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<dc:title xml:lang="fr">Déterminants cliniques et biomarqueurs de la gravité dans l’infection à SARS-CoV-2</dc:title>
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<dc:subject xml:lang="fr">COVID-19</dc:subject>
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<dc:subject xml:lang="fr">Ectonucléotidases</dc:subject>
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<dc:subject xml:lang="en">Ectonucleotidases</dc:subject>
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<dcterms:abstract xml:lang="fr">Cette thèse explore les déterminants cliniques et biologiques de la gravité du COVID-19 à travers trois axes complémentaires. L’analyse des ectonucléotidases sériques montre que l’activité CD73 augmente chez les patients hypoxémiques, alors qu’une activité faible s’associe à un profil inflammatoire et à une évolution défavorable. A l’inverse, CD39 reste sans lien avec la sévérité. L’étude de la charge virale nasopharyngée à l’admission ne met en évidence aucune association avec la sévérité ou la mortalité, renforçant le rôle majeur de la réponse immunitaire de l’hôte. Enfin, une cohorte dédiée analysera les vésicules extracellulaires circulantes pour caractériser leur implication dans l’immunothrombose et leur valeur potentielle comme biomarqueurs dynamiques. L’ensemble de ces travaux soutient une approche multimodale intégrant biomarqueurs enzymatiques, viraux et vésiculaires pour affiner la stratification du risque aux urgences.</dcterms:abstract>
<dcterms:abstract xml:lang="en">This thesis examines the clinical and biological determinants of COVID-19 severity through three complementary axes. Serum ectonucleotidase analysis shows that CD73 activity increases in hypoxemic patients, whereas low activity associates with an inflammatory profile and poor outcomes; in contrast, CD39 shows no relationship with severity. Nasopharyngeal viral load at admission is not associated with clinical severity or in-hospital mortality, underscoring the predominant role of the host immune response. Finally, a dedicated cohort will analyze circulating extracellular vesicles to characterize their involvement in immunothrombosis and their potential as dynamic biomarkers. Together, these findings support a multimodal approach integrating enzymatic, viral and vesicular biomarkers to refine risk stratification in the emergency setting.</dcterms:abstract>
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