RESUMEN
FASTER is an H2020 research project, within the European framework, in which Urban Search and Rescue (USAR) teams, in addition to other first responders, conduct an on-theground assessment of latest support technologies. These technologies are to be used in victim rescue response situations well as for coordination and safety procedures between disaster responders in diverse types of catastrophe scenarios. The tools have been developed by technical partners of the FASTER project committee and, with the aim of assessing the tools, two pilot exercises were conducted in collapsed buildings in Spain, simulating the impact of two earthquakes. The objective is to integrate and adapt the FASTER tools in initial interventions during the search for and rescue of victims. The focus is placed on information gathering in the disaster area, among other aspects. Simulation exercises were conducted in real locations involving collapsed buildings using drones, unmanned vehicles, canine wearables, a mobile command centre, a weather station and social network analysis, with real people acting the part of victims together with human dummy figures. Through these exercises, an assessment was carried out of the acceptability, ease of use, applicability, efficiency, and effectiveness of FASTER technology. The outbreak of the COVID-19 pandemic during the implementation of various pilot exercises was a setback that led us to introduce a USAR Camp deployment procedure involving preventive anti-COVID-19 measures, in accordance with the recommendations of official organisations such as INSARAG and the WHO. © 2023 by Nova Science Publishers, Inc. All rights reserved.
RESUMEN
COVID-19 has aspects on its pathogenesis that still need elucidating and an analysis of clinical and immunogenetic factors in each cohort of patients is paramount to understanding how genetic variability can explain the multiple clinical spectra seen in patients infected with SARS-CoV-2. The aim of this study was to correlate the KIR polymorphism/HLA class I ligand interactions from patients and healthy subjects with either the susceptibility or severity to COVID-19. Genotyping of HLA-A, -B, -C and KIR genes were carried out from 459 symptomatic as well as 667 non-infected Spanish Caucasian individuals using Lifecodes HLA-SSO and KIR-SSO kits (ImmucorTM, USA) and analyzed in the Luminex in this uni-centre case-control study performed at the University Hospital of Salamanca, Spain. Comparative KIR gene analysis showed that KIR2DS4 was significantly more representative in healthy versus infected individuals. When comparing subgroups of infected patients, KIR2DS3 had a higher frequency in those who progressed to a more severity disease and yet with higher mortality rate. Three functional combinations were significant on univariate analysis: KIR2DL2/C1, KIR2DS2/C1, and KIR2DS3/C1. However, in the multivariate analysis, only the KIR2DL2/C1 interaction remained significant (OR = 15.2 (95% CI 1.5-147), p = 0.0189). Compared with the solo-clinical characteristics predictive model, that included well-known comorbidity variables such as hypertension, age, sex, diabetes, C-reactive protein, dyslipidemia, smoking, ferritin, and fibrinogen, the clinical-and-KIR-based model showed a better ability to discriminate between severe and nonsevere patients with higher sensitivity and specificity. Our results support a fundamental role of KIR/ligand interaction in the clinical course of COVID-19. Since the KIR2DL2 gene has a high frequency in Spain (60%), the analysis of the KIR2DL2/C1 in symptomatic patients who require hospitalization could be helpful to better determine their prognosis.