CHARM: COVID-19 Health Action Response for Marines - association of antigen-specific interferon-gamma and IL2 responses with asymptomatic and symptomatic infections after a positive qPCR SARS-CoV-2 test

SARS-CoV-2 T cell responses are associated with COVID-19 recovery, and Class I- and Class II-restricted epitopes have been identified in the spike (S), nucleocapsid (N) and membrane (M) proteins and others. This prospective COVID-19 Health Action Response for Marines (CHARM) study enabled assessment of T cell responses in symptomatic and asymptomatic SARS-CoV-2 infected participants. At enrollment all participants were negative by qPCR; follow-up occurred biweekly and then bimonthly for the next 6 weeks. Study participants who tested positive by qPCR SARS-CoV-2 test were asked to enroll in an immune response sub-study. FluoroSpot interferon-gamma (IFN-{gamma}) and IL2 responses following qPCR-confirmed infection at enrollment (day 0), day 7 and 14 and more than 28 days later were measured using pools of 17mer peptides covering S, N, and M proteins, or CD4+CD8 peptide pools containing predicted epitopes from multiple SARS-CoV-2 antigens. Among 124 asymptomatic and 105 symptomatic participants, SARS-CoV-2 infection generated IFN-{gamma} responses to the S, N and M proteins that persisted longer in asymptomatic cases. IFN-{gamma} responses were significantly (p=0.001) more frequent to the N pool (51.4%) than the M pool (18.9%) among asymptomatic subjects; however, the difference was not statistically significant (p=0.06) for symptomatic subjects (N pool: 44.4%; M pool: 25.9%). In asymptomatic participants IFN-{gamma} responders to the CD4+CD8 pool responded more frequently to the S pool (55.6%) and N pool (57.1%), than the M pool (7.1%), but symptomatic participants, IFN-{gamma} responses were more frequent to the S pool (75.0%) than N pool (33.3%) and M pool (33.3%). The frequencies of IFN-{gamma} responses to the S and N+M pools peaked 7 days after the positive qPCR test among asymptomatic (S pool: 22.2%; N+M pool: 28.7%) and symptomatic (S pool: 15.3%; N+M pool 21.9%) participants and dropped by >28 days. Magnitudes of post-infection IFN-{gamma} and IL2 responses to the N+M pool were significantly correlated with IFN-{gamma} and IL2 responses to the N and M pools. These data further support the central role of Th1-biased cell mediated immunity IFN-{gamma} and IL2 responses, particularly to the N protein, in controlling COVID-19 symptoms, and justify T cell-based COVID-19 vaccines that include the N and S proteins.

Análise de pico de fluxo de tosse voluntária de pacientes em um hospital de urgências / Analysis of voluntary cough flow peak of patients in an emergency hospital

INTRODUÇÃO: A tosse, voluntária ou reflexa, é um dos principais mecanismos de depuração para proteção das vias aéreas. O pico de fluxo de tosse (PFT) é um método de avaliação específica, mas que vem demonstrando utilidade para avaliar riscos de complicação pulmonares bem como sua gravidade. Variável muito semelhante ao pico de fluxo expiratório cuja principal diferença consiste no fechamento da glote durante a manobra de tosse. Então avaliar a tosse é importante para identificar pacientes com alterações no pico de fluxo de tosse, e consequente risco de complicações pulmonares. OBJETIVO: Analisar o PFT voluntário e parâmetros clínicos e epidemiológicos em uma população internada nas enfermarias de um hospital de urgências. MÉTODOS: Estudo transversal com pacientes internados nas enfermarias de um Hospital Público de Goiânia. Foram coletados dados epidemiológicos e clínicos. O PFT foi mensurado pelo peak flow meter e a avaliação de dor através da Escala de Dor Visual Numérica associada à Escala de Dor de Faces. RESULTADOS: A amostra foi composta em sua maioria por homens 288 (81,36). A média de idade da população estudada foi de 45,91 anos (±20,14). Sessenta e um por cento dos pacientes (219) apresentaram tosse eficaz, e 43 (12,15%) tosse ineficaz, revelou associação com idade, sexo e diagnóstico. CONCLUSÃO: Os pacientes que mais apresentaram alterações na força de tosse foram os idosos, sexo feminino e vítimas acometidas por desordens neurológicas e toracoabdominais. [AU]

INTRODUCTION. Cough, whether voluntary or reflex, is one of the major clearance mechanisms for airway protection. Peak cough flow is a recent and specific evaluation method, but it has been useful for evaluating pulmonary complications as well as their severity. Variable very similar to the peak of expiratory flow whose main difference consists in the closure of the glottis during the maneuver of cough. Therefore, assessing cough is important to identify patients with changes in peak cough flow, and the consequent risk of pulmonary complications. OBJECTIVE: To analyze the peak flow of voluntary cough and its association with clinical and epidemiological parameters in a population hospitalized in the wards of an emergency hospital. METHODS: A cross-sectional study with 354 patients admitted to the wards of a Public Hospital of Goiânia. Epidemiological and clinical data were collected. Optic cough flow was measured by the peak flow meter and the pain assessment using the Numerical Visual Pain Scale associated with the Face Pain Scale. RESULTS: The sample consisted mostly of 288 (81,36) men. The mean age of the study population was 45,91 years (± 20,14). 61, 86% (219) of the patients had effective cough, and 43 (12,15%) had an ineffective cough. CONCLUSION: Patients who presented the greatest changes in coughing strength were the elderly, females and victims of neurological and thoracoabdominal disorders. [AU]

Conhecimento de parada cardiorrespiratória dos profissionais de sáude em um hospital público: estudo transversal / Knowledge of cardiorrespiratory arrest of health professionals in a public hospital: cross-current study

Introdução: A Parada Cardiorrespiratória é a interrupção súbita da atividade mecânica ventricular útil e suficiente, e da respiração. O sucesso na reversão desse quadro depende da qualidade do atendimento que a equipe oferece e uma resposta rápida e hábil pode fazer a diferença entre mortalidade e ausência/instalação de sequelas. Objetivo: avaliar o conhecimento teórico de profissionais médicos e enfermeiros no diagnóstico e tratamento da parada cardiorrespiratória em adultos em um hospital público de Goiânia ­ GO. Métodos: Trata-se de um estudo observacional e descritivo. Aplicou-se questionário próprio específico contendo perfil do profissional e avaliação de conhecimento teórico sobre parada cardiorrespiratória e ressuscitação cardiopulmonar no adulto, fundamentado nas recomendações da American Heart Association de 2015. Resultados: De 147 participantes, 89,80% foram reprovados em seus conhecimentos e apenas 10,20% da amostra foi aprovada. Quando associado o padrão de aprovação com as categorias profissionais observou-se que 4,41% dos enfermeiros e 15,19% dos médicos foram aprovados com p=0,031. Conclusão: o estudo evidencia uma deficiência no conhecimento dos profissionais sobre manejo na Parada Cardiorrespiratória. Sugere-se padronização do atendimento e otimização do treinamento em serviço para que haja maior capacitação e atitude profissional, paralelamente ao progresso científico e tecnológico. [AU]

Introduction: Cardiorespiratory arrest is the sudden cessation of useful and sufficient ventricular mechanical activity and respiration. The success in reversing this situation depends on the quality of care the team offers and a quick and skilled response can make the difference between mortality and absence/installation of sequelae. Objective: to evaluate the theoretical knowledge of medical professionals and nurses and in the diagnosis and treatment of cardiorespiratory arrest in adults in a public hospital in Goiânia - GO. Methods: This is an observational and descriptive study. A specific questionnaire containing the professional profile and theoretical knowledge evaluation on cardiorespiratory arrest and cardiopulmonary resuscitation in adults, based on the recommendations of the American Heart Association, 2015, was applied. Results: Out of 147 participants, 89.80% were failing their knowledge and only 10,20% of the sample was approved. When associated with the standard of approval with the professional categories, it was observed that 4,41% of the nurses and 15,19% of the physicians were approved with p= 0,031. Conclusion: the study evidences a deficiency in the professionals' knowledge about management in Cardiorespiratory Arrest. It is suggested standardization of service and optimization of in-service training so that there is greater training and professional attitude, in parallel with scientific and technological progress. [AU]

Optical Frequency Metrology of an Iodine-Stabilized He-Ne Laser Using the Frequency Comb of a Quantum-Interference-Stabilized Mode-Locked Laser.

We perform optical frequency metrology of an iodine-stabilized He-Ne laser using a mode-locked Ti:sapphire laser frequency comb that is stabilized using quantum interference of photocurrents in a semiconductor. Using this technique, we demonstrate carrier-envelope offset frequency fluctuations of less than 5 mHz using a 1 s gate time. With the resulting stable frequency comb, we measure the optical frequency of the iodine transition [(127)I2 R(127) 11-5 i component] to be 473 612 214 712.96 ± 0.66 kHz, well within the uncertainty of the CIPM recommended value. The stability of the quantum interference technique is high enough such that it does not limit the measurements.