ABSTRACT
As the SARS-CoV-2 pandemic persists, methods that can quickly and reliably confirm infection and immune status is extremely urgently and critically needed. In this contribution we show that combining laser induced breakdown spectroscopy (LIBS) with machine learning can distinguish plasma of donors who previously tested positive for SARS-CoV-2 by RT-PCR from those who did not, with up to 95% accuracy. The samples were also analyzed by LIBS-ICP-MS in tandem mode, implicating a depletion of Zn and Ba in samples of SARS-CoV-2 positive subjects that inversely correlate with CN lines in the LIBS spectra.
Subject(s)
COVID-19/blood , COVID-19/diagnosis , Immunity , Lasers , Pandemics , SARS-CoV-2/immunology , Spectrophotometry, Atomic/methods , Barium/analysis , COVID-19/epidemiology , COVID-19/virology , Data Accuracy , Discriminant Analysis , False Negative Reactions , False Positive Reactions , Humans , Machine Learning , Reverse Transcriptase Polymerase Chain Reaction/methods , SARS-CoV-2/genetics , Sensitivity and Specificity , Zinc/analysisABSTRACT
Background: Sacubitril/valsartan has changed the landscape of the pharmacological therapy of heart failure with reduced ejection fraction (HFrEF). We present our single-centre nurse-led initiation and titration clinic findings from Waikato Hospital. Method: Our retrospective analysis includes 149 consecutive patients with HFrEF who were commenced on sacubitril/valsartan by the Heart Failure Clinical Nurse Specialist (HF CNS) clinic between 1 October 2018 and 30 September 2019. Statistical analyses for Wilcoxon signed-rank test (two-tailed) were performed using Prism 8. Results: Our cohort of 149 patients were predominantly male (81%) with a median age of 68. The majority were either European (72%) or Māori (25%). Two-thirds (64%) were aetiologically non-ischaemic. Mean systolic blood pressure, mean GFR, mean weight and mean serum K+ were similar at baseline and at 6 month follow-up. 69% achieved target dose and 6% had withdrawal of sacubitril/valsartan. 36% had reduction in loop diuretic dose and 18% had mineralocorticoid antagonist withdrawn. Statistically significant differences were observed with decrease in NYHA Class (z = -7.961;p <.00001), decrease in NT-pro BNP (z = -6.441;p <.00001) and improvement in LVEF (z = -6.052;p <.00001) across the cohort. 10% (n = 15) were hospitalised for HF and 3.4% died (n = 5) within 6 months of commencing sacubitril/valsartan. Conclusion: Our early, single-centre experience with a nurse-initiated and led sacubitril-valsartan clinic has yielded results in keeping with the data from the PARADIGM-HF trial, whereby patients experience an improvement clinically (NYHA Class), biochemically (NT-pro BNP) and echocardiographically () with a favourable adverse effect profile. Further insights will be gleaned with longer-term follow-up in our cohort. [Formula presented]