INTRODUCTION:Loiasis has been associated with increased morbidity and mortality, particularly in cases of high microfilarial density. Treatment depends on initial microfilaraemia (Mf) and relies on ivermectin (IVM), diethylcarbamazine (DEC) or albendazole (ALB), all associated with serious adverse events. Our objective was to describe the clinical characteristics, management and outcomes of patients diagnosed with loiasis and Mf in France. METHODS:We conducted a multicenter retrospective study including patients with loiasis and Mf diagnosed and treated in France between 2000 and 2022, with at least one follow-up evaluation. We collected clinical and biological data, including Mf kinetics, for each treatment episode. RESULTS:A total of 150 patients (181 treatment episodes) were included across 27 centers. Median age was 35 years, and most patients presented symptoms (75.3%). Median Mf was 500 mf/ml; for 74% of episodes, baseline Mf below 2000 mf/ml, while 8% had baseline Mf above 8000 mf/ml. Twelve different treatment schemes were identified, the most common being a single dose of IVM (39%). Adverse events occurred in 12% of episodes, including one fatal event. On last follow-up visit, 9.3% of patients still experienced symptoms, 24.7% exhibited persistent Mf, and 19.3% had persistent blood eosinophilia, patients treated with stand-alone IVM experienced worse outcomes (18%, 72% and 39%, respectively). CONCLUSION:In France, loiasis treatment is inconsistent and frequently relies on inadequate options, including IVM monotherapy, which lacks therapeutic efficacy, and carries safety concerns. Our findings highlight real-world practices and indicates that better training is needed for practitioners treating patients with loiasis.

Antimicrobial resistance is a worldwide concern, especially in West Africa. Our objective was to study the impact of human presence on the dissemination of extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) in the environment by sampling feces from various animal species. ESBL-E fecal colonization was screened in patients from a Beninese hospital during their stay. Secondary sampling of 10–15 animal feces was conducted around the homes of 16 selected colonized patients. Each sample was cultured on selective media and tested for ESBL phenotype. Bacterial identification and antibiotic susceptibility were performed for ESBL-E. Patients’ community living spaces were categorized according to the proportion of cumulative housing surface into rural (< 30

BACKGROUND:Buruli ulcer is a neglected tropical disease caused by Mycobacterium ulcerans, primarily affecting rural populations in west and central Africa. Between 2004 and 2023, reported Buruli ulcer cases declined sharply across the continent from 5871 to 1573. Determining whether this decline reflects real epidemiological change or surveillance artifacts is crucial for global Buruli ulcer control. We aimed to quantify the incidence of Buruli ulcer in Benin, to analyse observed epidemiological changes, and to relate them to environmental and climate changes. METHODS:We did a nationwide, retrospective, observational study using data recorded by Benin's National Buruli Ulcer Control Programme at four specialised health-care centres in southern Benin over 16 years (2008-24). Data were collected prospectively at the time of patient care. 2568 patients with PCR-confirmed Buruli ulcer were included. Annual incidence trends were examined by age, sex, municipality, and clinical form of the lesion. Environmental and climatic variables, including water surface area, temperature, urbanisation, and land use, were integrated with patient data to assess ecological associations. In parallel, a large-scale environmental survey investigated the presence of M ulcerans DNA in aquatic ecosystems. Data census and population projections were obtained from the National Institute of Statistics and Demography of Benin; environmental variables were derived from spatial analyses conducted using open-access geospatial databases. FINDINGS:The incidence of Buruli ulcer decreased by nearly 80% during the study period, from 1·37 per 10 000 inhabitants (SD 0·21 per 10 000 inhabitants) in 2010-16 to 0·24 per 10 000 inhabitants in 2024, with the steepest decrease in children aged 15 years and younger. Historical age and sex differences in incidence largely disappeared over the period. The decrease in incidence coincided with a 25-30% reduction in open water surfaces and a more than 1°C rise in mean air temperature. M ulcerans DNA was undetectable in 122 aquatic sites sampled between 2021 and 2024. INTERPRETATION:To our knowledge, this study provides the first comprehensive, country-wide evidence of a sustained decline in Buruli ulcer incidence in Africa. Environmental changes, particularly climate warming and water surface reduction, might have contributed to this trend. Continued surveillance is essential to confirm whether Buruli ulcer foci are disappearing and to ensure early detection of potential re-emergence. FUNDING:French Ministry of Higher Education through the Doctoral School of Biology and Health, University of Angers, the French National Research Agency, and INSERM.

Background Autoimmune neutropenia (AIN) is the main cause of chronic neutropenia in children, but its infectious consequences remain poorly studied. The primary objective of this study was to evaluate infectious events leading to emergency department or hospital admissions during the first 2 years following the diagnosis of AIN in children.Methods We performed a retrospective, multicentre analysis of medical records from 21 French university hospitals of patients aged under 18 years diagnosed with AIN with positive antineutrophils autoantibodies. We collected data on emergency room visits and hospitalisations in the 2 years following diagnosis, causes of these events, microbiology results, management and outcome.Results One hundred and sixty-eight patients were enrolled. Median age at diagnosis of AIN was 13 months. AIN was predominantly diagnosed during an infectious episode (n=120, 71%). In the 2 years of follow-up after diagnosis, 248 events of emergency room visits and/or hospitalisations were reported (0.77 per patient-year). The most frequent diagnoses were common childhood viral or bacterial infections. The incidence rate of severe infections was 0.003 per patient-year. Despite the predominance of viral infections, 177 episodes (71%) led to hospitalisation and 166 (68%) to the initiation of antibiotic therapy, for a median duration of 7 days (IQR 3-10).Conclusion The risk of severe infections in children with AIN is low. During follow-up, we suggest being attentive to signs of severity during fever, particularly in children over 3 years of age and/or with other immunological comorbidities but not proposing systematic hospitalisation or additional antibiotic therapy.

This report describes a rare case of post-infectious meningoradiculitis caused by Bartonella henselae in a healthy 17-year-old male. The patient presented with bilateral peripheral facial palsy, paresthesia and absent deep tendon reflexes, following axillary lymphadenopathy related to cat scratches. Lumbar puncture showed lymphocytic pleocytosis, and serological results showed high titers of both IgG and IgM for Bartonella henselae. Electroneuromyography revealed prolonged F waves. Treatment included intravenous immunoglobulins and doxycycline, with gradual clinical improvement. A systematic literature review identified 20 cases of peripheral neurological involvement associated with Bartonella henselae, highlighting the diversity of neurological manifestations beyond encephalitis and neuroretinitis. This case illustrates the importance of considering Bartonella henselae in the differential diagnosis of inflammatory radiculopathies, especially in individuals who have had contact with cats and when more common causes are ruled out.

Objectives: NOVA and DENOVA scores were developed to guide endocarditis risk assessment in Enterococcus faecalis Bacteremia (EfB), but some of their criteria may be open to interpretation. We aimed to evaluate their inter-rater reliability and feasibility. Methods: Thirty-two physicians from four specialties involved in the management of endocarditis independently evaluated eight EfB patient records using the NOVA and DENOVA scores. Each score was applied eight times per case. Inter-rater reliability was measured with Krippendorff’s alpha, and agreement with Fleiss’ Kappa. Completion time was also recorded. Results: No record received identical scores from all raters. NOVA showed low inter-rater reliability (α = 0.37), while DENOVA reached moderate levels (α = 0.49). High agreement was found for extreme score values, but agreement dropped markedly for intermediate values. Among score items, Auscultation of murmur (A) and Valve disease (V) had the highest reliability (α > 0.8), while Duration of symptoms (D) and Origin of infection (O) had the lowest (α < 0.2). Completion times were similar between NOVA and DENOVA but varied by specialty. Conclusion: The reproducibility of these scores is limited, especially near critical thresholds, highlighting the need to complement scoring tools with clinical judgment in EfB.

Background:Morbidity associated with central nervous system tuberculosis (CNS TB) remains high due to persistent inflammation despite standard-of-care (SOC) treatment, including antituberculosis therapy and corticosteroids. Tumor necrosis factor alpha (TNF-α) is a key cytokine driving this inflammatory response, and a limited number of case reports suggest that TNF-α inhibitors may improve outcomes. We report the 1-year outcome of a cohort of consecutive patients treated with infliximab for severe CNS TB. Methods:Following the guidance provided by the French Tuberculosis Consilium, a standardized regimen of intravenous infliximab at 5 mg/kg per dose was used to treat CNS TB unresponsive to SOC. We retrospectively included consecutive patients who received at least 1 infliximab injection for CNS TB from 2017 to September 2021. Results:Eighteen patients with CNS TB, 94% with tuberculous meningitis, were included. Most had severe disease: 82% were classified as British Medical Research Council grade II or III, and 44% required intensive care unit admission. All demonstrated clinical and radiological worsening despite SOC; in 89% due to paradoxical reaction. At infliximab initiation, symptoms remained disabling, with a median modified Rankin scale (mRS) score of 3.5 (interquartile range, 3-4). One month after the first infusion, 38% showed improved mRS scores, increasing to 78% at 1 year. One-year survival was 94%; 1 death occurred 12 months after a single infliximab dose and was unrelated to TB treatment. Conclusions:Infliximab may represent a promising adjunctive treatment for CNS TB unresponsive to SOC, including paradoxical reaction. Prospective studies are needed to confirm these findings.

Finegoldia magna endocarditis is a rare and underdiagnosed condition, primarily affecting prosthetic valves. We report a case, along with a comprehensive literature review, highlighting its subacute presentation and the challenges in diagnosis due to frequent negative blood cultures. Molecular detection methods and prolonged delay for anaerobic cultures are crucial for identifying F. magna. Given the high risk of significant valvular damage, including abscess formation, surgical intervention might be required. Antibiotic treatments in the literature include penicillins, with or without metronidazole. Clinicians should consider this underestimated pathogen as a potential cause of early prosthetic valve endocarditis, particularly in cases of sterile blood cultures.

The efficacy of neutralizing SARS-CoV-2 monoclonal antibodies (mAbs) in preventing severe COVID-19 has been hindered by the diversity of viral strains and the complexity of patient populations. In this prospective cohort study, we used regression analyses to identify virological, immunological and clinical factors associated with viral clearance and emergence of escape mutations. We included 114 mainly immunocompromised high-risk patients with mild-to-moderate COVID-19 who received mAbs or direct antivirals to prevent COVID-19 progression. Nasopharyngeal SARS-CoV-2 RNA level at day 7 was independently associated with viral load at day 0, serum neutralization at day 7, and treatment received. The emergence of mutations within Spike was observed in 21.9% of patients, all being immunocompromised treated by Sotrovimab or Tixagevimab/Cilgavimab after Omicron emergence, and was independently associated with higher viral load and serum neutralization at day 7. Our data show that suboptimal neutralizing antibodies should be avoided in immunocompromised individuals, given the risk of emergence of viral escape mutations.

Introduction Les infections pulmonaires dues aux mycobactéries non tuberculeuses (ipMNT) nécessitent un traitement complexe et prolongé. Le maintien de l’observance au traitement est un enjeu important. MYCOCARE est un programme de suivi infirmier de 12 mois destiné à accompagner les patients atteints d’ipMNT. Méthodes Après inscription du patient au programme MYCOCARE par son médecin, une infirmière spécialisée dans la prise en charge des ipMNT réalise jusqu’à 5 entretiens téléphoniques sur 12 mois. Elle évalue l’observance (échelle de Morisky [EM8]), la tolérance (critères PRO-CTCAE : troubles gastro-intestinaux, toux, dyspnée, sommeil, fatigue, appétit) et la qualité de vie (EQ-5D-5L). Un numéro vert est à disposition pour répondre aux questions des patients. Le lien avec l’équipe médicale est maintenu via des comptes rendus adressés sur un extranet sécurisé.En cas de traitement par nébulisation, l’initiation se déroule à l’hôpital avec une séance d’éducation thérapeutique à la pratique et compréhension des traitements. L’autonomie du patient est évaluée à J7 et J21 du programme. Résultats Entre le 01/07/2021 et le 30/06/2024, 207 patients (âge moyen 61,2 ans ; 35 % H/F) suivis dans 88 hôpitaux ont été inclus. Au 30/06/2024, 58 patients (28 %) sont toujours accompagnés. Au total, 86 patients (41,6 %) ont suivi l’intégralité du programme et 63 (30,4 %) l’ont abandonné (28 à l’initiative du médecin, 14 à l’initiative du patient, 11 pour négativation des cultures, 10 sont décédés et 1 perdu de vue).Le score d’observance des traitements anti-infectieux est satisfaisant à M2 (score sur l’EM8 7,3±1,0 ; n=102), et ne varie pas significativement au cours du suivi (6,9±1,6 à M12 n=46, p=0,14, test post hoc). Le score de qualité de vie est acceptable et stable (7,4±3,2 à l’inscription (J0) et 7,2±2,9 à M12).Aucune variation significative du taux de déclarations des effets indésirables entre M2 et M12 n’a été remontée (3,2±2,2 à M2 vs 2,4±2,4 à M12, p=0,15). La fatigue, la toux et la dyspnée, les symptômes les plus rapportés, tendent à s’améliorer dans le temps. Conclusion Le programme MYCOCARE constitue un outil à la disposition des praticiens soignant des patients atteints d’ipMNT pouvant faciliter le suivi du traitement. Le taux faible de sorties du programme suggère une bonne acceptabilité des patients suivis. MYCOCARE pourrait contribuer à l’optimisation de l’observance thérapeutique et plus largement, contribuer à une meilleure coordination des acteurs de la prise en charge des ipMNT, favoriser le lien hôpital-ville, et contribuer à une meilleure compréhension de la maladie par les patients.

Background While invasive fusariosis and lomentosporiosis are known to be associated with fungemia, overall data on mold-related fungemia are limited, hampering early management. This study aimed to describe the epidemiology of mold-positive blood cultures.Methods Epidemiological and clinical data on mold-positive blood cultures from 2012 to 2022 were obtained from the RESSIF database. Pseudofungemia was excluded using modified Duthie and Denning criteria. Univariable and multivariable Firth logistical regression was used to study factors associated with 90-day mortality.Results Fusarium spp accounted for 67.5% of the 80 events, involving predominantly Fusarium fujikuroi spp complex (FFSC), Neocosmospora spp, and Fusarium oxysporum spp complex (FOSC). Lomentospora prolificans was the second most frequent (10%), followed by Trichoderma spp, Aspergillus spp, and Mucorales (5% each). Most patients had a history of hematological malignancy (HM) (70%). Forty-three percent had undergone allogeneic hematopoietic stem cell transplantation. Cutaneous and pulmonary lesions were common (43% each). Median time to blood culture positivity was 72 hours. HM and neutropenia were commonly reported in patients with FFSC, Neocosmospora spp, and L. prolificans fungemia. Pulmonary lesions were frequent in cases of L. prolificans fungemia. Patients with gastrointestinal conditions were frequently diagnosed with FOSC molds. HM (75%), particularly acute myeloblastic leukemia, was frequent in patients with Aspergillus spp fungemia. All patients with Trichoderma spp fungemia were exposed to corticosteroids. Day 90 mortality was 53%. Independent predictive factors of day 90 mortality included L. prolificans (odds ratio [OR], 33.3), Aspergillus spp fungemia (OR, 14.2), and corticosteroid exposure (OR, 7.85).Results Fusarium spp accounted for 67.5% of the 80 events, involving predominantly Fusarium fujikuroi spp complex (FFSC), Neocosmospora spp, and Fusarium oxysporum spp complex (FOSC). Lomentospora prolificans was the second most frequent (10%), followed by Trichoderma spp, Aspergillus spp, and Mucorales (5% each). Most patients had a history of hematological malignancy (HM) (70%). Forty-three percent had undergone allogeneic hematopoietic stem cell transplantation. Cutaneous and pulmonary lesions were common (43% each). Median time to blood culture positivity was 72 hours. HM and neutropenia were commonly reported in patients with FFSC, Neocosmospora spp, and L. prolificans fungemia. Pulmonary lesions were frequent in cases of L. prolificans fungemia. Patients with gastrointestinal conditions were frequently diagnosed with FOSC molds. HM (75%), particularly acute myeloblastic leukemia, was frequent in patients with Aspergillus spp fungemia. All patients with Trichoderma spp fungemia were exposed to corticosteroids. Day 90 mortality was 53%. Independent predictive factors of day 90 mortality included L. prolificans (odds ratio [OR], 33.3), Aspergillus spp fungemia (OR, 14.2), and corticosteroid exposure (OR, 7.85).Results Fusarium spp accounted for 67.5% of the 80 events, involving predominantly Fusarium fujikuroi spp complex (FFSC), Neocosmospora spp, and Fusarium oxysporum spp complex (FOSC). Lomentospora prolificans was the second most frequent (10%), followed by Trichoderma spp, Aspergillus spp, and Mucorales (5% each). Most patients had a history of hematological malignancy (HM) (70%). Forty-three percent had undergone allogeneic hematopoietic stem cell transplantation. Cutaneous and pulmonary lesions were common (43% each). Median time to blood culture positivity was 72 hours. HM and neutropenia were commonly reported in patients with FFSC, Neocosmospora spp, and L. prolificans fungemia. Pulmonary lesions were frequent in cases of L. prolificans fungemia. Patients with gastrointestinal conditions were frequently diagnosed with FOSC molds. HM (75%), particularly acute myeloblastic leukemia, was frequent in patients with Aspergillus spp fungemia. All patients with Trichoderma spp fungemia were exposed to corticosteroids. Day 90 mortality was 53%. Independent predictive factors of day 90 mortality included L. prolificans (odds ratio [OR], 33.3), Aspergillus spp fungemia (OR, 14.2), and corticosteroid exposure (OR, 7.85).Results Fusarium spp accounted for 67.5% of the 80 events, involving predominantly Fusarium fujikuroi spp complex (FFSC), Neocosmospora spp, and Fusarium oxysporum spp complex (FOSC). Lomentospora prolificans was the second most frequent (10%), followed by Trichoderma spp, Aspergillus spp, and Mucorales (5% each). Most patients had a history of hematological malignancy (HM) (70%). Forty-three percent had undergone allogeneic hematopoietic stem cell transplantation. Cutaneous and pulmonary lesions were common (43% each). Median time to blood culture positivity was 72 hours. HM and neutropenia were commonly reported in patients with FFSC, Neocosmospora spp, and L. prolificans fungemia. Pulmonary lesions were frequent in cases of L. prolificans fungemia. Patients with gastrointestinal conditions were frequently diagnosed with FOSC molds. HM (75%), particularly acute myeloblastic leukemia, was frequent in patients with Aspergillus spp fungemia. All patients with Trichoderma spp fungemia were exposed to corticosteroids. Day 90 mortality was 53%. Independent predictive factors of day 90 mortality included L. prolificans (odds ratio [OR], 33.3), Aspergillus spp fungemia (OR, 14.2), and corticosteroid exposure (OR, 7.85).Conclusions Underlying conditions and clinical presentation vary between genera and could be considered to guide early management. Fusarium species were the most common cause of mold-related fungemia. Patients' underlying conditions and clinical presentation differed between genera. Pulmonary and cutaneous lesions were common. Day 90 mortality was high and associated with corticosteroid exposure, Aspergillus spp, and Lomentospora prolificans infection.

BACKGROUND:Staphylococcus lugdunensis (SL) can cause infective endocarditis (IE), with unusually high complication and mortality rates. According to the 2023 Duke-ISCVID criteria, blood cultures positive for SL now count as a major microbiological criterion. OBJECTIVES:Our aim was to determine the contemporary characteristics of SLIE, and to identify the factors associated with all-cause in-hospital mortality. METHODS:Patients with definite SLIE between 2010 and 2024 were included in a collaborative study involving 17 centres in France, Spain, Brazil, Italy, and Ireland. RESULTS:We collected data on 112 patients with definite SLIE. Mean age was 67 ± 18 years, and 76 (67.9%) were males. Nosocomial and healthcare-related non-nosocomial SLIE accounted for 15.2% and 16.1% of cases, respectively. Prosthetic valves and cardiac implantable electronic devices (CIED) were involved in 36.6% and 10.7% of cases, respectively. Emboli occurred in 50%, heart failure in 32%, acute kidney injury in 39.4%, and perivalvular abscesses in 20.5% of cases. All strains were methicillin susceptible. Valve surgery was performed in 47 (42%) and CIED removal in 10 (8.9%) patients. All-cause in-hospital mortality was 29.5%. Variables associated with mortality were age (OR 1.10 per one-year increment, 95%CI [1.08-1.31], p < 0.001), malignancy (OR 26.22, [3.78-181.72], p < 0.001), a new severe mitral regurgitation (OR 17.10, [2.81-104.09], p = 0.002), paravalvular abscess (OR 63.40, [6.24-644.03], p < 0.001), and new high-degree atrioventricular block (OR 27.76, [2.49-309.82], p = 0.007). CONCLUSION:This international multicentre study confirms that SLIE mimics Staphylococcus aureus IE, particularly with regard to aggressiveness, healthcare-related acquisition, complications, and mortality. Of note, all SL isolates were methicillin-susceptible.

OBJECTIVES:The management of Enterococcus faecalis febrile urinary tract infections in men (FUTIEfM) is poorly standardized. We aimed to describe current prescribing practices among French infectious disease physicians. METHODS:An anonymous questionnaire was distributed via two national mailing lists between December 2023 and January 2024. The survey explored antibiotic choices, treatment duration, and scenarios prompting therapeutic abstention. RESULTS:A total of 203 physicians responded. Most (98%) reported managing at least one FUTIEfM case every six months. Amoxicillin was the preferred first-line treatment (86%), typically prescribed at 80-100 mg/kg/day (74%); treatment duration was 14 days in 69% and 21 days in 29% of cases. In penicillin-allergic patients, linezolid was the preferred alternative (51%), followed by fluoroquinolones (38%). Fluoroquinolones were deemed inappropriate by 37% of respondents, versus 9% for linezolid and 3% for amoxicillin. Among those considering treatment appropriate, a 14-day course was favored by 81% for linezolid and 92% for fluoroquinolones. Therapeutic abstention was frequently selected in cases of catheterization (51%), polymicrobial cultures (50%), or leukocyturia <10⁴/mL (64%). CONCLUSIONS:High-dose oral amoxicillin is the preferred treatment for FUTIEfM. Linezolid and fluoroquinolones (especially levofloxacin) are also used, though with less consensus. Therapeutic abstention appears appropriate in select clinical scenarios.

BACKGROUND:The COVID-19 pandemic led to major changes in patient care, with enhanced hygiene possibly reducing multidrug resistant bacteria transmission, while increased nursing workload and antibiotic use may have raised the risk of multidrug resistant bacteria acquisition. METHODS:A 5-year retrospective study compared extended spectrum beta lactamase Enterobacteriaceae (ESBL-E) acquisition rates in a single intensive care unit (ICU) between the pre-COVID and COVID periods. RESULTS:Between January 2018 and December 2022, 1,736 ICU patients (mean age 64 [49-79] years) were included. Admission severity was similar across periods, but ICU stay was longer during COVID (19 ± 19 vs 14 ± 13 days, P < .001), with more patients requiring mechanical ventilation (81% vs 73%, P < .001) for a longer duration (17 ± 19 vs 10 ± 10 days, P < .001). ESBL-E acquisition increased by 57.3% during the COVID period (14% [confidence interval (CI) 95 11.6-16.7] vs 8.9% [CI 95 7.1-11.0], P = .001), while admission carriage rates were similar (6% vs 8%, P = .57). In multivariate analysis, ICU stay duration (odds ratio [OR] = 1.01 per day), mechanical ventilation > 10 days, ESBL-E prevalence, and hemodialysis were associated with acquisition; noninvasive ventilation was protective. CONCLUSIONS:In our ICU, ESBL-E acquisition increased during the COVID period. Multivariate analysis linked it to length of stay, ESBL-E prevalence, mechanical ventilation > 10 days, and hemodialysis. Further studies are needed to assess post-COVID trends.

Introduction. - Following the Omicron wave in early 2022, an estimated 60-70% of the French population was infected with the SARS-CoV-2 virus. One out of ten infected subjects could have persistent symptoms three months after infection, representing a public health challenge. Current state of knowledge. - The persistent symptoms may be secondary to diverse entities with distinct mechanisms. While organic infection sequelae occur mainly after severe COVID19, some symptoms appear to be essentially psychological in origin; in addition, many subjects present stereotyped symptoms of fluctuating intensity with no identified anatomical or psychic substratum, often in the aftermath of a benign infection. The most frequent complaints are fatigue, pain, dyspnea and difficulty concentrating. Perspectives. - The hypotheses explored to explain these symptoms include: persistent immune dysfunction, inducted autoimmunity, and microbiome disturbances. Persistent viral antigens may lie at the crossroads of these mechanisms. To date, these different etiological avenues have yet to lead to the development of diagnostic tests or specific therapeutic strategies. Conclusion. - Prolonged symptoms after COVID-19 correspond to heterogeneous nosological entities with poorly understood mechanisms. (c) 2024 SPLF. Published by Elsevier Masson SAS. All rights are reserved, including those for text and data mining, AI training, and similar technologies.