ABSTRACT
The aim of this study was to validate the detection of anti-nucleocapsid protein (N protein) antibodies for the diagnosis of SARS-CoV-2 infection in light of the fact that most COVID-19 vaccines use the spike (S) protein as the antigen. Here, 3550 healthcare workers (HCWs) were enrolled from May 2020 (when no S protein vaccines were available). We defined SARS-CoV-2 infection if HCWs were found to be positive by RT-PCR or found to be positive in at least two different serological immunoassays. Serum samples from Biobanc I3PT-CERCA were analyzed by Roche Elecsys® (N protein) and Vircell IgG (N and S proteins) immunoassays. Discordant samples were reanalyzed with other commercial immunoassays. Roche Elecsys® showed the positivity of 539 (15.2%) HCWs, 664 (18.7%) were found to be positive by Vircell IgG immunoassays, and 164 samples (4.6%) showed discrepant results. According to our SARS-CoV-2 infection criteria, 563 HCWs had SARS-CoV-2 infection. The Roche Elecsys® immunoassay has a sensitivity, specificity, accuracy, and concordance with the presence of infection of 94.7%, 99.8%, 99.3%, and 0.96, respectively. Similar results were observed in a validation cohort of vaccinated HCWs. We conclude that the Roche Elecsys® SARS-CoV-2 N protein immunoassay demonstrated good performance in diagnosing previous SARS-CoV-2 infection in a large cohort of HCWs.
Subject(s)
COVID-19 , Humans , COVID-19/diagnosis , SARS-CoV-2/genetics , COVID-19 Vaccines , Antibodies, Viral , Sensitivity and Specificity , Immunoassay/methods , Nucleocapsid Proteins , Immunoglobulin G , VaccinationABSTRACT
The early detection of symptoms and rapid testing are the basis of an efficient screening strategy to control COVID-19 transmission. The olfactory dysfunction is one of the most prevalent symptom and in many cases is the first symptom. This study aims to develop a machine learning COVID-19 predictive tool based on symptoms and a simple olfactory test, which consists of identifying the smell of an aromatized hydroalcoholic gel. A multi-centre population-based prospective study was carried out in the city of Reus (Catalonia, Spain). The study included consecutive patients undergoing a reverse transcriptase polymerase chain reaction test for presenting symptoms suggestive of COVID-19 or for being close contacts of a confirmed COVID-19 case. A total of 519 patients were included, 386 (74.4%) had at least one symptom and 133 (25.6%) were asymptomatic. A classification tree model including sex, age, relevant symptoms and the olfactory test results obtained a sensitivity of 0.97 (95% CI 0.91-0.99), a specificity of 0.39 (95% CI 0.34-0.44) and an AUC of 0.87 (95% CI 0.83-0.92). This shows that this machine learning predictive model is a promising mass screening for COVID-19.
Subject(s)
COVID-19 , Smell , COVID-19/diagnosis , Humans , Machine Learning , Mass Screening , Prospective StudiesABSTRACT
Objetivos: Estimar el efecto de los antimaláricos (AM) sobre los diferentes dominios del índice de daño SLICC (SDI). Métodos: Se estudiaron pacientes con diagnóstico clínico reciente (≤2 años) de lupus eritematoso sistémico (LES) de la cohorte GLADEL. Variable de estudio: aumento en los dominios del SDI desde el ingreso a la cohorte. Variables independientes: características sociodemográficas, clínicas, laboratorio y tratamientos. El efecto de los AM, como variable dependiente del tiempo, sobre los dominios más frecuentes del SDI (ajustado por factores de confusión) fue examinado con un modelo de regresión de Cox multivariado. Resultados: De 1466 pacientes estudiados, 1049 (72%) recibieron AM con un tiempo medio de exposición de 30 meses (Q1-Q3: 11-57) y 665 pacientes (45%) presentaron daño durante un seguimiento medio de 24 meses (Q1-Q3: 8-55); 301 eventos fueron cutáneos, 208 renales, 149 neuropsiquiátricos, 98 musculoesqueléticos, 88 cardiovasculares y 230 otros. Después de ajustar por factores de confusión, el uso de AM se asoció a un menor riesgo de daño renal (HR 0,652; IC 95%: 0,472-0,901) y en el límite de la significancia estadística (HR 0,701, IC 95%: 0,481-1,024) para el dominio neuropsiquiátrico. Conclusión: En GLADEL, el uso de AM se asoció independientemente a un menor riesgo de daño acumulado renal.
Objective: To assess the effects of antimalarials (AM) over the items of the SLICC Damage Index (SDI). Methods: Patients with recent (≤2 years) diagnosis of systemic lupus erythematosus (SLE) from the GLADEL cohort were studied. End-point: increase in items SDI since cohort entry. Independent variables (socio-demographic, clinical, laboratory and treatment) were included. The effect of AM as a time dependent variable on most frequent SDI items (adjusting for potential confounders) was examined with a multivariable Cox regression model. Results: Of the 1466 patients included in this analysis, 1049 (72%) received AM with a median exposure time of 30 months (Q1-Q3: 11-57). Damage occurred in 665 (45%) patients during a median follow-up time of 24 months (Q1-Q3: 8-55). There were 301 integument, 208 renal, 149 neuropsychiatric, 98 musculoskeletal, 88 cardiovascular and 230 others less frequently represented damages. After adjusting for potential confounders at any time during follow-up, a lower risk of renal damage (HR 0.652; 95% CI: 0.472-0.901) and borderline for neuropsychiatric damage (HR 0.701, 95% CI: 0.481-1.024) was found. Conclusion: In the GLADEL cohort, after adjustment for possible confounding factors, AM were independently associated with a reduced risk of renal damage accrual.
Subject(s)
Lupus Erythematosus, Systemic , AntimalarialsABSTRACT
El artículo estudia la manera en la que los profesionales sanitarios comunican el diagnóstico de síndrome de Down a los padres. Para eso se analizan los relatos personales de las madres recogidos en las respuestas dadas por aquéllas a las preguntas abiertas de un cuestionario sobre "comunicación del diagnóstico". Los resultados muestran la insatisfacción de las madres ante la información recibida durante el diagnóstico prenatal y postnatal de síndrome de Down
The article studies the way in which health professionals communicate the diagnosis of Down syndrome to parents. For that the personal stories of the mothers collected in the answers given by them to the open questions of a questionnaire on "communication of the diagnosis" are analyzed. The results show the mothers' dissatisfaction with the information received during the prenatal and postnatal diagnosis of Down syndrome
Subject(s)
Humans , Male , Female , Child, Preschool , Adult , Down Syndrome/diagnosis , Mothers/psychology , Professional-Family Relations , Truth Disclosure/ethics , Communication , Cross-Sectional Studies , Self Report , Patient Satisfaction , Surveys and QuestionnairesABSTRACT
The article studies the way in which health professionals communicate the diagnosis of Down syndrome to parents. For that the personal stories of the mothers collected in the answers given by them to the open questions of a questionnaire on â³communication of the diagnosisâ³ are analyzed. The results show the mothers' dissatisfaction with the information received during the prenatal and postnatal diagnosis of Down síndrome.
Subject(s)
Down Syndrome , Mothers , Professional-Family Relations , Truth Disclosure , Adult , Child, Preschool , Communication , Cross-Sectional Studies , Down Syndrome/diagnosis , Female , Humans , Male , Mothers/psychology , Patient Satisfaction , Self ReportABSTRACT
An ecological risk assessment (ERA) was performed using the hazard quotient (HQ) method to evaluate the risks of oral exposure to polycyclic aromatic hydrocarbons (PAHs) for medium sized omnivorous mammals. This is the first in a series of three papers. In Mexico there is little experience in performing this kind of assessment for the terrestrial compartment, in particular for birds and mammals exposed to hydrocarbons. The purpose of this paper is to perform an ERA and to establish if the omnivorous mammalian species living in the area are at risk of adverse effects. The studied site is a land that in past years had been used for the disposition of petroleum tank bottom sludges, and scrap metals. Soil and water samples were collected and analyzed, and we obtained a list of the site's wildlife species as well as samples of the specimens, which were analyzed also. HQs were calculated for the hydrocarbons identified as chemicals of potential ecological concern (COPECs) and the omnivorous mammals of the site were evaluated. Toxicity reference values (TRVs) were taken from the appropriate literature, and the doses of exposure were estimated considering the ingestion of water, soil, and diet. Results indicated that potential risks associated to the oral exposure route were less than benchmarks for effects (in all cases HQ<1). The methodology is adequate in terms of the parameters considered in the calculations, but it was concluded that in order to reduce uncertainty, more research is required in Mexico. This should be primarily aimed at obtaining TRVs for mammals, and consider test species with body weights more similar to those found in the local fauna.
