Introduction Patients with sickle cell disease (SCD) are at risk of chronic kidney disease (CKD) and acute kidney injury (AKI). The risk of AKI associated with contrast media (CM) exposures in this population is uncertain. The objective was to investigate this temporal association in a multicentric case series. Methods We performed a retrospective self-controlled case series (SCCS) in adults followed-up in SCD centers of the Greater Paris University Hospitals who experienced AKI while hospitalized between 2013 and 2022. SCCS estimates the relative incidence (RI) of events during exposure periods (around CM exposure) compared to control periods within the same individual. Analyses were restricted to hospitalizations periods and accounted for time-varying confounders such as age, presence of albuminuria, reduced estimated glomerular filtration rate, and stay in a medical ward or intensive care unit. Results In the main analysis, that included 529 patients and 755 cases of AKI, AKI incidence increased significantly during the 7-day pre-exposure period (RI 2.53, 95% CI: 2.02–3.16), the 0–3 days post-exposure (RI 2.52, 95% CI: 1.99–3.19) and the 4–7 days post-exposure (RI 1.57, 95% CI: 1.20–2.06). Similar patterns were observed for stage 2 or 3 AKI, with higher RI. Conclusion In this cohort of hospitalized adults with SCD, mainly young patients with preserved kidney function and few comorbidities, the RI of AKI was twice as high both before and after CM exposure, suggesting the role of underlying clinical conditions and related medical interventions rather than a causal effect of CM.

Introduction: Patients with sickle cell disease (SCD) are at risk of chronic kidney disease (CKD) and acute kidney injury (AKI). The risk of AKI associated with contrast media (CM) exposures in this population is uncertain. The objective of this study was to investigate this temporal association in a multicentric case series. Methods: We performed a retrospective self-controlled case series (SCCS) in adults followed-up in SCD centers of the Greater Paris University Hospitals who experienced AKI during hospitalization between 2013 and 2022. SCCS estimates the relative incidence (RI) of events during exposure periods (around CM exposure) compared with control periods within the same individual. Analyses were restricted to hospitalizations periods and accounted for time-varying confounders such as age, presence of albuminuria, reduced estimated glomerular filtration rate, and stay in a medical ward or intensive care unit (ICU). Results: In the main analysis, that included 529 patients and 755 cases of AKI, AKI incidence increased significantly during the 7-day pre-exposure period (RI: 2.53, 95% confidence interval [CI]: 2.02-3.16), the 0 to 3 days postexposure (RI: 2.52, 95% CI: 1.99-3.19) and the 4 to 7 days postexposure (RI: 1.57, 95% CI: 1.20-2.06). Similar patterns were observed for stage 2 or 3 AKI, with higher RI. Conclusion: In this cohort of hospitalized adults with SCD, mainly young patients with preserved kidney function and few comorbidities, the RI of AKI was twice as high both before and after CM exposure, suggesting the role of underlying clinical conditions and related medical interventions rather than a causal effect of CM.

Background Up to 30% of individuals infected with COVID-19 experience persistent symptoms, known as post-COVID-19 condition (PCC), which can impair health-related quality of life (HRQoL). While post-COVID-19 condition (PCC) is known to affect health-related quality of life (HRQoL), the specific contribution of individual symptoms remains underexplored.This study examined how specific symptoms affect HRQoL in individuals with PCC compared to those who had COVID-19 without PCC and those never infected. Methods A cross-sectional survey was conducted among a nationally representative sample of 1,813 French adults through telephone and online interviews. Participants were grouped according to WHO PCC criteria, based on infection status and 31 persistent symptoms. HRQoL was measured using the Patient-Reported Outcomes Measurement Information System (PROMIS-29), and impairment was defined as having at least two affected domains. Logistic regressions adjusted for confounders were used to assess associations. Results Among 1,813 participants (365 with PCC, 1,270 previously infected without PCC, 178 never infected), impaired HRQoL was significantly more frequent in with PCC (36%) than in those previously infected without PCC or never infected (adjusted odds ratio: 2.02; 95% CI 1.19-3.42]).The symptoms most strongly associated with HRQoL impairment in PCC were anxiety (OR 3.75; 95% CI: 1.80-7.80), joint pain (OR 2.31; 95% CI: 1.15-4.65), and sleep disturbances (OR 2.14; 95% CI 1.08-4.25), whereas fatigue, shortness of breath, and memory issues had a weaker association with impaired HRQoL in PCC than in other groups. Conclusion PCC, and particularly joint pain, anxiety and sleep disturbance, are associated with impaired HRQoL. Targeted interventions for these symptoms may improve well-being in affected individuals.

AIM:To assess the impact of parameter settings when using the individualized dispensing patterns (IDP) method to estimate exposure duration from dispensing data. METHODS:We conducted a cohort study using a 2% representative sample of the French healthcare insurance database from 2013 to 2022. The IDP method derives drug exposure distribution in a population sample, applies a selected percentile of this distribution to each individual's initial dispensing and then adjusts subsequent exposures at the individual level, incorporating a possible grace period to link consecutive dispensings into continuous exposure episodes. We studied two drugs with contrasting prescribing patterns: tramadol and rivaroxaban. We varied four parameters independently, compared median episode duration estimates and assessed consistency of exposed days estimates using kappa coefficients. RESULTS:With the original IDP parameters, median continuous exposure episodes were 47 days for tramadol and 79 days for rivaroxaban. The impact of parameter choice was drug-specific: Percentile selection affected both drugs (kappa 0.58-0.65 for tramadol; 0.89-0.93 for rivaroxaban), sample population definition affected tramadol only (kappa 0.76), and grace period affected rivaroxaban (kappa 0.74-0.87). Heterogeneity across individual-level kappa values was always high (I2 > 80%). These results informed the selection of drug-specific parameters, yielding clinically more plausible median episode durations: 15 days for tramadol and 96 days for rivaroxaban. CONCLUSION:Consumption patterns in the study population should guide percentile and grace period selection. Tailored accordingly, the IDP method provides an adaptable framework for estimating drug exposure from databases. Transparent reporting of parameter selection is essential to ensure reproducibility and interpretability.

The French national surveillance of pertussis consists of several units, including general practitioners (GPs). Here, we report on the clinical characteristics of cases from January to December 2024 from primary care surveillance in France. During this period, a total of 689 pertussis cases were reported by GPs participating in the surveillance. The national incidence rate in general practice was estimated to be 244 cases per 100,000 inhabitants (95 % CI: 224-264). Sixty-one per cent of cases were female and 86 % had received at least one dose of pertussis vaccine. Among cases vaccinated with at least three doses, 77 % had been vaccinated for less than 5 years. The median age of the cases was 13 years, with children aged 1 to 6 years old being the most affected population. We reported here an increase in the incidence of pertussis in primary care in France since the beginning of 2024, peaking in July 2024. The characteristics of the cases appear to have shifted towards younger age and a higher proportion of individuals who had received at least one dose of the pertussis vaccine in their lifetime, regardless of whether it was administered according to the recommended schedule, compared with previous outbreaks. This study highlights the need for timely vaccination, especially in the young population.

Background Health service utilization is influenced by perceived and evaluated health status (need factors), sociodemographic characteristics and health beliefs (predisposing factors), and personal and community resources that facilitate or hinder access to care (enabling factors). No study has simultaneously quantified how these factors directly and indirectly influence psychotherapy and pharmacotherapy initiation for common mental disorders (CMD). The COVID-19 pandemic provides an opportunity to examine these dynamics due to heightened mental health needs and strained healthcare systems. Methods We conducted a cross-sectional study within the French Grippenet/Covidnet cohort (n=6,944) in April 2022. Data were collected through a voluntary online questionnaire. Participants not using CMD treatments before the pandemic (n=3,297) were included. Weighted structural equation modeling was used to analyze the direct and indirect pathways to psychotherapy and pharmacotherapy initiation. Results Psychotherapy initiation was directly associated with perceived need (poorer self-rated mental health, negative pandemic impact) and enabling factors (employed, mindfulness/relaxation activities, over-the-counter medication). Pharmacotherapy initiation was directly associated with evaluated need (CMD symptoms, non-psychiatric chronic disease), predisposing (female), and enabling factors (over-the-counter medication). Indirectly, predisposing factors influenced treatment initiation primarily through CMD symptoms (female, younger, lower education, living with adults, adverse life event and recent difficult event), while enabling and pandemic-related factors influenced it through poorer perceived need (loneliness, urban, employed, fewer financial difficulties, less deprived area, pandemic financial decline) and CMD symptoms (loneliness, less sport, most deprived area, symptomatic COVID-19). Conclusions This study highlights distinct pathways to psychotherapy and pharmacotherapy initiation and provides insights to improve access to each treatment. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The study was approved by the French Advisory Committee for Research on Information Treatment in Health (authorization 11.565) and the National Commission on Informatics and Liberty (authorization DR-2012-024). The surveys used in and performed for our study were de-identified I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors

Given the rise of telemonitoring and self-management, experts debate the respective advantages and disadvantages of these two approaches. To date, no study has directly compared the efficiency or cost-effectiveness of blood pressure (BP) telemonitoring initiated and supervised by healthcare professionals (HCPs) and self-management of patients autonomously following a prespecified plan, but both have been compared to standard in-office BP management. A 2017 meta-analysis showed that telemonitoring leads to faster BP reduction and a higher rate of patients reaching their BP target than standard care. A 2023 meta-analysis found that digital health intervention to assist patients, such as short message services (SMS), smartphone apps, and websites, led to a larger BP decrease compared to usual care but the high variability in study designs and potential biases temper these results. Currently, the evidence supporting self-management for BP control is less compelling than for telemonitoring. But clinical trials may not fully reflect real-world scenarios. Economic evaluations have not clearly shown that telemonitoring is more cost-effective than standard care. In some studies, healthcare costs were even higher in the telemonitoring group, although this must be weighed against the benefits. On the opposite, some digital self-management tools do not collect identifiable user information, therefore face fewer regulatory constraints, and finally are less costly. Telemonitoring requires significant involvement and time to devote from HCPs to manage data and respond to alerts, raising concerns about increased workload. On the opposite, self-management vs. telemonitoring reduces the workload for HCPs because patients manage their own BP readings and interactions with digital tools autonomously. Another critical aspect to consider is the relationship between patients and HCPs, which differs greatly between telemonitoring and self-management. However, we still lack a full understanding of patient and HCP expectations regarding autonomy and monitoring. The 2023 European Society of Hypertension (ESH) guidelines now endorse digital interventions and self-titration algorithms. There are many differences between self-managing and telemonitoring to claim that one is superior to the other. A more constructive approach is to explore how they can complement each other.

BACKGROUND AND IMPORTANCE:Vaso-occlusive crisis is the main reason for emergency department (ED) visits for patients with sickle cell disease. Therapeutic management involves multimodal analgesia, which often comprises the administration of morphine. Recently, the use of virtual reality (VR) has garnered growing interest as a nonpharmacological approach for pain modulation. OBJECTIVE:The objective of this study was to assess the impact of integrating VR on the reduction of the total dose of morphine administered during vaso-occlusive crisis. SETTINGS AND PARTICIPANTS:This was a prospective before-and-after study conducted in a French adult ED on patients with sickle cell disease and acute pain from vaso-occlusive crisis. INTERVENTION OR EXPOSURE:During the first period, patients were managed according to the standard protocol, with no use of VR. During the second period, patients were able to benefit from VR sessions in addition to the usual care. OUTCOME MEASURES AND ANALYSIS:The primary outcome was the total dose of morphine administered in the ED. Secondary objectives were to evaluate the feasibility, tolerance, acceptability, and effectiveness of VR in pain management, measured using a numeric rating scale. MAIN RESULTS:A total of 97 patients were included in the study, 50 during the noninterventional phase and 47 during the interventional phase. The median morphine dose was 30.7 mg [interquartile range (IQR), 19.7-45.7] in the VR group and 37.7 mg (IQR, 24.7-53.3) in the control group. The median difference between the two groups was -7 mg [95% confidence interval (CI), (-18.6 to 4.6)]. In the VR group, 18.2% of patients (8 out of 44 responders) reported side effects, which included primarily dizziness (50%), followed by nausea (25%) and headaches (25%). Additionally, 83.3% (35 out of 42 responders) of patients expressed the desire to use this method again. CONCLUSION:In this prospective study, the use of VR did not reduce the total morphine dose administered in the ED for patients with acute pain and vaso-occlusive crisis. However, the use of VR appeared to be effectively integrated into multimodal pain management, with a high level of patient satisfaction.

BACKGROUND:Various factors associated with long COVID have been evidenced, but the heterogeneity of definitions and epidemiological investigations has often hidden risk pathways relevant for understanding and preventing this condition. METHODS:This nationwide random sampling survey conducted in France after the Omicron waves in autumn 2022 assessed eight sets of factors potentially associated with long COVID in a structured epidemiological investigation based on a conceptual model accounting for the relationships between these sets of factors. A representative sample of 1813 adults of whom 55% were infected with SARS-CoV-2 was assessed for infection dates and context, post-COVID symptoms and these factors. Four definitions of long COVID, including the World Health Organisation's, were used. RESULTS:Female sex, household size (≥2), low financial security, negative impact of COVID-19 pandemic on occupation and work conditions, number of comorbidities (≥2), presence of respiratory disease, mental and sensory disorders, number of SARS-CoV-2 infections (≥2) and initial symptoms (≥6), perceived high severity of COVID-19 are positively and consistently associated with long COVID. Age ≥ 75 years, retirement, SARS-CoV-2 vaccination (≥2 doses) and good perceived information regarding long Covid are negatively associated with the condition. CONCLUSIONS:The broad spectrum of factors confirmed here strongly suggests that long COVID should be regarded not only as a direct complication of SARS-CoV-2 infection but also as driven by a broader network of contextual, medical, psychological and social factors. These factors should be better considered in strategies aimed at limiting the long COVID burden in the general population.

Most adults with sickle cell disease (SCD) attend the emergency department (ED), with significant interindividual and temporal variability. To identify the patterns of ED use, we analysed data from adults with SCD followed at a French reference centre who had ≥1 ED visit between 1 October 2013 and 31 December 2019. We used a survival model to estimate the cumulative risk of ED visits and its variability over time and applied clustering methods on these two dimensions to identify typical patterns of ED utilization. Among 656 adults (9080 ED visits), two clusters emerged: a low-use group with 529 individuals (81%) and 2924 ED visits (32%) and a high-use group with 127 individuals (19%) and 6156 ED visits (68%). All high-use group members experienced ED visits in bursts, defined as at least three visits within 3 months and at least three times more than during the previous 3 months. Bursts were uncommon in the low-use group (5% of individuals). Among individuals experiencing bursts, two ED visits less than a month apart increased the risk of another ED visit within the next month (adjusted HR 3.51 [95% CI 2.95-4.16]). Understanding factors triggering bursts of ED visits in adults with SCD may enable targeted interventions.

An increase in hospitalizations for respiratory illnesses due to Mycoplasma pneumoniae was reported in France in late October 2023. Data in primary care are scarce and microbiological or radiological investigations are not routinely recommended for community-acquired pneumonia. We computed weekly incidence rates of pneumonia and bronchiolitis cases from the electronic records of French general practitioners from January 2016 to August 2024. These weekly incidences were described in the light of the Covid-19 pandemic, overall and by age group. For better interpretation, the weekly incidences of pneumonia and bronchiolitis were compared with virological surveillance data of acute respiratory infections observed in general practice. During the 2016–2024 period, 108,539 cases of pneumonia and 46,411 cases of bronchiolitis were identified from 51,351,414 consultations. The incidence of pneumonia consultations in general practice during the 2022–2023 and 2023–2024 seasons is similar to that observed before the Covid-19 pandemic, after two seasons of low incidence (2020–2021 and 2021–2022). However, the 2023–2024 pneumonia epidemic is the strongest ever observed in children (0–14 years, and especially among the 5–14 years) in general practice since 2016, with an earlier onset. Regarding the incidence of bronchiolitis in children, the 2023–2024 season was in line with the 2021–2022, 2022–2023 and pre-pandemic seasons. No abnormal circulation of classical seasonal viruses was observed during the 2023–2024 season. The sharp increase in pneumonia cases observed this season among children in primary care settings requires the implementation of studies to understand the cause and to confirm or refute the possible association with M. pneumoniae as observed in hospitals. Given the impact of the Covid-19 pandemic on the circulation of pathogens, it would be useful to extend, even on a temporary basis, the traditional microbiological surveillance in primary care to include common bacterial pathogens affecting the upper and lower respiratory tract, such as M. pneumoniae, S. pneumoniae or Streptococcus A.

Objectives. - Hospital-acquired infections (HAIs) during community disease outbreaks threaten vulnerable hospitalized patients. This study compares the outcomes of hospitalized patients who had COVID-19 as either a HAI or a community-acquired infection (CAI). Methods. - We conducted a retrospective cohort study involving adult patients hospitalized across 39 greater Paris University hospitals between January 27th, 2020, and April 21st, 2021, who tested positive for SARS-CoV-2 PCR during their stay. Patients were classified as CAI if they tested positive within 72 hours of admission and HAI if they tested negative within 72 hours but later positive. HAI was subclassified as possible (first positive test between days 4-7), probable (days 8-13), or definite (day 14 onward). Patients with probable or definite HAI were matched 1:3 to CAI patients for age, sex, and comorbidities, to compare intensive care unit (ICU) transfer and in-hospital death between both groups. Results. - Of 10,831 patients, 506 (4.7%) were classified as HAI. They were older and had more comorbidities. After matching, the 333 patients with probable or definite HAI were less likely to be transferred to the ICU (hazard ratio [HR] 0.57, 95% CI 0.38-0.85) compared to their 999 CAI controls and had a higher risk for in-hospital death (HR 1.58, 95% CI 1.16-2.14). Conclusion. - Patients with COVID-19 as a HAI face a higher risk of death compared to patients hospitalized with COVID-19 acquired in the community and are less likely to be admitted to the ICU. Strict infection control measures are needed during community outbreaks to protect hospitalized patients. (c) 2025 The Authors. Published by Elsevier Masson SAS on behalf of Societe Nationale Franc, aise de Medecine Interne (SNFMI). This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).

Socioeconomic position (SEP) is associated with long COVID risk and health-related quality of life (HRQoL). SEP may influence the relationship between long COVID and HRQoL, but evidence is lacking. Our study therefore evaluated the influence of SEP on the relationship between long COVID or post-COVID-19 condition (PCC) and HRQoL in a representative sample of the general French population. After the Omicron waves in autumn 2022, a representative sample of 1448 adults infected with SARS-CoV-2 was assessed for post-COVID-19 symptoms, demographics, SEP, health factors and HRQoL using the PROMIS-29 questionnaire measuring HRQoL in eight domains (physical function, anxiety, depression, fatigue, sleep disturbance, ability to participate in social roles and activities, pain interference and pain intensity). PCC was defined according to the World Health Organisation. A conceptual model of the relationship between PCC and impaired HRQoL was proposed. Modifying effects of age, sex and SEP variables (geographic origin, education, household size, occupational category, employment status, household income) on the relationship between PCC and HRQoL were tested in the framework of this model. PCC, low education level and household income negatively impacted overall HRQoL and 5/8 PROMIS-29 domains (depression, fatigue, sleep disturbance, social participation and pain intensity). PCC-induced HRQoL impairment was significantly higher among people without a long tertiary education, unemployed individuals, business owners and entrepreneurs and people from mainland France. Healthcare providers and policymakers should better account for the differential impact of long COVID on HRQoL according to SEP. They should promote strategies to reduce health inequalities and lessen the burden of this condition in the general population.

Understanding the risks of COVID-19-related consequences for vulnerable groups such as people with multimorbidity is crucial to better tailor health care and public health measures. The main objective of this study was to explore the association between multimorbidity and WHO-defined post-COVID condition (PCC), while also considering the association with SARS-COV-2 infection given that the infection is a prerequisite of PCC. This population-representative cross-sectional study was conducted in the general adult population in mainland France between 29 August and 31 December 2022 (N = 1813). The analyses of the association between multimorbidity (defined as disease count and most prevalent dyads/triads) and PCC or SAR-COV-2 infection were adjusted for age, sex, socioeconomic variables and number of infections (for PCC only) using adjusted Poisson regression with robust variance. The study population had a mean age (SD) of 53 (± 18.5) years, while 53.6

Individuals with sickle cell disease (SCD) and sickle cell trait (SCT) face an increased risk of complications from COVID-19 due to their susceptibility to infections and venous thromboembolism. We selected 28 studies from 3228 references in bibliographic databases to compare COVID-19 outcomes (hospitalization, ICU admission, need for ventilatory support, thromboembolic events, and mortality) between patients with SCD or SCT and control patients. Compared to control patients, the pooled risk of hospitalization was not significantly higher in those with SCT (odds ratio [OR] 1.13, 95

Introduction Acute painful episodes and acute chest syndromes are common complications of sickle cell disease (SCD), often leading to emergency department (ED) visits. ED utilization differs among patients with SCD and varies over time for most individual. Factors such as genotype, age, sex, medication adherence, previous SCD complications, psychiatric comorbidities, and meteorological conditions have been suggested as contributors to this variability. This study aims to identify the main patterns of ED utilization in adults with SCD, and describe associated factors. Patients and methods We analyzed data from all adults with SCD followed up at a French reference center and hospitalized at least once between October 1, 2013 and December 31, 2019. We used a Cox model for recurrent events with fixed and time dependent variables to estimate (i) the cumulative risk of ED visits and (ii) its variability over time. We then applied clustering methods on these two dimensions to identify typical patterns of ED utilization and compared the characteristics of individuals across these patterns. Results We included 656 adults with SCD, accounting for 9,080 ED visits over a median follow-up of 5 years (interquartile range [IQR] 3–6), corresponding to 1 ED visit per patient per year (IQR 1–3). Of these visits, 5,157 (57%) resulted in home discharge, 3,573 (39%) led to hospital admission, and 350 (4%) required transfer to the intensive care unit.Two clusters of patients emerged, based on their ED utilization: 529 (81%) with low ED use, accounting for 2,924 ED visits (32%); 127 (19%) with high ED use, accounting for 6,156 ED visits (68%). Patients in the high-use group had a higher prevalence of usual risk factors for ED visit, such as younger age, SS/Sβ0 genotype or past acute chest syndrome. They also had a significantly higher prevalence of psychiatric comorbidities (56% vs. 14%, P<0.001), notably anxious disorders (40% vs. 6%, P<0.001).All individuals in the high-use group experienced bursts of ED visits, defined as at least 3 visits within 3 months and at least 3 times more than during the previous 3 months. This burst pattern was uncommon in the low-use group (7% of patients). Among patient prone to bursts, ED visits spaced less than a month apart were followed by a significantly increased risk of a new ED visit within the next month (adjusted hazard ratio 3.49 [95%CI 2.95–4.06]). Discussion Our findings highlight two main patterns of ED utilization in adults with SCD, with a small subset of patients (19%) accounting for more than two thirds of ED visits (68%). These high-use patients have a markedly higher prevalence of psychiatric comorbidities and frequently experience bursts of ED visits, which strongly predict subsequent visits in the short term. These findings underscore the importance of integrating psychiatric support into SCD care and closely monitoring patients during burst period, to prevent recurrent ED visits. Conclusion Better understanding the factors that trigger bursts of ED visits in adults with SCD may lead to targeted interventions, such as mental health support, aimed at reducing ED utilization and improving patient outcomes and experience.

OBJECTIVE:Depressive symptoms may overlap with those of long COVID. This cross-sectional study aims to compare the prevalence of depressive symptoms among individuals infected with SARS-CoV-2 with versus without long COVID and to explore specific associations with each of the nine core symptoms of major depression. METHODS:Data regarding age, gender, SARS-CoV-2 infections, current symptoms, their date of onset, impact on daily functioning, and consideration of alternative diagnoses were collected through phone interviews between September and December 2022 in a nationally representative sample of adults aged ≥18. Data on chronic health conditions and depressive symptoms (PHQ-9) were collected online in infected participants with or without long COVID, according to the WHO definition of the post-COVID-19 condition. RESULTS:Among 1247 participants (mean age (SD): 48.3 (14.3) years, 53.3 % of women), 12.8 % had long COVID and 87.2 % experienced SARS-CoV-2 infection at least 3 months prior to the survey without long COVID. Participant with long COVID were four-fold more likely to have a PHQ-9 score ≥ 10 than those without (44.0 % versus 11.1 %). Three symptoms out of nine were independently associated with long COVID: little interest or pleasure (aOR [95 % CI]: 2.01 [1.03-3.92]), feeling tired or having little energy (1.92 [1.10-3.33]), and poor attention/concentration (2.02 [1.03-3.96]). CONCLUSION:Clinicians should screen patients with long COVID for major depression but associations with specific depressive symptoms suggest some clinical overlap. Future studies should consider the course of each depressive symptom separately and focus on those less prone to overlap with symptoms of long COVID.