ABSTRACT
1301 Table 1PDSA Cycles 1 Launch of Quiz Night. Variety of questions, including region specific (‘Name the Hospital’ and ‘Guess the Consultant’ childhood photo rounds) and general rounds. 2 Further promotion, including a regional twitter hashtag. Addition of attendee requested rounds (continuing mixture of deanery specific and general rounds) 3 Head of School and TPDs invited to guest host rounds and addition of further innovative (COVID face mask) photo rounds 4 Quiz Night held in conjunction with regional PAFTAS award ceremony evening 5 Special edition quizzes (Back to School, Christmas Quiz) ResultsThe quiz was attended by a mixture of clinical, non-clinical, senior and junior paediatric staff and their families. Attendance ranged from 20–40 per quiz, peaking during lockdown. We received a total of 39 responses to our questionnaire.100% (n = 39) reported they would attend again and would recommend the quiz to a friend or colleague. 97% (n = 38) reported they agree or strongly agree that the quiz boosts staff morale. 92% (n = 36) reported it improved workplace relationships. When asked whether they preferred the quiz to be only trainee or consultant based, 100% (n = 39) reported they wanted it to be open to all.Attendees reported that it was a ‘great initiative’ that allowed people to ‘connect with colleagues’ at a time where this was ‘not possible in groups outside of work due to COVID.’ They ‘loved the banter’ and the ‘imaginative rounds.’ Thematic analysis demonstrated that what people valued most was the ‘chance to see friends’ from ‘around the region,’ ‘getting everyone together,’ and the ‘community feel’ created by these events through the ‘light-hearted entertainment.’ConclusionsThrough innovative photo rounds, guest hosts, and friendly competition, the quiz was a ‘wonderful way to get trainees and consultants of the region together,’ improving staff morale and workplace relationships. Hopefully one day we can ‘do it in a pub.’
ABSTRACT
The mechanisms that underpin COVID-19 disease severity, and determine the outcome of infection, are only beginning to be unraveled. The host inflammatory response contributes to lung injury, but circulating mediators levels fall below those in classical cytokine storms. We analyzed serial plasma samples from 619 patients hospitalized with COVID-19 recruited through the prospective multicenter ISARIC clinical characterization protocol U.K. study and 39 milder community cases not requiring hospitalization. Elevated levels of numerous mediators including angiopoietin-2, CXCL10, and GM-CSF were seen at recruitment in patients who later died. Markers of endothelial injury (angiopoietin-2 and von-Willebrand factor A2) were detected early in some patients, while inflammatory cytokines and markers of lung injury persisted for several weeks in fatal COVID-19 despite decreasing antiviral cytokine levels. Overall, markers of myeloid or endothelial cell activation were associated with severe, progressive, and fatal disease indicating a central role for innate immune activation and vascular inflammation in COVID-19.
Subject(s)
Lung Diseases , von Willebrand Diseases , Wounds and Injuries , COVID-19 , InflammationABSTRACT
Serological detection of antibodies to SARS-CoV-2 is essential for establishing rates of seroconversion in populations, detection of seroconversion after vaccination, and for seeking evidence for a level of antibody that may be protective against COVID-19 disease. Several high-performance commercial tests have been described, but these require centralised laboratory facilities that are comparatively expensive, and therefore not available universally. Red cell agglutination tests have a long history in blood typing, and general serology through linkage of reporter molecules to the red cell surface. They do not require special equipment, are read by eye, have short development times, low cost and can be applied as a Point of Care Test (POCT). We describe a red cell agglutination test for the detection of antibodies to the SARS-CoV-2 receptor binding domain (RBD). We show that the Haemagglutination Test (HAT) has a sensitivity of 90% and specificity of 99% for detection of antibodies after a PCR diagnosed infection. The HAT can be titrated, detects rising titres in the first five days of hospital admission, correlates well with a commercial test that detects antibodies to the RBD, and can be applied as a point of care test. The developing reagent is composed of a previously described nanobody to a conserved glycophorin A epitope on red cells, linked to the RBD from SARS-CoV-2. It can be lyophilised for ease of shipping. We have scaled up production of this reagent to one gram, which is sufficient for ten million tests, at a cost of ~0.27 UK pence per test well. Aliquots of this reagent are ready to be supplied to qualified groups anywhere in the world that need to detect antibodies to SARS-CoV-2, but do not have the facilities for high throughput commercial tests.