Dendritic cells (DC) connect the innate and adaptive arms of the immune system and carry out numerous roles that are significant in the context of viral disease. Their functions include the control of inflammatory responses, the promotion of tolerance, cross-presentation, immune cell recruitment and the production of antiviral cytokines. Based primarily on the available literature that characterizes the behaviour of many DC subsets during Severe acute respiratory syndrome (SARS) and coronavirus disease 2019 (COVID-19), we speculated possible mechanisms through which DC could contribute to COVID-19 immune responses, such as dissemination of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to lymph nodes, mounting dysfunctional inteferon responses and T cell immunity in patients. We highlighted gaps of knowledge in our understanding of DC in COVID-19 pathogenesis and discussed current pre-clinical development of therapies for COVID-19.

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Background:The development of Entrustable Professional Activities (EPAs) has generally focused on expert panel approaches, which are often limited to physician stakeholders. Optimally, a much wider group of stakeholders should be consulted and include all people gaining value from trainees’ patient care performance. The present study explored the perceptions of a variety of stakeholder groups regarding the relevance and comprehensiveness of EPAs developed for a Canadian Family Medicine Residency program.Methods: Through the use of an online survey consisting of dichotomous and open-ended questions, this study explored and compared the perceptions of a variety of stakeholder groups (policy makers, health administrators, health professionals, teachers, and public) regarding the relevance and comprehensiveness of 25 EPAs articulated by a family medicine residency program.Results:Agreement on appropriateness of the 25 articulated EPAs ranged from 90% to 100%, displaying a high level of alignment between stakeholders. Stakeholders identify two gap areas within the EPA framework: 1) provision of surgical assistance and 2) addictions care.Conventional content analysis identified three key themes that cut across multiple areas of the survey: 1) Interprofessional collaboration (IPC), 2) Inclusivity, and 3) Scope of EPAs. Comparative analysis consisted of exploring agreements, gaps, and other differences of perspectives between stakeholder groups. Although many of the stakeholder groups made comments regarding IPC and Inclusivity, the patient group in particular was more likely to raise these themes. Comments from patient groups were also overall more general, identifying overarching trends rather than specific pinpoint issues. Physicians, other health professionals, and resident groups, (Ie. health professional groups) on the other hand tended to answer with much more specificity, identifying issues relating to scope of EPAs.Conclusions: The present study demonstrates that a multi-stakeholder approach can feasibly be used to validate an EPA framework. In addition to confirming that a previously articulated set of EPAs largely reflected the range of activities expected of family physicians serving a population, it identified a number of potential areas of improvement in the framework.