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SARS-CoV-2 proteins

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    COVID-19 MESHD anosmia MESHD and gustatory symptoms as a prognosis factor: a subanalysis of the HOPE COVID-19 MESHD (Health Outcome Predictive Evaluation for COVID-19 MESHD) Registry

    Authors: Jesús Porta-Etessam; Iván Núñez-Gil; Nuria González García; Cristina Fernández; María Viana-LLamas; Charbel Maroun Eid; Rodolfo Romero; Marta Molina; Aitor Uribarri; Victor Becerra; Marcos García Aguado; Jia Huang; Elisa Rondano; Enrico Cerrato; Emilio Alfonso; Alex Castro; francisco Marín; Sergio Raposeiras; Martino Pepe; Gisela Feites; Paloma Mate; Bernardo Cortese; Luís Buzón; Jorge Javita; Vicente Estrada

    doi:10.21203/rs.3.rs-158894/v1 Date: 2021-01-27 Source: ResearchSquare

    Olfactory and gustatory dysfunctions MESHD ( OGD MESHD) are a frequent symptom of Coronavirus disease 2019 MESHD ( COVID-19 MESHD). It has been proposed that the neuroinvasive potential of the novel SARS-CoV-2 could be due to olfactory bulb invasion, conversely studies suggest it could be a good prognostic factor. The aim of the current study was to investigate the prognosis value of OGD in COVID-19 MESHD.These symptoms were recorded on admission from a cohort study of 5868 patients with confirmed or highly suspected COVID-19 MESHD infection included in the multicenter international HOPE Registry (NCT04334291).There was statistical relation in multivariate analysis for OGD in gender, more frequent in female 12.41% vs 8.67% in male, related to age, more frequent under 65 years, presence of hypertension MESHD, dyslipidemia MESHD, diabetes MESHD, smoke, renal insufficiency MESHD, lung, heart, cancer MESHD and neurological disease MESHD. We did not find statistical differences in pregnant (p=0.505), patient suffering cognitive (p=0.484), liver (p=0.1) or immune disease (p=0.32). There was inverse relation (protective) between OGD MESHD and prone positioning (0.005) and death MESHD (<0.0001), but no with ICU (0.165) or mechanical ventilation (0.292). On univariable logistic regression OGD was found to be inversely related to death in COVID-19 MESHD patients. The Odds Ratio was 0.26 (0.15-0.44) (p<0.001) and Z was -5.05.The presence of anosmia MESHD is fundamental in the diagnosis of SARS.CoV-2 infection MESHD, but also could be important when classifying patients and in therapeutic decisions. Even more knowing that it is an early symptom of the disease. Knowing that other situations as being Afro-American or Latino-American, Hypertension MESHD, renal insufficiency MESHD, or increase of C-reactive protein HGNC ( CRP HGNC) imply a worse prognosis we can make a clinical score to estimate the vital prognosis of the patient.The exact pathogenesis of SARS-CoV-2 that causes olfactory and gustative disorders remains unknown but seems related to the prognosis. This point is fundamental, insomuch as could be a plausible way to find a treatment. 

    Evaluation of Patients With Covid-19 MESHD Diagnosis for Chronic Diseases MESHD

    Authors: Murat Altuntas; Habip Yilmaz; Emre Güner

    doi:10.21203/rs.3.rs-135761/v1 Date: 2020-12-24 Source: ResearchSquare

    Aim: Covid-19 MESHD is one of the most important pandemics in the world history. Chronic diseases MESHD, which are risk factors that increase the case fatality rates, have been the leading cause of death MESHD all over the world. In this study, it was aimed to detect coexisting diseases in patients hospitalized with the diagnosis of Covid-19 MESHD.           Material and Method: It was carried out with the data of 229 inpatients in an intensive care unit between 01.06.2020 - 30.06.2020. Among the inclusion criteria of the study; it is necessary to have a diagnosis confirmed by PCR test, to be hospitalized in the relevant intensive care unit on the date of the study and to have data accessible through the hospital automation system. According to literature; chronic diseases of the patients and their effects on the covid-19 MESHD process were evaluated. Statistical analyzes were performed using the Statistical Package for Social Sciences (SPSS) version 24.0 (IBM Corp .; Armonk, NY, USA).Results: It was seen that the average age of the patients were 61.4±15.9 years old. While the average symptom duration was 8.2±5.3 days; total hospitalization period was 13.1±5.9 days. The length of stay of 75 patients who were sent to intensive care unit was determined as 10.1±7.1. The most common chronic disease MESHD among patients was hypertension MESHD with 47.2%. This was followed by diabetes mellitus MESHD (32.8%) and heart disease MESHD (27.5%), respectively. In the presented study, cough MESHD (59.4%), fever MESHD (58.5%) and shortness of breath MESHD (45.9%) were found to be the most common symptoms. Leukopenia MESHD, impairments in liver and muscle enzymes, abnormal C-reactive protein HGNC, ferritin and d-dimer levels were the important laboratory findings.Conclusion: Particular attention should be paid to the elderly Covid-19 MESHD patients with chronic diseases MESHD, especially DM MESHD, HT MESHD and cancer MESHD.

    Intubation prognosis in COVID-19 MESHD patients and associated factors: a cross-sectional study

    Authors: Mostafa Mohammadi; Hesam Aldin Varpaei; Majid Amini

    doi:10.21203/rs.3.rs-115894/v1 Date: 2020-11-25 Source: ResearchSquare

    Background: In December 2019, a new pathogen, HCoV, or New Corona Virus 2019 (2019-nCoV), was recognized in Wuhan, China, causing a pandemic. COVID-19 MESHD has a wide range of clinical severity. Approximately 3.2% of patients within some periods of the disease require intubation and invasive ventilation. Methods: This study was descriptive-analytical and was conducted in the Imam Khomeini Hospital. Patients with Covid-19 MESHD who required endotracheal intubation were identified and their clinical signs and laboratory parameters were recorded. SPSS23 software was used for statistical analysis. Results: 120 patients with coronavirus with different conditions were evaluated. The mean age was 55±14. 30 patients had cardiovascular disease MESHD ( hypertension MESHD) and 20 endocrine disease MESHD( diabetes MESHD). Respiratory acidosis MESHD, decreased oxygen saturation, lymphopenia MESHD, and increased CRP HGNC were the most common finding before intubation. 31 patients had no comorbidity conditions. However, 27 patients had more than one comorbidity condition, and 23 experienced acute respiratory distress syndrome MESHD. The mortality rate was 49.2%. Discussion: Although all laboratory parameters and patients symptoms can affect the treatment outcome, it was found that WBC and absolute lymphocyte count, BUN, SOFA and APACHE scores, inflammatory index ratio CRP HGNC / LDH % CRP HGNC / ESR% and ESR / LDH%, arterial blood gas indices, pulse rate, and patient temperature before intubation are among the parameters that can affect the patient's 14-day prognosis. Conclusion: Except for the mentioned items, CRP HGNC / LDH% ratio seems to be a good indicator for checking the prognosis of discharge or death MESHD of patients within 14 days, However, CRP HGNC / ESR% and ESR / LDH% are appropriate criteria for determining the prognosis for discharge or stay in the ICU for more than 14 days.

    Epidemiological, clinical, and laboratory findings for patients of different age groups with confirmed coronavirus disease 2019 MESHD ( COVID-19 MESHD) in a hospital in Saudi Arabia

    Authors: Mutasim E Ibrahim; Obaid S AL-Aklobi; Mosleh M Abomughaid; Mushabab A. Al-Ghamdi

    doi:10.1101/2020.10.21.20217083 Date: 2020-10-25 Source: medRxiv

    Background: Although the coronavirus disease 2019 MESHD ( COVID-19 MESHD) pandemic continues to rage worldwide, clinical and laboratory studies of this disease have been limited in many countries. We investigated the epidemiologic, clinical, and laboratory findings of COVID-19 MESHD infected MESHD patients to identify the effective indicators correlated with the disease. Methods: A retrospective study was conducted at King Abdullah Hospital in Bisha Province, Saudi Arabia, from March 20 to June 30, 2020. Patients of different age groups were confirmed as having COVID-19 MESHD infection using a real-time polymerase chain reaction. The demographic, clinical, and laboratory data of the patients were statistically analyzed. Results: Of the 137 patients, 88 were male and 49 were female, with a mean age of 49.3 years (SD,18.4). The patients were elderly (n=29), adults (n=103), and children (n=5). Of these, 54 (39.4%) had comorbidities, 24% were admitted to the intensive care unit (ICU), and 12 (8.8%) died. On admission, the main clinical manifestations were fever MESHD (82.5%), cough (63.5%), shortness of breath MESHD (24.8%), chest pain MESHD (19.7%), and fatigue MESHD (18.2%). In all patients, increased neutrophils and decreased lymphocytes were observed. Patients' lactate dehydrogenase (LDH) was elevated. C-reactive protein HGNC ( CRP HGNC) was elevated in 46.7%, D-dimer in 41.6%, and the erythrocyte sedimentation rate (ESR) in 39.4% of patients. The elderly showed higher neutrophil (p=0.003) and lower lymphocyte (p=0.001) counts than adults and children. Glucose, creatine kinase-MB, LDH, bilirubin, D-dimer, and ESR were significantly higher in the elderly than in the adults. The COVID-19 MESHD death group had a higher leucocyte count (p = 0.043), and higher urea (p=0.025) and potassium (p=0.026) than the recovered group but had a lower hemoglobin concentration (p=0.018). A significant association was determined between COVID-19 MESHD death MESHD (x2(1)=17.751, p<0.001), and the presence of cardiovascular disease MESHD (x2(1)=17.049, p<0.001), hypertension MESHD (x2(1)=7.659, p=0.006), renal failure MESHD (x2(1)=4.172, p<0.04), old age (t(135) = 4.747, p <0.001), and ICU admission (x2(1) = 17.751 (1), p<0.001). Conclusions: The common symptoms found in this study could be useful for identifying potential COVID-19 MESHD patients. Investigating some of the laboratory and clinical parameters could help assess the disease progression, risk of mortality, and follow up patients who could progress to a fatal condition.

    Patterns of Multimorbidity and Risk of Severe SARS-CoV-2 Infection MESHD: an observational study in the U.K.

    Authors: Yogini V Chudasama; Francesco Zaccardi; Clare L Gillies; Cameron Razieh; Thomas Yates; David E Kloecker; Alex V Rowlands; Melanie J Davies; Nazrul Islam; Samuel Seidu; Nita G Forouhi; Kamlesh Khunti

    doi:10.1101/2020.10.21.20216721 Date: 2020-10-23 Source: medRxiv

    Background Pre-existing comorbidities have been linked to SARS-CoV-2 infection MESHD but evidence is sparse on the importance and pattern of multimorbidity (2 or more conditions) and severity of infection indicated by hospitalisation or mortality. We aimed to use a multimorbidity index developed specifically for COVID-19 MESHD to investigate the association between multimorbidity and risk of severe SARS-CoV-2 infection MESHD. Methods We used data from the UK Biobank linked to laboratory confirmed test results for SARS-CoV-2 infection MESHD and mortality data from Public Health England between March 16 and July 26, 2020. By reviewing the current literature on COVID-19 MESHD we derived a multimorbidity index including: 1) angina MESHD; 2) asthma; 3) atrial fibrillation MESHD; 4) cancer MESHD; 5) chronic kidney disease MESHD; 6) chronic obstructive pulmonary disease MESHD; 7) diabetes mellitus MESHD; 8) heart failure MESHD; 9) hypertension MESHD; 10) myocardial infarction MESHD; 11) peripheral vascular disease MESHD; 12) stroke MESHD. Adjusted logistic regression models were used to assess the association between multimorbidity and risk of severe SARS-CoV-2 infection MESHD (hospitalisation or death MESHD). Potential effect modifiers of the association were assessed: age, sex, ethnicity, deprivation, smoking status, body mass index, air pollution, 25-hydroxyvitamin D, cardiorespiratory fitness MESHD, high sensitivity C-reactive protein HGNC. Results Among 360,283 participants, the median age was 68 [range, 48-85] years, most were White (94.5%), and 1,706 had severe SARS-CoV-2 infection MESHD. The prevalence of multimorbidity was more than double in those with severe SARS-CoV-2 infection MESHD (25%) compared to those without (11%), and clusters of several multimorbidities were more common in those with severe SARS-CoV-2 infection MESHD. The most common clusters with severe SARS-CoV-2 infection MESHD were stroke MESHD with hypertension MESHD (79% of those with stroke MESHD had hypertension MESHD); diabetes MESHD and hypertension MESHD (72%); and chronic kidney disease MESHD and hypertension MESHD (68%). Multimorbidity was independently associated with a greater risk of severe SARS-CoV-2 infection MESHD (adjusted odds ratio 1.91 [95% confidence interval 1.70, 2.15] compared to no multimorbidity). The risk remained consistent across potential effect modifiers, except for greater risk among men. Conclusion The risk of severe SARS-CoV-2 infection MESHD is higher in individuals with multimorbidity, indicating the need to target research and resources in people with SARS-CoV-2 infection MESHD and multimorbidity.

    Trends in Covid-19 MESHD risk-adjusted mortality rates in a single health system

    Authors: Leora Horwitz; Simon A. Jones; Robert J. Cerfolio; Fritz Francois; Joseph Greco; Bret Rudy; Christopher M Petrilli

    doi:10.1101/2020.08.11.20172775 Date: 2020-08-14 Source: medRxiv

    Early reports showed high mortality from Covid-19 MESHD; by contrast, the current outbreaks in the southern and western United States are associated with fewer deaths, raising hope that treatments have improved. However, in Texas for instance, 63% of diagnosed cases are currently under 50, compared to only 52% nationally in March-April. Current demographics in Arizona and Florida are similar. Therefore, whether decreasing Covid-19 MESHD mortality rates are a reflection of changing demographics or represent improvements in clinical care is unknown. We assessed outcomes over time in a single health system, accounting for changes in demographics and clinical factors. Methods We analyzed biweekly mortality rates for admissions between March 1 HGNC and June 20, 2020 in a single health system in New York City. Outcomes were obtained as of July 14, 2020. We included all hospitalizations with laboratory-confirmed Covid-19 MESHD disease. Patients with multiple hospitalizations (N=157, 3.3%) were included repeatedly if they continued to have laboratory-confirmed disease. Mortality was defined as in-hospital death MESHD or discharge to hospice care. Based on prior literature, we constructed a multivariable logistic regression model to generate expected risk of death MESHD, adjusting for age; sex; self-reported race and ethnicity; body mass index; smoking history; presence of hypertension MESHD, heart failure MESHD, hyperlipidemia MESHD, coronary artery disease MESHD, diabetes MESHD, cancer MESHD, chronic kidney disease MESHD, or pulmonary disease MESHD individually as dummy variables; and admission oxygen saturation, D-dimer, C reactive protein HGNC, ferritin, and cycle threshold for RNA detection. All data were obtained from the electronic health record. We then calculated the sum of observed and expected deaths in each two-week period and multiplied each period's observed/expected (O/E) risk by the overall average crude mortality to generate biweekly adjusted rates. We calculated Poisson control limits and indicated points outside the control limits as significantly different, following statistical process control standards. The NYU institutional review board approved the study and granted a waiver of consent. Results We included 4,689 hospitalizations, of which 4,661 (99.4%) had died or been discharged. The median age, and the proportion male or with any comorbidity decreased over time; median real-time PCR cycle threshold increased (indicating relatively less concentration of virus) (Table). For instance, median age decreased from 67 years in the first two weeks to 49 in the last two. Peak hospitalizations were during the fifth and sixth study weeks, which accounted for 40% of the hospitalizations. Median length of stay for patients who died or were discharged to hospice was 8 days (interquartile range, 4-16). Unadjusted mortality dropped each period, from 30.2% in the first two weeks to 3% in the last two weeks, with the last eight weeks being lower than the 95% control limits. Risk adjustment partially attenuated the mortality decline, but adjusted mortality rates in the second-to-last two weeks remained outside the control limits (Figure, Table). The O/E risk of mortality decreased from 1.07 (0.64-1.67) in the first two weeks to 0.39 (0.08-1.12) in the last two weeks. Discussion In this 16-week study of Covid-19 MESHD mortality at a single health system, we found that changes in demographics and severity of illness at presentation account for some, but not all, of the decrease in unadjusted mortality. Even after risk adjustment for a variety of clinical and demographic factors, mortality was significantly lower towards the end of the study period. Incremental improvements in outcomes are likely a combination of increasing clinical experience, decreasing hospital volume, growing use of new pharmacologic treatments (such as corticosteroids, remdesivir and anti-cytokine treatments), non-pharmacologic treatments (such as proning), earlier intervention, community awareness, and lower viral load exposure from increasing mask wearing and social distancing. It is also possible that earlier periods had a more virulent circulating strain. In summary, data from one health system suggest that Covid-19 MESHD remains a serious disease for high risk patients, but that outcomes may be improving.

    Sex-specificity of mortality risk factors among hospitalized COVID-19 MESHD patients in New York City: prospective cohort study

    Authors: Tomi Jun; Sharon Nirenberg; Patricia Kovatch; Kuan-lin Huang

    doi:10.1101/2020.07.29.20164640 Date: 2020-08-01 Source: medRxiv

    Objective: To identify sex-specific effects of risk factors for in-hospital mortality among COVID-19 MESHD patients admitted to a hospital system in New York City. Design: Prospective observational cohort study with in-hospital mortality as the primary outcome. Setting: Five acute care hospitals within a single academic medical system in New York City. Participants: 3,086 hospital inpatients with COVID-19 MESHD admitted on or before April 13, 2020 and followed through June 2, 2020. Follow-up till discharge or death MESHD was complete for 99.3% of the cohort. Results: The majority of the cohort was male (59.6%). Men were younger (median 64 vs. 70, p<0.001) and less likely to have comorbidities such as hypertension MESHD (32.5% vs. 39.9%, p<0.001), diabetes MESHD (22.6% vs. 26%, p=0.03), and obesity MESHD (6.9% vs. 9.8%, p=0.004) compared to women. Women had lower median values of laboratory markers associated with inflammation MESHD compared to men: white blood cells (5.95 vs. 6.8 K/uL, p<0.001), procalcitonin (0.14 vs 0.21 ng/mL, p<0.001), lactate dehydrogenase (375 vs. 428 U/L, p<0.001), C-reactive protein HGNC (87.7 vs. 123.2 mg/L, p<0.001). Unadjusted mortality was similar between men and women (28.8% vs. 28.5%, p=0.84), but more men required intensive care than women (25.2% vs. 19%, p<0.001). Male sex was an independent risk factor for mortality (OR 1.26, 95% 1.04-1.51) after adjustment for demographics, comorbidities, and baseline hypoxia MESHD. There were significant interactions between sex and coronary artery disease MESHD (p=0.038), obesity MESHD (p=0.01), baseline hypoxia MESHD (p<0.001), ferritin (p=0.002), lactate dehydrogenase (p=0.003), and procalcitonin (p=0.03). Except for procalcitonin, which had the opposite association, each of these factors was associated with disproportionately higher mortality among women. Conclusions: Male sex was an independent predictor of mortality, consistent with prior studies. Notably, there were significant sex-specific interactions which indicated a disproportionate increase in mortality among women with coronary artery disease MESHD, obesity MESHD, and hypoxia MESHD. These new findings highlight patient subgroups for further study and help explain the recognized sex differences in COVID-19 MESHD outcomes.

    Patient characteristics and predictors of mortality in 470 adults admitted to a district general hospital in England with Covid-19 MESHD

    Authors: Joseph V Thompson; Nevan Meghani; Bethan M Powell; Ian Newell; Roanna Craven; Gemma Skilton; Lydia J Bagg; Irha Yaqoob; Michael J Dixon; Eleanor J Evans; Belina Kambele; Asif Rehman; Georges Ng Man Kwong

    doi:10.1101/2020.07.21.20153650 Date: 2020-07-27 Source: medRxiv

    Background Understanding risk factors for death MESHD in Covid 19 is key to providing good quality clinical care. Due to a paucity of robust evidence, we sought to assess the presenting characteristics of patients with Covid 19 and investigate factors associated with death MESHD. Methods Retrospective analysis of adults admitted with Covid 19 to Royal Oldham Hospital, UK. Logistic regression modelling was utilised to explore factors predicting death. Results 470 patients were admitted, of whom 169 (36%) died. The median age was 71 years (IQR 57 to 82), and 255 (54.3%) were men. The most common comorbidities were hypertension MESHD (n=218, 46.4%), diabetes MESHD (n=143, 30.4%) and chronic neurological disease MESHD (n=123, 26.1%). The most frequent complications were acute kidney injury MESHD (n=157, 33.4%) and myocardial injury MESHD (n=21, 4.5%). Forty three (9.1%) patients required intubation and ventilation, and 39 (8.3%) received non-invasive ventilation Independent risk factors for death MESHD were increasing age (OR per 10 year increase above 40 years 1.87, 95% CI 1.57 to 2.27), hypertension MESHD (OR 1.72, 1.10 to 2.70), cancer MESHD (OR 2.20, 1.27 to 3.81), platelets <150x103/microlitre (OR 1.93, 1.13 to 3.30), C-reactive protein HGNC >100 micrograms/mL (OR 1.68, 1.05 to 2.68), >50% chest radiograph infiltrates, (OR 2.09, 1.16 to 3.77) and acute kidney injury MESHD (OR 2.60, 1.64 to 4.13). There was no independent association between death MESHD and gender, ethnicity, deprivation level, fever MESHD, SpO2/FiO2 (oxygen saturation index), lymphopenia MESHD or other comorbidities. Conclusions We characterised the first wave of patients with Covid 19 in one of Englands highest incidence areas, determining which factors predict death. These findings will inform clinical and shared decision making, including the use of respiratory support and therapeutic agents.

    Clinical Characteristics of SARS-CoV-2 pneumonia diagnosed in a primary care practice in Madrid (Spain)

    Authors: Marina Guisado-Clavero; Ana Herrero Gil; Marta Pérez Álvarez; Marta Castelo Jurado; Ana Herrera Marinas; Vanesa Aguilar Ruiz; Ileana Gefaell Iarrondo; Miguel Menéndez; Sara Ares-Blanco

    doi:10.21203/rs.3.rs-42357/v2 Date: 2020-07-13 Source: ResearchSquare

    Background: Possible cases of SARS-CoV-2 infection MESHD were diagnosed in primary care in Madrid, some of these cases had pneumonia MESHD. Most of the SARS-CoV-2 pneumonia MESHD published data came from hospitalised patients. This study set out to describe clinical characteristics of patients with SARS-CoV-2 pneumonia MESHD diagnosed in primary care across age groups and type of pneumonia MESHD.Methods: Observational retrospective study obtaining clinical data from the electronic health records of patients who were followed-up by SARS-CoV-2 possible infection in a primary care practice in Madrid. All the cases were collected by in-person or remote consultation during the 10th March to the 7th of April. Exposure: Diagnosis of SARS-CoV-2 pneumonia MESHD by chest X-ray ordered by the GP. Main outcomes and measures: Symptoms of SARS-CoV-2 pneumonia MESHD, physical examination and diagnostic tests as a blood test, nasopharyngeal swab results for RT-PCR (Reverse transcriptase-polymerase chain reaction) and chest X-ray results. Results: The overall SARS-CoV-2 pneumonias MESHD collected were 172 (female 87 [50.6%], mean age 60.5 years (standard deviation [SD] 17.0). Comorbidities were body mass index ≥25 kg/m 2 (90 [52.3%]), hypertension MESHD 83 [48.3%]), dyslipidaemia (68 [39.5%]) and diabetes MESHD (33 [19.2%]). The sample was stratified by age groups (<50 years, 50-75 years and ≥75 years). Clinical manifestations at onset were fever MESHD (144 [83.7%]), cough (140 [81.4%]), dyspnoea MESHD (103 [59.9%]) and gastrointestinal disturbances MESHD (72 [41.9%]). Day 7.8 (SD:4.1) from clinical onset was the mean day of pneumonia MESHD diagnosis. Bilateral pneumonia MESHD was more prevalent than unilateral (126 [73.3%]) and 46 [26.7%]). Patients with unilateral pneumonia MESHD were prone to higher pulse oximetry (96% vs 94%, p <0.001). We found differences between unilateral and bilateral cases in C-reactive protein HGNC (29.6 vs 81.5mg/L, p <0.001), and lymphocytes (1400.0 vs 1000.0E3/ml, p<0.001). Complications were registered: 42 (100%) of patients ≥75 years were admitted into hospital; pulmonary embolism MESHD was only present at bilateral pneumonia MESHD (7 patients [5.6%]) and death MESHD occurred in 1 patient with unilateral pneumonia MESHD (2.2%) vs 10 patients (7.9%) with bilateral pneumonia MESHD ( p 0.170).Conclusion: Clinical manifestations of SARS-CoV-2 pneumonia MESHD were fever MESHD, cough and dyspnoea MESHD; this was especially clear in the elderly. We described different characteristics between unilateral and bilateral pneumonia MESHD.

    Clinical Characteristics and Prognosis of Patients with COVID-19 MESHD Combineded with or without Diabetes, Hypertension or Coronary

    Authors: Haoxiang Li; Jianguo Zhang; Jinhui Zhang; Ling Yang; Dong Wang; Li Zhao; Xia Deng; Guoyue Yuan

    doi:10.21203/rs.3.rs-36840/v1 Date: 2020-06-19 Source: ResearchSquare

    Bcakground: This study was to investigate the clinical characteristics and prognosis of COVID-19 MESHD patients combined with or without major chronic diseases MESHD like diabetes MESHD, hypertension MESHD or coronary. Methods: We retrospectively analyzed 183 patients with COVID-19 MESHD diagnosed at First People's Hospital of Jiangxia District (FPHJD) in Wuhan, China attended by Affiliated Hospital of Jiangsu University supporting medical team from February 1, 2020 to March 15, 2020. Patients were divided into simple COVID-19 MESHD group(n=134), COVID-19 MESHD combined with diabetes MESHD, hypertension MESHD or coronary group(n=49). Besides, COVID-19 MESHD patients with diabetes MESHD, hypertension MESHD or coronary were further classified into severe pneumonia MESHD group(n=23) and common pneumonia MESHD group(n=26), death MESHD group(n=17) and survival group(n=32). The prognosis of COVID-19 MESHD patients was evaluated by analyzing the clinical data and the results of laboratory tests. Results: 183 patients were included in this study, of whom 166 were discharged and 16 died in hospital. 49 (26.92%) patients had a comorbidity, with hypertension MESHD being the most common [37 (20.33%) patients], followed by diabetes MESHD [25 (13.74%) patients] and coronary heart disease MESHD [4 (2.2%) patients]. Compared with simple COVID-19 MESHD group, the proportion of history of chronic respiratory system disease MESHD, age, D-dimer, procalcitonin, C-reactive protein HGNC, myoglobin HGNC, cardiac troponin I, creatine kinase MB, lactate dehydrogenase, white blood cell count, neutrophil count, neutrophil percentage, blood urea nitrogen, creatinine and mortality rate were significantly higher in COVID-19 MESHD combined with chronic diseases group, whereas lymphocyte count, lymphocyte percentage and alanine transferase were significantly lower in COVID-19 MESHD combined with chronic diseases group. Among COVID-19 MESHD patients with chronic diseases MESHD, D-dimer, procalcitonin, C-reactive protein, myoglobin, cardiac troponin I, lactate dehydrogenase, white blood cell count, neutrophil count, neutrophil percentage, blood urea nitrogen, death MESHD rate was significantly higher in severe pneumonia MESHD group than common pneumonia group. While lymphocyte count and lymphocyte percentage were significantly lower in severe pneumonia MESHD group than common pneumonia group. Besides, we found that the proportion of history of chronic respiratory system disease MESHD, D-dimer, procalcitonin, myoglobin HGNC, cardiac troponin I, creatine kinase MB, lactate dehydrogenase, neutrophil count, neutrophil percentage, blood urea nitrogen were significantly higher in death group compared with survival group, whereas lymphocyte count and lymphocyte percentage were significantly lower in survival group. In COVID-19 MESHD combined with chronic diseases group, univariate logistic regression showed that the risk for severe pneumonia MESHD were D-dimer, C-reactive protein HGNC, lactate dehydrogenase, white blood cell count, neutrophil count and neutrophil percentage. Univariate logistic regression also showed that the risk for death MESHD were D-dimer, lactate dehydrogenase, white blood cell count, neutrophil count, neutrophil percentage and blood urea nitrogen. Multivariate regression logistic showed that lactate dehydrogenase were independent risk factors for death among COVID-19 MESHD patients combined with chronic diseases MESHD. Cox regression analysis showed that compared with simple COVID-19 MESHD group, the RR(95% CI) in COVID-19 MESHD patients combined with diabetes MESHD, hypertension MESHD, and coronary were 2.187 (1.141~4.191) for death MESHD (P<0.05). Conclusion: Among COVID-19 MESHD patients combined with diabetes MESHD, hypertension MESHD or coronary, the risk factors for severe pneumonia MESHD were D-dimer, C-reactive protein HGNC, lactate dehydrogenase, white blood cell count, neutrophil count and neutrophil percentage, whereas the risk factors for death MESHD were D-dimer, lactate dehydrogenase, white blood cell count, neutrophil count, neutrophil percentage and blood urea nitrogen. Moreover, lactate dehydrogenase were independent risk factors for death MESHD. The mortality rate of COVID-19 MESHD patients combined with diabetes MESHD, hypertension MESHD or coronary was higher than that of simple COVID-19 MESHD patients.

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MeSH Disease
HGNC Genes
SARS-CoV-2 Proteins


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