat, Clément Gouraud, Hélène Blanché, Marcel Goldberg, Olivier Robineau, Cédric Lemogne, Nicolas Hoertel, Emmanuel Wiernik, Xavier de Lamballerie, Jean-François Deleuze, Mathilde Touvier, Joane Matta, Marie Zins, Brigitte Ranque, Cohortes épidémiologiques en population (CONSTANCES), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université de Paris (UP), Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Università degli Studi di Firenze = University of Florence [Firenze] (UNIFI), Unité des Virus Emergents (UVE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), Fondation Jean Dausset - Centre d’Etudes du Polymorphisme Humain [Paris] (CEPH), Hôpital Hôtel-Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Corentin Celton [Issy-les-Moulineaux], Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), ANR-10-COHO-06, ANR-20-COVI-000, 20RR052-00, AstraZeneca, Merck Sharp and Dohme, MSD, Agence Nationale de la Recherche, ANR: 20DMIA014-0, Institut National de la Santé et de la Recherche Médicale, Inserm, Fondation pour la Recherche Médicale, FRM: C20-26, Ministère des Affaires Sociales et de la Santé, H. Lundbeck A/S, Funding/Support: The CONSTANCES cohort benefits from grant ANR-11-INBS-0002 from the French National Research Agency. CONSTANCES is supported by the Caisse Nationale d’Assurance Maladie, the French Ministry of Health, the Ministry of Research, and the Institut National de la Santé et de la Recherche Médicale (INSERM). CONSTANCES is also partly funded by AstraZeneca, Lundbeck, L’Oréal, and Merck Sharp & Dohme Corp. The Santé, Pratiques, Relations et Inégalités Socials en Population Générale Pendant la Crise COVID-19 (SAPRIS) and SAPRIS-Sérologie (SERO) study was supported by grants ANR-10-COHO-06 and ANR-20-COVI-000 from the Agence Nationale de la Recherche, grant 20DMIA014-0 from Santé Publique France, grant 20RR052-00 from the Fondation pour la Recherche Médicale, and grant C20-26 from INSERM., reported personal fees and nonfinancial support from Gilead, ViiV Healthcare, and Merck Sharp & Dohme Corp outside the submitted work. Dr Carrat reported personal fees from Sanofi outside the submitted work. Dr de Lamballerie reported grants from the French Ministry of Research and the French Institute of Health and Medical Research during the conduct of the study. Dr Hoertel reported personal fees and nonfinancial support, Santé, Pratiques, Relations et Inégalités Sociales en Population Générale Pendant la Crise COVID-19–Sérologie (SAPRIS-SERO) Study Group: Sofiane Kab, Adeline Renuy, Stephane Le-Got, Celine Ribet, Emmanuel Wiernik, Marcel Goldberg, Marie Zins, Fanny Artaud, Pascale Gerbouin-Rérolle, Mélody Enguix, Camille Laplanche, Roselyn Gomes-Rima, Lyan Hoang, Emmanuelle Correia, Alpha Amadou Barry, Nadège Senina, Gianluca Severi, Julien Allegre, Fabien Szabo de Edelenyi, Nathalie Druesne-Pecollo, Younes Esseddik, Serge Hercberg, Mathilde Touvier, Marie-Aline Charles, Pierre-Yves Ancel, Valérie Benhammou, Anass Ritmi, Laetitia Marchand, Cécile Zaros, Elodie Lordmi, Adriana Candea, Sophie de Visme, Thierry Simeon, Xavier Thierry, Bertrand Geay, Marie-Noelle Dufourg, Karen Milcent, Delphine Rahib, Nathalie Lydie, Clovis Lusivika-Nzinga, Gregory Pannetier, Nathanael Lapidus, Isabelle Goderel, Céline Dorival, Jérôme Nicol, Fabrice Carrat, Cindy Lai, Liza Belhadji, Hélène Esperou, Sandrine Couffin-Cadiergues, Jean-Marie Gagliolo, Hélène Blanché, Jean-Marc Sébaoun, Jean-Christophe Beaudoin, Laetitia Gressin, Valérie Morel, Ouissam Ouili, Jean-François Deleuze, Laetitia Ninove, Stéphane Priet, Paola Mariela Saba Villarroel, Toscane Fourié, Souand Mohamed Ali, Abdenour Amroun, Morgan Seston, Nazli Ayhan, Boris Pastorino, Xavier de Lamballerie, ANR-11-INBS-0002,CONSTANCES,La cohorte CONSTANCES - Infrastructure épidémiologique ouverte pour la recherche et la surveillance(2011), ANR-10-COHO-0006,E4N,Etude Epidémiologique des Enfants de femmes de l'Education Nationale(2010), ANR-20-COVI-0009,SAPRIS,Santé, perception, pratiques, relations et inégalités sociales en population générale pendant la crise COVID-19(2020), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), HAL UVSQ, Équipe, Infrastructures - La cohorte CONSTANCES - Infrastructure épidémiologique ouverte pour la recherche et la surveillance - - CONSTANCES2011 - ANR-11-INBS-0002 - INBS - VALID, Cohortes - Etude Epidémiologique des Enfants de femmes de l'Education Nationale - - E4N2010 - ANR-10-COHO-0006 - COHO - VALID, and Santé, perception, pratiques, relations et inégalités sociales en population générale pendant la crise COVID-19 - - SAPRIS2020 - ANR-20-COVI-0009 - COVID-19 - VALID

Subjects
education.field_of_study, medicine.medical_specialty, business.industry, [SDV]Life Sciences [q-bio], Population, Disease, Odds ratio, Logistic regression, Serology, [SDV] Life Sciences [q-bio], Clinical research, Quality of life, Internal medicine, Cohort, Internal Medicine, medicine, Humans, Educational Measurement, education, business, Original Investigation
Abstract

International audience; Importance: After an infection by SARS-CoV-2, many patients present with persistent physical symptoms that may impair their quality of life. Beliefs regarding the causes of these symptoms may influence their perception and promote maladaptive health behaviors. Objective: To examine the associations of self-reported COVID-19 infection and SARS-CoV-2 serology test results with persistent physical symptoms (eg, fatigue, breathlessness, or impaired attention) in the general population during the COVID-19 pandemic. Design, Setting, and Participants: Participants in this cross-sectional analysis were 26823 individuals from the French population-based CONSTANCES cohort, included between 2012 and 2019, who took part in the nested SAPRIS and SAPRIS-SERO surveys. Between May and November 2020, an enzyme-linked immunosorbent assay was used to detect anti-SARS-CoV-2 antibodies. Between December 2020 and January 2021, the participants reported whether they believed they had experienced COVID-19 infection and had physical symptoms during the previous 4 weeks that had persisted for at least 8 weeks. Participants who reported having an initial COVID-19 infection only after completing the serology test were excluded. Main Outcomes and Measures: Logistic regressions for each persistent symptom as the outcome were computed in models including both self-reported COVID-19 infection and serology test results and adjusting for age, sex, income, and educational level. Results: Of 35852 volunteers invited to participate in the study, 26823 (74.8%) with complete data were included in the present study (mean [SD] age, 49.4 [12.9] years; 13731 women [51.2%]). Self-reported infection was positively associated with persistent physical symptoms, with odds ratios ranging from 1.39 (95% CI, 1.03-1.86) to 16.37 (95% CI, 10.21-26.24) except for hearing impairment (odds ratio, 1.45; 95% CI, 0.82-2.55) and sleep problems (odds ratio, 1.14; 95% CI, 0.89-1.46). A serology test result positive for SARS-COV-2 was positively associated only with persistent anosmia (odds ratio, 2.72; 95% CI, 1.66-4.46), even when restricting the analyses to participants who attributed their symptoms to COVID-19 infection. Further adjusting for self-rated health or depressive symptoms yielded similar results. There was no significant interaction between belief and serology test results. Conclusions and Relevance: The findings of this cross-sectional analysis of a large, population-based French cohort suggest that persistent physical symptoms after COVID-19 infection may be associated more with the belief in having been infected with SARS-CoV-2 than with having laboratory-confirmed COVID-19 infection. Further research in this area should consider underlying mechanisms that may not be specific to the SARS-CoV-2 virus. A medical evaluation of these patients may be needed to prevent symptoms due to another disease being erroneously attributed to "long COVID.".

Published
2022
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7. Do not neglect SARS-CoV-2 hospitalization and fatality risks in the middle-aged adult population

Author

Xavier de Lamballerie, Daniel Lévy-Bruhl, Mathilde Touvier, Simon Cauchemez, Juliette Paireau, Gianluca Severi, Fabrice Carrat, Nathanael Lapidus, Marie Zins, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Modélisation mathématique des maladies infectieuses - Mathematical modelling of Infectious Diseases, Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), Santé publique France - French National Public Health Agency [Saint-Maurice, France], Unité des Virus Emergents (UVE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Università degli Studi di Firenze = University of Florence [Firenze] (UNIFI), Equipe 3: EREN- Equipe de Recherche en Epidémiologie Nutritionnelle (CRESS - U1153), Université Sorbonne Paris Nord-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Université de Paris (UP), Cohortes épidémiologiques en population (CONSTANCES), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université de Paris (UP), The SAPRIS-SERO study was supported by Agence Nationale de la Recherche, #ANR-10-COHO-06, Fondation pour la Recherche Médicale (#20RR052-00), Inserm (Institut National de la Santé et de la Recherche Médicale), #C20-26., The SAPRIS-SERO study group Sofiane Kab, Adeline Renuy, Stephane Le-Got, Celine Ribet, Emmanuel Wiernik, Marcel Goldberg, Marie Zins (Constances cohort). Fanny Artaud, Pascale Gerbouin-Rérolle, Mélody Enguix, Camille Laplanche, Roselyn Gomes-Rima, Lyan Hoang, Emmanuelle Correia, Alpha Amadou Barry, Nadège Senina, Gianluca Severi (E3N-E4 N cohort). Fabien Szabo de Edelenyi, Nathalie Druesne-Pecollo, Younes Esseddik, Serge Hercberg, Mathilde Touvier (NutriNet-Santé cohort). Marie-Aline Charles, Pierre-Yves Ancel, Valérie Benhammou, Anass Ritmi, Laetitia Marchand, Cecile Zaros, Elodie Lordmi, Adriana Candea, Sophie de Visme, Thierry Simeon, Xavier Thierry, Bertrand Geay, Marie-Noelle Dufourg, Karen Milcent (Epipage2 and Elfe child cohorts). Clovis Lusivika-Nzinga, Gregory Pannetier, Nathanael Lapidus, Frédéric Chau, Isabelle Goderel, Céline Dorival, Jérôme Nicol, Fabrice Carrat (IPLESP–methodology and coordinating data center). Cindy Lai, Hélène Esperou, Sandrine Couffin-Cadiergues (Inserm). Jean-Marie Gagliolo (Institut de Santé Publique). Hélène Blanché, Jean-Marc Sébaoun, Jean-Christophe Beaudoin, Laetitia Gressin, Valérie Morel, Ouissam Ouili, Jean-François Deleuze (Fondation Jean-Dausset, CEPH-Biobank). Stéphane Priet, Paola Mariela Saba Villarroel, Toscane Fourié, Souand Mohamed Ali, Abdenour Amroun, Morgan Seston, Nazli Ayhan, Boris Pastorino, Xavier de Lamballerie (Unité des Virus Émergents)., ANR-10-COHO-0006,E4N,Etude Epidémiologique des Enfants de femmes de l'Education Nationale(2010), HAL-SU, Gestionnaire, Cohortes - Etude Epidémiologique des Enfants de femmes de l'Education Nationale - - E4N2010 - ANR-10-COHO-0006 - COHO - VALID, Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), Università degli Studi di Firenze = University of Florence (UniFI), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Université Paris Cité (UPCité), and Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université Paris Cité (UPCité)

Subjects
Male, Adult, Age-Specific Death Rate, Short Communication, media_common.quotation_subject, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Population, Risk Assessment, Neglect, Young Adult, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Pandemic, Humans, Medicine, 030212 general & internal medicine, Young adult, education, Aged, 030304 developmental biology, media_common, Aged, 80 and over, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, 0303 health sciences, education.field_of_study, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, business.industry, SARS-CoV-2, Incidence (epidemiology), COVID-19, Middle Aged, 3. Good health, Hospitalization, Infectious Diseases, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Relative risk, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Female, Age Specific Death Rate, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, business, Risk assessment, Demography
Abstract

Highlights • During the first wave of the pandemic in France, the estimated overall infection hospitalization ratio (IHR, probability of hospitalization in infected adults) was 2.7%. • At that time, the estimated overall infection fatality ratio (IFR, probability of death in infected adults) was 0.49%. • Both IHR and IFR were higher in men. • IHR approximately doubled every 10 years while IFR doubled every 5 years. • IFR should not be neglected, even in young and middle-aged adults (0.042% in individuals aged 40-50 years)., Objectives This study aimed at estimating the SARS-CoV-2 infection hospitalization (IHR) and infection fatality ratios (IFR) in France. Patients and methods A serosurvey was conducted in 9782 subjects from the two French regions with the highest incidence of COVID-19 during the first wave of the pandemic and coupled with surveillance data. Results IHR and IFR were 2.7% and 0.49% overall. Both were higher in men and increased exponentially with age. The relative risks of hospitalization and death were 2.1 (95% CI: 1.9-2.3) and 3.8 (2.4-4.2) per 10-year increase, meaning that IHR and IFR approximately doubled every 10 and 5 years, respectively. They were dramatically high in the very elderly (80-90 years: IHR: 26%, IFR: 9.2%), and also substantial in younger adults (40-50 years: IHR: 0.98%, IFR: 0.042%). Conclusions These findings support the need for comprehensive preventive measures to help reduce the spread of the virus, even in young or middle-aged adults.

Published
2021
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