Menstrual Toxic Shock Syndrome: Encourage Proper Tampon Use to Limit Risks

Inserm’s new educational video on staphylococcal toxic shock. © Camille Henry/Inserm

Staphylococcal toxic shock syndrome is linked to the presence of Staphylococcus aureus bacteria in the vaginal microbiota of some women for whom the misuse of intravaginal protection (tampons, menstrual cups, etc.) could increase the likelihood of developing it. Toxic shock is characterized by multiple symptoms that include digestive disorders, high fever, and skin rashes. In the most severe cases, it can lead to multi-organ failure and death.

Although the incidence of toxic shock remains very rare, researchers from Inserm, CNRS, Hospices Civils de Lyon, Université Claude Bernard Lyon 1 and ENS Lyon within the International Center for Research in Infectious Diseases and the National Reference Centre for Staphylococci have identified the risk factors that may in some cases favor it. In a study published in March 2020 in the journal EClinical Medicine, Prof. Gérard Lina’s team suggests simple measures to put in place for better tampon use during menstruation.


All the advice can be found in Inserm’s new educational video aimed at raising awareness and reassuring tampon users. 

Do not hesitate to share this prevention tool on your platforms and distribute it widely.

Alzheimer’s Disease: Sweet Snacks May Not Go Down So Well in Those With a Genetic Predisposition

Alzheimer’s Disease: Sweet Snacks May Not Go Down So Well in Those With a Genetic Predisposition © Robert Anderson on Unsplash

While genetic predisposition is a major factor in the risk of developing age-related dementia, and Alzheimer’s disease in particular, environmental factors such as diet also have an important role to play. Thanks to the 12-year follow-up of nearly 2,800 French people over the age of 65, a research team from Unit 1061 Neuropsychiatry: Epidemiological and Clinical Research (Inserm/Université de Montpellier) has sought to understand the impact of meals high in sugars (simple sugars and refined carbohydrates) on the risk of developing dementia. Its research shows a link between the consumption of sugars during the afternoon snack and the risk of developing Alzheimer’s disease in people with genetic predispositions. These results published in Alzheimer’s and Dementia pave the way for a better understanding of the links between environmental and genetic risk factors and could lead to improved dementia prevention strategies.

According to WHO forecasts, more than 152 million people could be affected by age-related dementia by 2050. There is currently no treatment to cure or slow the progression of these conditions, which include Alzheimer’s disease. It is therefore essential to identify the factors favoring their development and on which it would be possible to take preventive action.

For several years now, nutrition has been recognized as an important factor in good brain aging. In particular, several animal studies have emphasized the role of a high intake of sugars – which include starch and added sugars (glucose and fructose syrups, sucrose) – in aggravating the clinical signs of Alzheimer’s disease and, in particular, in accelerating the appearance of amyloid deposits (senile plaques) characteristic of Alzheimer’s disease.

But while environment plays a role in the development of Alzheimer’s disease, the importance of genetic factors is not to be overlooked. This is particularly the case of the APOE gene, which comes in three forms (or alleles): E2, E3 and E4. People who carry the E4 allele of this gene are at increased risk of developing Alzheimer’s disease.

However, until now, no human studies had explored a potential link between genetic predisposition, the consumption of sugars, and the risk of dementia.

A team led by Inserm researcher Sylvaine Artero in Unit 1061 Neuropsychiatry: Epidemiological and Clinical Research (Inserm/Université de Montpellier) wished to highlight the links between the onset of dementia (in particular Alzheimer’s disease) in humans, genetic predispositions linked to the E4 allele, and the consumption of sugars. They analyzed 12 years of data from nearly 2,800 participants in the French Three-City Study, which has been following nearly 10,000 French people over 65 years of age since 1999. They studied the development of 350 cases of dementia related to eating habits and more specifically their contribution to glycemic load (the ability of a food to raise blood glucose levels according to the portion consumed) estimated over four meals: breakfast, lunch, afternoon snack, and dinner.

In participants without the at-risk genotype, the research team found no association between the onset of dementia and the consumption of sugars with the four daily meals.

However, in participants with the E4 allele of the APOE gene, the researchers observed an association between the consumption of sugars during the afternoon snack and the onset of dementia. For the APOE4 individuals who tended to eat an afternoon snack, the risk of developing Alzheimer’s disease was increased by 2 to 3 times for each additional serving equivalent to the glycemic load of 30 grams of baguette, regardless of daily energy intake, physical activity, presence of co-morbidities or adherence to a healthy Mediterranean-type diet. However, no such association was revealed for the other meals of the day.

But why would the consumption of sugars during the afternoon snack have a greater impact on people with genetic predispositions?

According to Artero, “one hypothesis to consider would be the potential impact of insulin resistance – a pathology involved in type 2 diabetes and favored by the consumption of sugars – on the risk of developing dementia”.

Indeed, it has already been shown in animals that carriers of the E4 allele had a less efficient glucose metabolism. They would therefore be more likely to develop insulin resistance. However, the sugary foods consumed during the afternoon snack tend to be low in fat and fiber. They are eaten more quickly and without being accompanied by other types of food, such as at main meals. As a result, they are absorbed into the bloodstream much faster during digestion, triggering a peak in insulin.

Repeated daily, these insulin peaks could eventually lead to peripheral insulin resistance but also to cerebral insulin resistance (in which the brain is less sensitive to insulin and less able to use glucose) via oxidative stress and inflammation, which would encourage the development of dementia, phenomena to which E4 allele carriers are more sensitive,” says Artero.

These results pave the way for new prevention strategies but need to be confirmed by other population-based studies and further investigated by experimental studies in order to better understand the links between sugar consumption, insulin resistance and the development of dementia,” concludes Artero.

COVID-19: Vaccine Research at Inserm

The mobilization of Inserm researchers has led to major advances in SARS-CoV-2 knowledge and vaccine research.

© Inserm/Depardieu, Michel

Developing an effective and safe vaccine is one of the priority objectives in the fight to contain the COVID-19 pandemic. Since the complete sequencing of the SARS-CoV-2 genome in January 2020, research teams in France and internationally have been working tirelessly to better understand the immune response following infection and to test candidate vaccines. At Inserm, a dozen teams are involved in vaccine research projects. In particular, three initiatives have recently been selected by France’s Ministry of Higher Education, Research and Innovation on the advice of the COVID-19 Analysis, Research and Expertise Committee (CARE) and Inserm’s REACTing consortium, in order to receive special support and thus accelerate research.

Currently, more than 200 teams around the world are engaged in research projects to develop a vaccine against COVID-19. These include some thirty French groups that are members of the AVIESAN alliance or the biotech/industry ecosystem. Researchers from Inserm are also not to be outdone, since a dozen of these projects involve its units.

While the degree of progress of this research varies, some of these teams are currently in the phase of identifying the antigenic sequences of the virus that induce the specific immune response against SARS-CoV-2 and minimize the possible production of facilitator antibodies (a type of antibody that facilitates the entry of the virus into cells). In addition, some of the proposed vaccine platforms have been used previously for other candidate vaccines, including against HIV, influenza and toxoplasma, or for oncology vaccines.

The various ongoing projects can be divided into three main categories. The first is that of subunit vaccines, which do not contain live components but rather antigenic fragments of the pathogen. The second is a group of live attenuated candidate vaccines, all of which are prophylactic. The third is vaccines based on DNA or RNA coding for SARS-CoV-2 antigens.

Innovative candidate vaccines

Within this dynamic ecosystem, three projects involving Inserm units have been identified as priorities by the Ministry of Higher Education, Research and Innovation.

The first is driven by the Vaccine Research Institute (VRI), under the supervision of Inserm. The team led by Pr. Yves Lévy is involved in French COVID-19, the national cohort of patients infected with SARS-CoV-2, coordinated by Inserm’s REACTing network, in conjunction with 56 hospitals in France. Initially, using data from these patients, the researchers’ objective was to characterize the immune response in COVID-19 positive patients. Indeed, this data is essential and a prerequisite for the development of any vaccine. Based on this work, but also on their expertise in vaccine research, they are now developing a candidate vaccine in which the SARS-CoV-2 antigens would be presented by monoclonal antibodies to certain key cells of the immune system (dendritic cells). VRI has already developed several candidate vaccines based on this strategy, including against HIV (for which clinical trials will start in 2020).

The second vaccine research project, carried out at the Lille Center for Infection and Immunity by Inserm researcher Camille Locht and his team, is based on the repurposing of vectors with known activity, by integrating SARS-CoV-2 antigenic sequences. In this particular case, the chosen vector is a whooping cough vaccine. The objective is to develop a safe candidate vaccine, whose action on the body is well documented and very specific to the novel coronavirus because it incorporates carefully selected antigens.

Led by Inserm researcher Patrice Marche at the Institute for Advanced Biosciences and researcher Fabrice Navarro, head of CEA-Leti’s Microfluidic Systems and Bioengineering Laboratory, the third project also proposes an original vaccine approach against SARS- CoV- 2. It is based on an innovative delivery system involving lipid nanoparticles developed by the researchers. These highly stable and well-tolerated nanoparticles were originally created to encapsulate and transport drugs to target cells. In the fight against SARS- CoV-2, the researchers hope to encapsulate antigens of the virus to elicit a strong immune response.

Having already used this technique in HIV vaccine research, the team should quickly be able to develop this new candidate vaccine on a large scale, which represents a major advantage in making research faster and more efficient.

Developing a safe and effective vaccine against COVID-19 is a long process. Nevertheless, the mobilization of the scientific community, and in particular Inserm researchers, is enabling major advances to be made in terms of understanding the virus and the immune response to it, and in terms of setting up numerous trials to test a wide variety of vaccine strategies in record time.

Cardiac arrest outside the hospital during the peak of the COVID-19 epidemic: studies highlight pulmonary embolism as the main determinant

Cardiac arrest outside the hospital during the peak of the Covid-19 pandemic could be partly due to massive pulmonary embolism© Adobe Stock

French investigators from the Paris Medico-Legal Institute, the radiology department of the Sainte-Anne hospital / GHU Paris, the anesthesia-resuscitation department of the AP-HP hospitals Saint-Louis and Lariboisière, the University of Paris, Inserm and CNRS have hypothesized that cardiac arrests outside the hospital during the peak of the COVID-19 pandemic could be partly due to massive pulmonary embolism. The details of this work were published on May 28, 2020 in the European Journal of Heart Failure .

The Forensic Institute of Paris and the radiology department of Sainte-Anne hospital use whole-body scanners for examinations requested by the justice authorities. These scanners were compared between the two-week period corresponding to the epidemic peak (March 23 to April 7, 2020) and all of 2019. The elements sought on the scanner were the presence of signs of pulmonary infection suggestive of COVID-19, phlebitis of the lower limbs and proximal pulmonary embolism, responsible for cardiac arrest.

This study shows that requests for forensic autopsies for unexplained sudden death were 14 times more frequent during the epidemic peak than in 2019.

The vast majority of unexplained sudden deaths during the epidemic peak had lung lesions suspected of Covid-19 infection.

The age of the deceased patients ranged from 27 to 99 years. Most people died at home, some had fever and / or cough, and the majority suddenly lost contact with family or emergency services 30 minutes to a few hours before the onset of cardiac arrest.

CT analysis shows a 3 times higher frequency of proximal pulmonary embolism and phlebitis during the epidemic peak compared to all of 2019.

These results suggest that a significant proportion of the victims of sudden death during the epidemic peak were probably linked to proximal pulmonary embolism which must be quickly referred to cardiogenic shock treatment centers. This study also confirms the vital role of intensive prevention of thrombosis in patients with COVID-19 infection.

Inflammatory Bowel Disease: Immune Cells Spearheading the Cure

This microscopic image of a section of mouse intestine shows significant lesions, inflammatory signs and dysfunctional healing of the intestinal mucosa. © Sonnenberg Lab

Inflammations of the intestine affect many patients, often with reduced therapeutic prospects. The role of iron in these inflammatory processes is increasingly well documented, opening up new avenues of treatment. A collaborative study between the team led by Inserm research director Carole Peyssonnaux at Institut Cochin (Inserm/CNRS/Université de Paris) and Greg Sonnenberg’s team in New York (Weill Cornell Medicine) shows that the hormone that regulates iron levels in the body is produced by immune cells during inflammation of the intestine, and that it helps repair damage to the intestinal mucosa. This research has been published in Science.

Infections, inflammatory bowel disease (IBD) such as Crohn’s disease, and colorectal cancer are associated with inflammation of the intestine. In patients, the intestinal mucosa may then be damaged, with bleeding and impaired distribution of iron in the body often being observed.

For several years, Inserm research director Carole Peyssonnaux and her team at Institut Cochin (Inserm/CNRS/Université de Paris) have been interested in the role of hepcidin in disease settings. This hormone regulates iron metabolism in the body and is mainly produced by the liver. However, the researchers had already shown that in the case of certain pathologies, hepcidin is also secreted in other tissues.

Their new study, carried out in collaboration with Gregory F. Sonnenberg’s team from Cornell University in the United States and published in April 2020 in the journal Science, shows that in a context of intestinal inflammation, hepcidin is also expressed by specific immune cells, the dendritic cells of the intestine.

New therapeutic avenues

The scientists first studied the intestinal healing process in several groups of mice, all with inflammation of the intestine. For one of these groups of mice, the gene coding for hepcidin was not expressed. Compared to the other groups of mice in which this gene functioned normally, this resulted in greater continuous weight loss, but also in less effective healing of the intestinal mucosa.

The researchers have confirmed that hepcidin plays an important role in the healing of intestinal lesions. However, they still wondered whether it was the hepcidin normally secreted by the liver that had this beneficial effect or whether, in this disease setting, this iron-regulating hormone was produced in other organs.

Using mouse models in which the gene coding for hepcidin was only deficient in the liver, the researchers were able to show, surprisingly, that the healing process was independent of hepatic hepcidin production. Following intestinal injury and in a context of inflammation, the local dendritic cells of the intestine were the dominant source of production of this hormone.

The research also emphasizes that hepcidin interacts with a key iron transporter called ferroportin, which is present on other immune cells in the intestine (macrophages), thereby promoting iron sequestration and preventing the proliferation of iron-dependent bacteria in intestinal lesions. This process helps to limit the severity of the inflammation.

To determine whether this phenomenon also occurs in humans, the researchers looked at samples taken from pediatric IBD patients. They confirmed that the dendritic cells in the human intestine also produce hepcidin in response to injury. This pathway may therefore be clinically important for people with IBD. “Our study suggests that hepcidin may have a protective role because if the gene that codes for this hormone is deleted, the severity of the disease is greater. The use of hepcidin mimetic treatments could therefore have a therapeutic role in promoting iron sequestration, reducing its availability to bacteria that proliferate in the intestine and promoting the healing of lesions,” concludes Peyssonnaux.

Repetitive negative thinking linked to dementia risk

Persistently engaging in negative thinking patterns may raise the risk of Alzheimer’s disease, finds a new UCL-led study.

In the study of people aged over 55, published in Alzheimer’s & Dementia, researchers found ‘repetitive negative thinking’ (RNT) is linked to subsequent cognitive decline as well as the deposition of harmful brain proteins linked to Alzheimer’s.

The researchers say RNT should now be further investigated as a potential risk factor for dementia, and psychological tools, such as mindfulness or mediation, should be studied to see if these could reduce dementia risk.

Lead author Dr Natalie Marchant (UCL Psychiatry) said: “Depression and anxiety in mid-life and old age are already known to be risk factors for dementia. Here, we found that certain thinking patterns implicated in depression and anxiety could be an underlying reason why people with those disorders are more likely to develop dementia.

“We hope that our findings could be used to develop strategies to lower people’s risk of dementia by helping them to reduce their negative thinking patterns.”

For the Alzheimer’s Society-supported study, the research team from UCL, INSERM and McGill University studied 292 people over the age of 55 who were part of the PREVENT-AD cohort study, and a further 68 people from the IMAP+ cohort.

Over a period of two years, the study participants responded to questions about how they typically think about negative experiences, focusing on RNT patterns like rumination about the past and worry about the future. The participants also completed measures of depression and anxiety symptoms.

Their cognitive function was assessed, measuring memory, attention, spatial cognition, and language. Some (113) of the participants also underwent PET brain scans, measuring deposits of tau and amyloid, two proteins which cause the most common type of dementia, Alzheimer’s disease, when they build up in the brain.

The researchers found that people who exhibited higher RNT patterns experienced more cognitive decline over a four-year period, and declines in memory (which is among the earlier signs of Alzheimer’s disease), and they were more likely to have amyloid and tau deposits in their brain.

Depression and anxiety were associated with subsequent cognitive decline but not with either amyloid or tau deposition, suggesting that RNT could be the main reason why depression and anxiety contribute to Alzheimer’s disease risk.

“We propose that repetitive negative thinking may be a new risk factor for dementia as it could contribute to dementia in a unique way,” said Dr Marchant.

The researchers suggest that RNT may contribute to Alzheimer’s risk via its impact on indicators of stress such as high blood pressure, as other studies have found that physiological stress can contribute to amyloid and tau deposition.

Co-author Dr Gael Chételat (INSERM and Université de Caen-Normandie) commented: “Our thoughts can have a biological impact on our physical health, which might be positive or negative. Mental training practices such as meditation might help promoting positive- while down-regulating negative-associated mental schemes.

“Looking after your mental health is important, and it should be a major public health priority, as it’s not only important for people’s health and well-being in the short term, but it could also impact your eventual risk of dementia.”

The researchers hope to find out if reducing RNT, possibly through mindfulness training or targeted talk therapy, could in turn reduce the risk of dementia. Dr Marchant and Dr Chételat and other European researchers are currently working on a large project to see if interventions such as meditation may help reduce dementia risk by supporting mental health in old age.*

Dr Marchant concluded: “Taken alongside other studies, which link depression and anxiety with dementia risk, we expect that chronic negative thinking patterns over a long period of time could increase the risk of dementia. We do not think the evidence suggests that short-term setbacks would increase one’s risk of dementia.”



Eliminating Senescent Cells Is Not the Answer to a Long and Healthy Life

Senescent cells. © Inserm/Lemaitre, Jean Marc/U661

Until now considered highly promising in the fight against aging, the therapeutic strategy of eliminating the senescent cells that accumulate in the body is being challenged by the team of Dmitry Bulavin, Inserm researcher at the Institute for Research on Cancer and Aging of Nice (Inserm/CNRS/Université Côte d’Azur). Their research using mice has shown that in the liver the first senescent cells appear in a population of hepatic cells that play a major role in detoxifying the body. When they studied the elimination of these senescent cells, the researchers saw that the effect on liver function deterioration was worse than that of aging. Their findings,published in Cell Metabolism, provide new avenues for ensuring longer life expectancy in good health.

Aging is associated with the deterioration of many functions of the body and the onset of age-related diseases. Eyesight, hearing, muscle, heart and kidney function decline and the risks of cancer, cardiovascular disease and dementia steadily increase.

Also observed is the accumulation of so-called “senescent” cells in the tissues. While unable to divide due to having lost their function, these cells can induce inflammation and the production of oxidized residues that are toxic to the body. Removing these senescent cells from the body to reduce inflammation and restore tissue and organ function is seen as an interesting therapeutic strategy. Medicines whose mode of action is based on eliminating the survival factors of senescent cells (thus leading to their death) are even in development.

Senescent cells in the liver appear in green on the image. ©Dmitry Bulavin

However, before continuing with the development of these therapeutic strategies, Dmitry Bulavin, Inserm researcher at the Institute for Research on Cancer and Aging of Nice (IRCAN, Inserm/CNRS/Université Côte d’Azur) and his team consider that it is first necessary to gain a deeper understanding of the emergence of these cells, their impacts on the body, and to study whether eliminating them would not have any unexpected harmful effects.

To do this, the researchers developed genetically-modified mouse models in order to track in vivo the appearance and localization of senescent cells over time, by monitoring the expression of gene p16 – a senescence marker common to all cell types.

Some of the models studied were also able to spontaneously eliminate their cells that strongly express p16.

Fibrosis instead of senescence

The researchers observed that the first senescent cells appeared primarily and in large quantities in the liver and more particularly in the sinusoidal endothelial cells found on its surface. These cells play a major role in detoxifying the body, enabling the passage of molecular “waste” from the blood to the liver where it is broken down and then eliminated. “To begin with, senescence has no impact on the filtering activity, which continues to function correctly. But over time, this function decreases and toxic residues inducing oxidative stress start to build up in the body. This early-onset mechanism could be a trigger for aging and the onset of age-related diseases. So we focused on this tissue to study the impact of the spontaneous elimination of senescent cells in our animal model”, explains Bulavin.

The team observed that the mice that underwent elimination of their senescent liver cells generally did not do as well as the others.

Not only did they present a blood platelet problem predictive of early mortality, but also hepatic fibrosis (scar tissue in the liver) that appeared with the destruction of the senescent cells. “This repair mechanism is harmful to tissues with the effect on their deterioration being more rapid than the gradual appearance of senescent cells”, explains Bulavin, who considers that the solution therefore does not lie in eliminating all of the senescent cells. “Instead, we must find ways of delaying the effect of senescence. Previous research has shown that senescence is characterized by epigenetic marks, chemical modifications that alter the functioning of DNA, but not its sequence. They prevent the expression of numerous genes. With my team, we will now explore a promising avenue that involves reprogramming the senescent cells to make them lose their senescence and make them functional again”, he concludes.

Covid-19: Publication of a prospective observational study in the journal BMJ in children with hyper-inflammatory syndrome related to Kawasaki disease

©Piron Guillaume on Unsplash

The team of the Department of General Pediatrics and Infectious Diseases of the Necker-Enfants Malades AP-HP Hospital, the Institut Pasteur, Inserm and the University of Paris, conducted a prospective observational study between April 27 and May 15, 2020 to describe the characteristics of children and adolescents hospitalized in a context of Kawasaki disease-like syndrome in a COVID-19 epidemic context, with a systemic hyper-inflammatory expression. The results of this study were published on June 3, 2020  in the journal BMJ.

This work included all children and adolescents hospitalized during the study period with signs of Kawasaki disease. Clinical and biological data, imaging and cardiac ultrasound data, treatments and clinical course were collected. A nasopharyngeal sample for SARS-CoV-2 by RT-PCR and a sample for IgG antibodies against the virus were systematically performed for all patients included.

During the study period, 21 patients were admitted to the general pediatrics and infectious diseases department with signs of Kawasaki disease. Their median age was 7.9 years (range, 3.7-16.6 years), and 12 patients (57%) had a parent or grandparent born in a sub-Saharan African country. Twelve patients (57%) developed shock syndrome related to Kawasaki disease and 16 patients (76%) developed myocarditis. Seventeen patients (81%) required intensive care or pediatric resuscitation. All of these children had noisy digestive symptoms at the onset of the disease and all had high inflammatory markers. Nineteen patients (90%) had markers of recent SARS-CoV-2 infection (RT-PCR positive for 8/21, and presence of IgG antibodies for 19/21 patients). All patients received intravenous immunoglobulins and ten (48%) also received corticosteroids. The clinical course was favorable in all cases. Coronary dilations were detected in five (24%) patients during hospitalization.

The abnormally high number of children and adolescents with Kawasaki disease recently observed in the Paris region could be linked to exposure to SARS-CoV-2. The study conducted cannot formally establish a causal link with infection with the SARS-CoV-2 virus despite very strong suspicion.

The characteristics of these patients differ from those observed during classic Kawasaki disease: these patients are older, more often of descent from a sub-Saharan African country, with more frequently digestive manifestations in the foreground, severe forms of myocarditis and hemodynamic instability.

COVID-19 and the Environment: A European Program Coordinated by Inserm gives its recommendations

© Randy Colas on Unsplash


Launched in 2019, the primary objective of the Health Environment Research Agenda for Europe (HERA), coordinated by Inserm and ISGlobal (Barcelona), is to provide the European Commission with an environment, climate, and health research agenda for 2020-2030. Faced with the health emergency created by the current pandemic, the program’s leaders are working on new recommendations to conduct research focusing on the links between environment, human health, and the COVID-19 pandemic. These initial recommendations indicate that far from being distinct fields, pandemic risk and environmental issues are closely linked and that an integrated vision of the health factors is both necessary and useful.

Against the unprecedented backdrop of the COVID-19 global pandemic, public health issues have taken center stage. More than ever, scientific knowledge derived from research is becoming a key tool to understand the societal impact of this pandemic and to guide the implementation of public health policies. The Health Environment Research Agenda for Europe (HERA), coordinated by Inserm, was launched in January 2019 and involves 15 European countries. As requested by the European Commission, the program’s objective is to provide the institution with an environment, climate, and health research agenda for 2020-2030 by identifying research needs and priorities in order to propose roadmaps that federate the various European partners. A preliminary agenda was proposed in February 2020.

Following the emergence of the pandemic, the European Commission has requested the addition of a supplementary research agenda with a COVID-19 component in order to investigate the links between pandemic, climate change, environment, and health.

In an initial report published in May 2020, HERA’s leaders have defined three priority research areas with the aim of better understanding the links between environment, emergence, spread, and impact of SARS-CoV-2. Their intention is to offer the authorities tools to establish public policies in line with the context and prevention of the pandemic, and which respect environment and individual health.

  1. Environmental drivers of SARS-CoV-2 emergence and spread

Improved understanding of the emergence of SARS-CoV-2 involves finding out more about its lifecycle and how the interactions between humans and animals (wild, farmed, or domestic) have contributed to it – and in particular the impact of human activities on deforestation, biodiversity, and wild animal behaviors.

The researchers also recommend the continued study of the issues of climate sensitivity and virus seasonality. Obtaining more information on how the virus spreads and identifying its potential resistance to certain environments would make it possible to improve our understanding of how it is propagated.

These studies must be accompanied by the development of solid and innovative modelling tools.

  1. Health impact of COVID-19 and environmental stressors

The researchers emphasize the importance of harmonizing cohorts, tools, and methodologies at European level in order to better identify at risk populations. The use of major European patient cohorts would make it possible to evaluate more precisely and more reliably the interactions between the pandemic, the response to it, and the diseases favored by environmental factors. Large-scale cohorts would also notably improve the evaluation of comorbidities that are linked to the chronic diseases implicated in severe cases of COVID-19, particularly cardiovascular and pulmonary diseases.

We observe that chronic diseases contributing to COVID-19 severity are at least partially promoted by environmental factors, states Robert Barouki who is coordinating the project at Inserm, “it would be particularly relevant to study how various environmental factors impact the immune and cardiovascular systems“, he adds.

Such data would prove valuable to better understand, at individual country level, the efficacy of various health and environmental protection policies that were established to respond to the pandemic.

  1. Impact of COVID-19 on society, the economy, and health

Evaluating of the psychological and socioeconomic impacts of various response strategies to the pandemic will also prove essential to minimize them and to improve resilience at European, national, and individual levels.

Knowing more about the societal impact (lifestyle changes, role of the urban environment, redefinition of the work environment, impact on physical and mental health, worsening of domestic violence, vulnerable populations, etc.) of the inter-human strategies which were set up to limit viral spread, such as lockdown or social distancing, will make it possible to better understand the means of implementing new public policies. 

The European Commission has already launched a call for projects relating to COVID-19.  One of its components aims to support and harmonize the studies on cohorts at European level. Other calls for projects are expected to follow. “The development of research at the crossroads of pandemics, environment, and health is relevant not only to the current crisis but also to prevent and better manage future health crises, particularly those in line with climate change”, specifies Barouki, “just like the concept of the exposome, it is important that we now move towards a more integrated vision of human and planetary health”.

In the coming weeks, HERA researchers will issue longer-term proposals to elucidate the links between the onset and severity of pandemics and environmental and climate changes.