ABSTRACT
Background Tests that can diagnose COVID-19 rapidly and predict prognosis would be significantly beneficial. We studied the ability of breath analysis using gas chromatography-ion mobility spectrometry (GC-IMS) for diagnosis of COVID-19 and as a predictor for subsequent requirement for Continuous Positive Airway Pressure (CPAP). Methods We undertook a single centre prospective observational study in patients with COVID-19, other respiratory tract infections and healthy controls. Participants provided one breath sample for GC-IMS analysis. We used cross validation analysis to create models that were then tested against the original cohort data. Further multivariable analysis was undertaken to adjust for differences between the comparator groups. Results Between 01/02/2021 and 24/05/2021 we recruited 113 participants, of whom 72 (64%) had COVID-19, 20 (18%) had another respiratory tract infection and 21 (19%) were healthy controls. Differentiation between patients with COVID-19 and healthy controls, and patients with COVID-19 and those with other respiratory tract infections, was achieved with high accuracy. Identification of patients with subsequent requirement for CPAP was completed with moderate accuracy and was not independently associated on multivariable analysis. Conclusions We have shown that GC-IMS has a high capability to distinguish between acute COVID-19 infection and other disease states. Breath analysis shows promise as a predictor of subsequent requirement for CPAP in hospitalised patients with COVID-19. This platform has considerable benefits due to the test being rapid, non-invasive and not requiring specialist laboratory processing.
Subject(s)
COVID-19 , Respiratory Tract InfectionsABSTRACT
Little is known about T-cell responses during acute coronavirus disease-2019 (COVID-19). We measured T-cell interferon gamma (IFN-{gamma}) responses to spike 1 (S1), spike 2 (S2), nucleocapsid (N) and membrane (M) SARS-CoV-2 antigens using the T-SPOT(R) Discovery SARS-CoV-2 assay, a proven EliSPOT technology, in 114 hospitalised adult COVID-19 patients and assessed their association with clinical disease phenotype. T-SPOT(R) Discovery SARS-CoV-2 responses were detectable within 2 days of a positive PCR and did not correlate with vaccination status or symptom duration. Higher responses to S1 protein associated with a higher symptom burden, and serum IL-6 levels. Despite treatment with dexamethasone this subgroup was also at greater risk of requiring continuous positive airway pressure (CPAP) in the days following sampling. Higher T-cell responses measured using T-SPOT(R) Discovery SARS-CoV-2 associate with progressive disease in acute COVID-19 disease and may have utility as a prognostic biomarker that should be evaluated in larger cohorts.
Subject(s)
Coronavirus Infections , COVID-19ABSTRACT
Objectives YouTube is the largest open-access media website and an increasingly recognised resource in Medical Education, with much content related to Neurosurgery. External Ventricular Drain (EVD) insertion is frequently undertaken by neurosurgical trainees. Online and distant learning have gained popularity during this COVID-19 pandemic more than ever. We evaluated content on YouTube as to its use as an effective open-access learning resource for EVD insertion as a key neurosurgical procedure. Methods A keyword search identified videos related to EVD insertion on 01/06/2020. Inclusion criteria was created to focus on content aimed at describing the technique of EVD insertion. An educational scoring system was devised related to the procedure of EVD insertion. Each video was scored on our educational score, JAMA Benchmark Criteria and Global Quality Score (GQS). They were subsequently categorised as effective or ineffective. Results A total of 12/700 videos met inclusion criteria. Dates posted ranged from 01/07/2012 – 24/04/2019, with views range 359 – 166,388, and mean of 30,531 (SD 49,570). Four videos (33%) were considered an effective learning resource. The cohort had a mean educational score of 6.91 (SD 3.86), with median JAMA score and GQS 2/4 (SD 0.62) and 2/5 (SD 1.6) respectively. A strong correlation was found between viewership and score (R 0.85, p<0.005) Conclusion The majority of YouTube content on EVD insertion is an ineffective resource. Neurosurgeons and Institutions could harness YouTubes broad access by posting high-quality educational content. This is more important than ever with increasing emphasis on online training resources, YouTube included.