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1.
J Mol Diagn ; 23(12): 1661-1670, 2021 12.
Article in English | MEDLINE | ID: covidwho-1540788

ABSTRACT

Severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) is transmitted through airborne particles in exhaled breath, causing severe respiratory disease, coronavirus disease-2019 (COVID-19), in some patients. Samples for SARS-CoV-2 testing are typically collected by nasopharyngeal swab, with the virus detected by PCR; however, patients can test positive for 3 months after infection. Without the capacity to assay SARS-CoV-2 in breath, it is not possible to understand the risk for transmission from infected individuals. To detect virus in breath, the Bubbler-a breathalyzer that reverse-transcribes RNA from SARS-CoV-2 particles into a sample-specific barcoded cDNA-was developed. In a study of 70 hospitalized patients, the Bubbler was both more predictive of lower respiratory tract involvement (abnormal chest X-ray) and less invasive than alternatives. Samples tested using the Bubbler were threefold more enriched for SARS-CoV-2 RNA than were samples from tongue swabs, implying that virus particles were being directly sampled. The barcode-enabled Bubbler was used for simultaneous diagnosis in large batches of pooled samples at a lower limit of detection of 334 genomic copies per sample. Diagnosis by sequencing can provide additional information, such as viral load and strain identity. The Bubbler was configured to sample nucleic acids in water droplets circulating in air, demonstrating its potential in environmental monitoring and the protective effect of adequate ventilation.

2.
iScience ; 24(11): 103215, 2021 Nov 19.
Article in English | MEDLINE | ID: covidwho-1446746

ABSTRACT

Multisystem inflammatory syndrome in children (MIS-C) is a life-threatening disease occurring several weeks after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Deep immune profiling showed acute MIS-C patients had highly activated neutrophils, classical monocytes and memory CD8+ T-cells, with increased frequencies of B-cell plasmablasts and double-negative B-cells. Post treatment samples from the same patients, taken during symptom resolution, identified recovery-associated immune features including increased monocyte CD163 levels, emergence of a new population of immature neutrophils and, in some patients, transiently increased plasma arginase. Plasma profiling identified multiple features shared by MIS-C, Kawasaki Disease and COVID-19 and that therapeutic inhibition of IL-6 may be preferable to IL-1 or TNF-α. We identified several potential mechanisms of action for IVIG, the most commonly used drug to treat MIS-C. Finally, we showed systemic complement activation with high plasma C5b-9 levels is common in MIS-C suggesting complement inhibitors could be used to treat the disease.

3.
Archives of Disease in Childhood ; 106(Suppl 1):A361-A362, 2021.
Article in English | ProQuest Central | ID: covidwho-1443515

ABSTRACT

BackgroundThe COVID-19 pandemic has placed unprecedented stress on the healthcare system and the professionals that work within it. It is increasingly recognised that peer support helps to strengthen resilience for professionals working within stressful systems, whether in healthcare or in other industries. Models such as Schwartz rounds and Balint groups focus on emotional responses to pre-determined themes or participant-suggested clinical cases in a facilitated, supportive group discussion setting away from the clinical area. Both methods have been shown to improve staff wellbeing whilst preventing the development of ‘burnout’ in participants. However, the need for social distancing during the pandemic increased the difficulty of organising safe face-to-face group discussion at a time when peer support methods were arguably needed more than ever.ObjectivesTo pilot a facilitated peer support session in a virtual format and assess the acceptability of the format for trainees.MethodsA themed discussion entitled ‘In This Bleak Midwinter’ was incorporated into the January 2021 regional ST3 trainee study day, which was convened virtually via Zoom videoconferencing software. 21 ST3 trainees were split into three virtual breakout rooms, with at least one trainee per group given a short briefing beforehand and asked to prepare something to begin the discussion. One trainee was removed from the session due to camera issues, as the faculty felt video was crucial for maximising engagement with the session and maintaining the trust necessary to develop a ‘safe space’ for open discussion. Three members of a local chaplaincy team, trained in Schwartz and Balint methodology, facilitated group discussions which lasted for approximately 55 minutes. A scheduled break followed to allow trainees to reflect and recover before continuing with the rest of the day’s programme. Feedback was gathered via anonymous online survey.Results85% of trainees rated the session as ‘excellent’ on a five-point Likert scale, the most positive rating possible. 58% of respondents specifically mentioned the session in a free text question asking for ‘three good things about the day’. Three trainees stated in a free text question asking ‘how could the day be improved?’ that they would like facilitated peer support sessions to be scheduled during every monthly teaching programme. One trainee subsequently sought professional help for their mental health and directly cited the session as the driver to do so.ConclusionsThe considerable positive feedback suggests that facilitated peer support sessions can be successful when held in a virtual format. Data on lasting effects were not gathered and future research could try to ascertain whether the positive reactions produced medium-term and long-term benefits, similar to face-to-face sessions. Future research could also examine the effect of cameras on engagement, as this seemed the main barrier to participation and engagement in our pilot session.

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