Long-term Alterations of Host-microbiome Interactions and Cardiovascular and Respiratory Diseases Progression After Pneumonia

• Blood samples (Other): Four blood samples will be taken outside standard care for groups A, B, C and D: at inclusion, M6 and M18 (only at inclusion for group C).
• Oropharyngeal swabs (Other): An oropharyngeal swab will be taken to analyze patients\' upper airway microbiome at inclusion, M6 and M18.
• ECG (Other): Performed at inclusion, M6 and M18
• Cardiopulmonary exercise test, spirometry, plethysmography, pulmonary absorption of carbon monoxide in a single inspiration (Other): Cardiopulmonary exercise test, spirometry, plethysmography, pulmonary absorption of carbon monoxide in a single inspiration: These tests will be performed consecutively for 2 hours at inclusion M6 and M18. These tests will be performed to assess respiratory and cardiac function.

Primary outcomes

• Major adverse cardiovascular events (MACE) [6 months]: Major adverse cardiovascular events (MACE) at 6 months

Secondary outcomes

• Rate of events [Month 6 and Month 18]: Rate of events : nonfatal stroke, nonfatal myocardial infarction, hospital admission for heart failure, and cardiovascular death
• Rate of thrombo-embolic events [Month 6 and Month 18]: Rates of thrombo-embolic events : pulmonary embolism, deep venous thrombosis
• Rate of patients with poor cardiorespiratory fitness [6 Month]: Poor tolerance defined as VO2max lower than the normal values for age
• Long-term CVD progression [Month 6 and Month 18]: * Decrease in VO2max measured by cardiopulmonary exercise stress testing * \- Rates of CVD are defined as * % patients with VO2max lower than normal values for age and sex. * % patients with new rhythm cardiac alterations, of new repolarisation abnormality
• Rates of major respiratory events [Month 6 and Month 18]: Rates of major respiratory events are defined as COPD exacerbation, asthma exacerbation, hospitalization for respiratory failure, and respiratory-related mortality
• NYHA (New York Heart Association) classification [Month 6 and Month 18]: NYHA (New York Heart Association) classification of dyspnea
• mMRC (Modified Medical Research Council) Dyspnoea Scale [Month 6 and Month 18]: mMRC (Modified Medical Research Council) Dyspnoea Scale (Grade O to 4 : grade O = I only get breathless with strenuous exercise ; grade 4 : I am too breathless to leave the house or I am breathless when dressing/undressing)
• Rate of restrictive chronic respiratory distress [Month 6 and Month 18]: Rate of restrictive chronic respiratory distress defined as% of patients withCPT (Total Lung Capacity) lower than normal values
• Rate of obstructive chronic respiratory distress progression [Month 6 and Month 18]: Rate of obstructive chronic respiratory distress progression
• Percentage of patients with diffusion capacity for carbon monoxide (DLCO) lower than normal values for age and sex [Month 6 and Month 18]: Percentage of patients with diffusion capacity for carbon monoxide (DLCO) lower than normal values for age and sex
• Percentage of patients with vital capacity, expiratory reserve volume, and inspiratory reserved volume lower than normal values for age and sex [Month 6 and Month 18]: Percentage of patients with vital capacity, expiratory reserve volume, and inspiratory reserved volume lower than normal values for age and sex
• Rate of patients with secondary lower respiratory tract infection [Month 6 and Month 18]: Rate of patients with secondary lower respiratory tract infection defined as clinical signs of infection with new infiltrate on Chest-X-Ray
• Rate of patients with non-respiratory infection [Month 6 and Month 18]: * Rates of patients with secondary lower respiratory tract infection defined as clinical signs of infection (fever, cough, hyperleukocytosis or leukopenia), with new infiltrate on Chest-X-Ray (performed as standard of care). * Rates of patients with non-respiratory infection defined as pyelonephritis, septicemia, skin infection or others.
• Rates of patients with the Montreal Cognitive Assessment (MoCA) score values lower than 27 [Month 6 and Month 18]: Rates of patients with the Montreal Cognitive Assessment (MoCA) score values lower than 27
• Glasgow Outcome Scale Extended values [Month 6 and Month 18]: Glasgow Outcome Scale Extended values to assess global disability and recovery after traumatic brain injury
• Brief Pain Inventory score [Month 6 and Month 18]: BPI score. This self-assessment questionnaire assesses the maind imensions of pain : intensity, functional disability, social and family repercussions and level of psychological distress (scale 0-10 : 0 = no pain , 10 = worst pain)
• Rates of patients with chronic pain [Month 6 and Month 18]: Rates of patients with chronic pain (yes/no) as defined as worse pain score value within the last 24 hours superior to 3
• Rates of patients with severe symptoms of anxiety [Month 6 and Month 18]: Rates of patients with severe symptoms of anxiety defined as HADS_a and HADS_d >=11
• Mean Satisfaction With Life Scale (SWLS) score [Month 6 and Month 18]: Experience of CVRD progression from the patients' perspectives assessed by mean SWLS score
• Correlation between SWLS and EQ-5D-5L dimensions and utility scores [Month 6 and Month 18]: Correlation between Satisfaction With Life Scale (SWLS) and 5-level EQ-5D dimensions and utility scores
• SF(Short Form)-36 score [Month 6 and Month 18]: Patients' responses to the SF-36 to estimate the change in Health-Related Quality of Life (HRQoL) over time
• Mean QALYs (Quality-Adjusted Life-Years) [18 months]: Mean QALYs (Quality-Adjusted Life-Years)
• EPICES (Evaluation of precariousness and health inequalities in health examination centers) score [Month 6, Month 18 and Month 30]: Rate of socio-economical precarity defined as EPICES (Evaluation of precariousness and health inequalities in health examination centers) score values \> 30 at M6, 18 and M30
• Modelisation of host-microbiome interactions [Month 0, Month 6 and Month 18]: Modelisation of host-microbiome interactions

Sex: All, ages: 18 Years to 80 Years

Inclusion Criteria:

Group A (patients with acute cardiac disease)

* Male or female
* Hospitalized for acute coronary syndrome for less than 7 days.
* Informed consent from the patient
* Person insured under a health insurance scheme

Group B (patients with chronic cardiovascular disease)

* Male or female,
* Undergoing coronary artery by-pass surgery
* Hospitalized in intensive care unit for \> 12 hours
* Informed consent from the patient
* Person insured under a health insurance scheme

Group C (patients at risk of CVRD without chronic cardiovascular disease)

* Male or female,
* Familial high levels of cholesterol or triglycerides
* With no personal history of CVRD, with a recent negative cardiac exercise test (last test inferior to 12 months)
* Follow-up for lipid abnormalities at high risk of CVRD events
* Informed consent from the patient
* Person insured under a health insurance scheme

Group D (patients with HAP)

* Male or female
* With one or more risk factors for CVD among:

Age ≥ 65 years old Smoking, Abnormal lipidic levels, High blood pressure, Obesity, Diabetes mellitus, Chronic kidney disease

* Cured from mechanically ventilated HAP during the current hospitalization
* Informed consent from the patient or relatives
* Person insured under a health insurance scheme

Exclusion Criteria:

* Groups A, B, C and D
* Age <80 years old
* Immunosuppression pre-existing to the index hospitalisation, defined as lymphopenia; 500 elements/mm3, haematologic cancer, aplasia, chemotherapy/radiotherapy for cancer within 3 months prior to the inclusion, or anti-graft rejection drug.
* Pregnant women, breastfeeding women.
* Adults under guardianship or trusteeship.
* Low probability of survival at day 28.

  o Groups A, B, C
* Community-acquired pneumonia or Hospital-acquired pneumonia within the last year.