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HGNC Genes

SARS-CoV-2 proteins

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    LENZILUMAB EFFICACY AND SAFETY IN NEWLY HOSPITALIZED MESHD COVID-19 MESHD SUBJECTS: RESULTS FROM THE LIVE-AIR PHASE 3 RANDOMIZED DOUBLE-BLIND PLACEBO-CONTROLLED TRIAL

    Authors: Zelalem Temesgen; Charles D. Burger; Jason Baker; Christopher Polk; Claudia Libertin; Colleen Kelley; Vincent C Marconi; Robert Orenstein; Cameron Durrant; Dale Chappell; Omar Ahmed; Gabrielle Chappell; Andrew Badley

    doi:10.1101/2021.05.01.21256470 Date: 2021-05-05 Source: medRxiv

    BACKGROUND: Severe COVID19 MESHD pneumonia MESHD results from a hyperinflammatory immune response (cytokine storm, CS), characterized by GM CSF HGNC mediated activation and trafficking of myeloid cells, leading to elevation of downstream inflammatory chemokines ( MCP1 HGNC, IL8 HGNC, IP10 HGNC), cytokines ( IL6 HGNC, IL1 HGNC), and other markers of systemic inflammation MESHD ( CRP HGNC, D dimer, ferritin). CS leads to fever MESHD, hypotension MESHD, coagulopathy MESHD, respiratory failure MESHD, ARDS, and death MESHD. Lenzilumab is a novel Humaneered anti-human GM CSF HGNC monoclonal antibody that directly binds GM CSF HGNC and prevents signaling through its receptor. The LIVE AIR Phase 3 randomized, double blind, placebo controlled trial investigated the efficacy and safety of lenzilumab to assess the potential for lenzilumab to improve the likelihood of ventilator free survival (referred to herein as survival without ventilation, SWOV), beyond standard supportive care, in hospitalized subjects with severe COVID-19 MESHD. METHODS: Subjects with COVID-19 MESHD (n=520), >18 years <94% oxygen saturation on room air and/or requiring supplemental oxygen, but not invasive mechanical ventilation, were randomized to receive lenzilumab (600 mg, n=261) or placebo (n=259) via three intravenous infusions administered 8 hours apart. Subjects were followed through Day 28 following treatment. RESULTS: Baseline demographics were comparable between the two treatment groups: male, 64.7%; mean age, 60.5 years; mean BMI, 32.5 kg/m2; mean CRP HGNC, 98.36 mg/L; CRP HGNC was <150 mg/L in 77.9% of subjects. The most common comorbidities were obesity MESHD (55.1%), diabetes MESHD (53.4%), chronic kidney disease MESHD (14.0%), and coronary artery disease MESHD (13.6%). Subjects received steroids (93.7%), remdesivir (72.4%), or both (69.1%). Lenzilumab improved the likelihood of SWOV by 54% in the mITT population (HR: 1.54; 95% CI: 1.02 to 2.31, p=0.041) and by 90% in the ITT population (HR: 1.90; 1.02 to 3.52, nominal p=0.043) compared to placebo. SWOV also relatively improved by 92% in subjects who received both corticosteroids and remdesivir (1.92; 1.20 to 3.07, nominal p=0.0067); by 2.96-fold in subjects with CRP HGNC<150 mg/L and age <85 years (2.96; 1.63 to 5.37, nominal p=0.0003); and by 88% in subjects hospitalized <2 days prior to randomization (1.88; 1.13 to 3.12, nominal p=0.015). Survival was improved by 2.17-fold in subjects with CRP HGNC<150 mg/L and age <85 years (2.17; 1.04 to 4.54, nominal p=0.040). CONCLUSION: Lenzilumab significantly improved SWOV in hospitalized, hypoxic subjects with COVID-19 MESHD pneumonia MESHD over and above treatment with remdesivir and/or corticosteroids. Subjects with CRP HGNC<150 mg/L and age <85 years demonstrated an improvement in survival and had the greatest benefit from lenzilumab. NCT04351152

    Association Between Cystatin C HGNC, Cystatin C HGNC Rangeability and Mortality of COVID-19 MESHD Patients With or Without Type 2 Diabetes Mellitus: An Opportunistic Retrospective Analysis

    Authors: Lei Yang; Dou Xu; Yiqing Tan; Bolin Li; Dan Zhu; Jingbo Wang; Hui Sun; Xinglong Liu; Xiao-Pu Zheng; Ling Zhu; Zhongyu Li

    doi:10.21203/rs.3.rs-112220/v1 Date: 2020-11-19 Source: ResearchSquare

    Background: Since December of 2019, novel coronavirus (SARS-CoV-2)-induced pneumonia MESHD ( COVID-19 MESHD) exploded in Wuhan, and rapidly spread throughout China. Patients with COVID-19 MESHD demonstrated quite different appearances and outcomes in clinical manifestations. We aimed to figure out whether risk factors of the cystatin C HGNC (CysC) and the CysC rangeability are influencing the prognosis of COVID-19 MESHD patients with or without type 2 diabetes mellitus MESHD ( T2DM MESHD).Methods: 675 T2DM MESHD patients and 602 non- T2DM MESHD patients were divided into low CysC group, high CysC group and low CysC rangeability group, high CysC rangeability group according to the serum CysC level and the change range of CysC. Demographic characteristics, clinical data and laboratory results of the four groups were collected and analyzed.Results: Our data showed that COVID-19 MESHD patients with high CysC level and CysC rangeability had more organic damage MESHD and higher mortality rate compared to those with low level or low rangeability of CysC. Furthermore, patients with higher CysC level and CysC rangeability also demonstrated higher blood lymphocytes (lymph), C-reactive protein HGNC (CRP), alanine aminotransferase HGNC (ALT), aspartate aminotransferase ( AST HGNC) which may greatly influence disease progression and poor prognosis of COVID-19 MESHD. After adjusting for possible confounders, multivariate analysis revealed that CysC≤0.93mg/dl as a reference, CysC>0.93mg/dl were significantly associated with the risk of heart failure MESHD (OR=2.401, 95% CI: 1.118–5.156) and all-cause death MESHD (OR=2.734, 95% CI: 1.098-6.811); referring to CysC rangeability≤0, CysC rangeability>0 significantly associated with all-cause death MESHD (OR=4.029, 95% CI: 1.864-8.706). Further grouped by T2DM MESHD, these associations were stronger in T2DM MESHD than in non- T2DM MESHD.Conclusions: It suggests that CysC level and CysC rangeability contribute to clinical manifestations and may influence the prognosis of COVID-19 MESHD. The CysC is considered as a potential risk factor of the prognosis of COVID-19 MESHD. Special medical care and appropriate intervention should be performed in COVID-19 MESHD patients with elevated CysC during hospitalization and later clinical follow-up, especially for those with T2DM MESHD.

    Helmet CPAP HGNC to treat hypoxic pneumonia MESHD outside the ICU: an observational study during the COVID-19 MESHD outbreak

    Authors: Andrea Coppadoro; Annalisa Benini; Robert Fruscio; Luisa Verga; Paolo Mazzola; Giuseppe Bellelli; Marco Carbone; Giacomo Mulinacci; Alessandro Soria; Beatrice Noe'; Eduardo Beck; Riccardo Di Sciacca; Davide Ippolito; Giuseppe Citerio; Grazia Valsecchi; Andrea Biondi; Alberto Pesci; Paolo Bonfanti; Davide Gaudesi; Giacomo Bellani; Giuseppe Foti

    doi:10.21203/rs.3.rs-92708/v2 Date: 2020-10-14 Source: ResearchSquare

    Background: Respiratory failure MESHD due to COVID-19 MESHD pneumonia MESHD is associated with high mortality and may overwhelm health care systems, due to the surge patients requiring advanced respiratory support. Shortage of intensive care unit (ICU) beds required many patients to be treated outside the ICU despite severe gas exchange impairment MESHD. Helmet is as effective interface to provide Continuous Positive Airway Pressure ( CPAP HGNC) non-invasively. We report data about the usefulness of helmet CPAP HGNC during pandemic, either as an effective treatment, a bridge to intubation or a rescue therapy for patients with care limitations (DNI).Methods: In this observational study we collected data regarding patients failing standard oxygen therapy (i.e. non-rebreathing mask) due to COVID-19 MESHD pneumonia MESHD treated with a free flow helmet CPAP HGNC system. Patients’ data were recorded before, at initiation of CPAP HGNC treatment and once a day, thereafter. CPAP HGNC failure was defined as a composite outcome of intubation or death MESHD.Results: A total of 306 patients were included; 42% were deemed as DNI. Helmet CPAP HGNC treatment was successful in 69% of the full-treatment and 28% of the DNI patients (P<0.001). With helmet CPAP HGNC, PaO2/FiO2 ratio doubled from about 100 to 200 mmHg (P<0.001); respiratory rate decreased from 28 [22-32] to 24 [20-29] breaths per minute, P<0.001). C-Reactive Protein HGNC, time to oxygen mask failure MESHD, age, PaO2/FiO2 during CPAP HGNC, number of comorbidities were independently associated with CPAP HGNC failure. Helmet CPAP HGNC was maintained for 6 [3-9] days, almost continuously during the first two days. None of the full treatment patients died before intubation in the wards.Conclusions: Helmet CPAP HGNC treatment is feasible for several days outside the ICU, despite persistent impairment in gas exchange. It was used, without escalating to intubation, in the majority of full treatment patients after standard oxygen therapy failed. DNI patients could benefit from helmet CPAP HGNC as rescue therapy to improve survival.Trial Registration: NCT04424992

    Association between corticosteroids and intubation or death among patients with COVID-19 MESHD pneumonia in non-ICU settings: an observational study using of real-world data from 51 hospitals in France and Luxembourg

    Authors: Viet-Thi Tran; Matthieu Mahevas; Firouze Bani Sadr; Olivier Robineau; Thomas Perpoint; Elodie Perrodeau; Laure Gallay; Philippe Ravaud; Francois Goehringer; Xavier Lescure; - COCORICO

    doi:10.1101/2020.09.16.20195750 Date: 2020-09-18 Source: medRxiv

    Objective To assess the effectiveness of corticosteroids on outcomes of patients with mild COVID-19 MESHD pneumonia MESHD. Methods We used routine care data from 51 hospitals in France and Luxembourg to assess the effectiveness of corticosteroids at 0.8 mg/kg/day eq. prednisone (CTC group) vs standard of care (no-CTC group) among patients [≤] 80 years old with COVID-19 MESHD pneumonia MESHD requiring oxygen without mechanical ventilation. The primary outcome was intubation or death at Day 28. Baseline characteristics of patients were balanced using propensity score inverse probability of treatment weighting. Results Among the 891 patients included in the analysis, 203 were assigned to the CTC group. At day 28, corticosteroids did not reduce the rate of the primary outcome (wHR 0.92, 95% CI 0.61 to 1.39) nor the cumulative death rate (wHR 1.03, 95% CI 0.54 to 1.98). Corticosteroids significantly reduced the rate of the primary outcome for patients requiring oxygen [≥] at 3L/min (wHR 0.50, 95% CI 0.30 to 0.85) or C-Reactive Protein HGNC ( CRP HGNC) [≥] 100mg/L (wHR 0.44, 95%CI 0.23 to 0.85). We found a higher number of hyperglycaemia events MESHD among patients who received corticosteroids, but number of infections were similar across the two groups. Conclusions We found no association between the use of corticosteroids and intubation or death MESHD in the broad population of patients [≤]80 years old with COVID-19 MESHD hospitalized in non-ICU settings. However, the treatment was beneficial for patients with [≥] 3L/min oxygen or CRP HGNC [≥] 100mg/L at baseline. These data support the need to confirm the right timing of corticosteroids for patients with mild COVID.

    Telmisartan for treatment of Covid-19 MESHD patients: an open randomized clinical trial. Preliminary report.

    Authors: Mariano Duarte; Facundo G Pelorosso; Liliana Nicolosi; M. Victoria Salgado; Hector Vetulli; Analia Aquieri; Francisco Azzato; Mauro Basconcel; Marcela Castro; Javier Coyle; Ignacio Davolos; Eduardo Esparza; Ignacio Fernandez Criado; Rosana Gregori; Pedro Mastrodonato; Maria Rubio; Sergio Sarquis; Fernando Wahlmann; Rodolfo Pedro Rothlin

    doi:10.1101/2020.08.04.20167205 Date: 2020-08-11 Source: medRxiv

    Background. Covid-19 MESHD, the disease caused by SARS-CoV-2, is associated with significant respiratory-related morbidity and mortality. Angiotensin receptor blockers (ARBs) have been postulated as tentative pharmacological agents to treat Covid-19 MESHD-induced lung inflammation MESHD. Trial design. This trial is a parallel group, randomized, two arm, open label, multicenter superiority trial with 1:1 allocation ratio. Methods. Participants included patients who were 18 years of age or older and who had been hospitalized with confirmed Covid-19 MESHD with 4 or fewer days since symptom onset. Exclusion criteria included intensive care unit admission prior to randomization and use of angiotensin receptor blocker or angiotensin converting enzyme inhibitors at admission. Participants in the treatment arm received telmisartan 80 mg bid during 14 days plus standard care. Participants in the control arm received standard care alone. Primary outcome was to achieve significant reductions in plasma levels of C-reactive protein HGNC in telmisartan treated Covid-19 MESHD patients at day 5 and 8 after randomization. Key secondary outcomes included time to discharge evaluated at 15 days after randomization and admission to ICU and death MESHD at 15- and 30-days post randomization. We present here a preliminary report. Results. A total of 78 patients were included in the interim analysis, 40 in the telmisartan and 38 in the control groups. CRP HGNC levels at day 5 in the control group were 51.1 +/- 44.8 mg/L (mean +/- SD; n=28) and in the telmisartan group were 24.2 +/- 31.4 mg/L (mean +/- SD; n=32, p<0.05). At day 8, CRP HGNC levels were 41.6 +/- 47.6 mg/L (mean +/- SD; n=16) and 9.0 +/- 10.0 mg/L (mean +/- SD; n=13, p < 0.05) in the control and telmisartan groups, respectively. Also, analysis of time to discharge by Kaplan-Meier method showed that telmisartan treated patients had statistically significant lower time to discharge (median time to discharge control group=15 days; telmisartan group=9 days). No differences were observed for ICU admission or death MESHD. No significant adverse events related to telmisartan were reported. Conclusions. In the present preliminary report, despite the small number of patients studied, ARB telmisartan, a well-known inexpensive safe antihypertensive drug, administered in high doses, demonstrates anti-inflammatory effects and improved morbidity in hospitalized patients infected with SARS -CoV-2, providing support for its use in this serious pandemia (NCT04355936).

    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.

    Prolonged low-dose methylprednisolone in patients with severe COVID-19 MESHD pneumonia

    Authors: Francesco Salton; Paola Confalonieri; Pierachille Santus; Sergio Harari; Raffaele Scala; Simone Lanini; Valentina Vertui; Tiberio Oggionni; Antonella Caminati; Vincenzo Patruno; Mario Tamburrini; Alessandro Scartabellati; Mara Parati; Massimiliano Villani; Dejan Radovanovic; Sara Tomassetti; Claudia Ravaglia; Venerino Poletti; Andrea Vianello; Anna Talia Gaccione; Luca Guidelli; Rita Raccanelli; Donato Lacedonia; Paolo Lucernoni; Maria Pia Foschino Barbaro; Stefano Centanni; Michele Mondoni; Matteo Davi; Alberto Fantin; Xueyuan Cao; Lucio Torelli; Antonella Zucchetto; Marcella Montico; Annalisa Casarin; Micaela Romagnoli; Stefano Gasparini; Martina Bonifazi; Pierlanfranco D'Agaro; Alessandro Marcello; Danilo Licastro; Barbara Ruaro; Maria Concetta Volpe; Reba Umberger; Gianfranco Umberto Meduri; Marco Confalonieri

    doi:10.1101/2020.06.17.20134031 Date: 2020-06-20 Source: medRxiv

    Background In hospitalized patients with COVID-19 MESHD pneumonia MESHD, progression to acute respiratory failure MESHD requiring invasive mechanical ventilation (MV) is associated with significant morbidity and mortality. Severe dysregulated systemic inflammation MESHD is the putative mechanism. We hypothesize that early prolonged methylprednisolone (MP) treatment could accelerate disease resolution, decreasing the need for ICU and mortality. Methods We conducted a multicenter, observational study to explore the association between exposure to prolonged, low-dose, MP treatment and need for ICU referral, intubation or death MESHD within 28 days (composite primary endpoint) in patients with severe COVID-19 MESHD pneumonia MESHD admitted to Italian respiratory high-dependency units. Secondary outcomes were invasive MV-free days and changes in C-reactive protein HGNC ( CRP HGNC) levels. Results Findings are reported as MP (n=83) vs. control (n=90). The composite primary endpoint was met by 19 vs. 40 [adjusted hazard ratio (HR) 0.41; 95% confidence interval (CI): 0.24-0.72]. Transfer to ICU and need for invasive MV was necessary in 15 vs. 27 (p=0.07) and 14 vs. 26 (p=0.10), respectively. By day 28, the MP group had fewer deaths (6 vs. 21, adjusted HR=0.29; 95% CI: 0.12-0.73) and more days off invasive MV (24.0 plus-or-minus sign 9.0 vs. 17.5 plus-or-minus sign 12.8; p=0.001). Study treatment was associated with rapid improvement in PaO2:FiO2 and CRP HGNC levels. The complication rate was similar for the two groups (p=0.84). Conclusion In patients with severe COVID-19 MESHD pneumonia MESHD, early administration of prolonged MP treatment was associated with a significantly lower hazard of death MESHD (71%) and decreased ventilator dependence. Randomized controlled studies are needed to confirm these findings.

    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.

    GLUCOCOVID: A controlled trial of methylprednisolone in adults hospitalized with COVID-19 MESHD pneumonia

    Authors: Luis Corral; Alberto Bahamonde; Francisco Arnaiz delas Revillas; Julia Gomez-Barquero; Jesica Abadia-Otero; Carmen Garcia-Ibarbia; Victor Mora; Ana cerezo-hernandez; Jose L Hernandez; Graciela Lopez-Muniz; Fernando Hernandez-Blanco; Jose M Cifrian; Jose M Olmos; Miguel Carrascosa; maria Carmen farinas; Jose A Riancho; - Glucocovid investigators

    doi:10.1101/2020.06.17.20133579 Date: 2020-06-18 Source: medRxiv

    Background. We aimed to determine whether a 6-day course of intravenous methylprednisolone (MP) improves outcome in patients with SARS CoV-2 infection MESHD at risk of developing Acute Respiratory Distress Syndrome MESHD ( ARDS MESHD). Methods. Multicentric, partially randomized, preference, open-label trial, including adults with COVID-19 MESHD pneumonia MESHD, impaired gas exchange and biochemical evidence of hyper-inflammation MESHD. Patients were assigned to standard of care (SOC), or SOC plus intravenous MP [40mg/12h 3 days, then 20mg/12h 3 days]. The primary endpoint was a composite of death MESHD, admission to the intensive care unit (ICU) or requirement of non-invasive ventilation (NIV). Results. We analyzed 85 patients (34, randomized to MP; 22, assigned to MP by clinician preference; 29, control group). Patient age (mean 68{+/-}yr) was related to outcome. The use of MP was associated with a reduced risk of the composite endpoint in the intention-to-treat, age-stratified analysis (combined risk ratio -RR- 0.55 [95% CI 0.33-0.91]; p=0.024). In the per-protocol analysis, RR was 0.11 (0.01-0.83) in patients aged 72 yr or less, 0.61 (0.32-1.17) in those over 72 yr, and 0.37 (0.19-0.74, p=0.0037) in the whole group after age-adjustment by stratification. The decrease in C-reactive protein HGNC levels was more pronounced in the MP group (p=0.0003). Hyperglycemia MESHD was more frequent in the MP group. Conclusions A short course of MP had a beneficial effect on the clinical outcome of severe COVID-19 MESHD pneumonia MESHD, decreasing the risk of the composite end point of admission to ICU, NIV or death MESHD.

    A pattern categorization of CT findings to predict outcome of COVID-19 MESHD pneumonia

    Authors: Chao Jin; Yan Wang; Carol C. Wu; Huifang Zhao; Ting Liang; Zhe Liu; Zhijie Jian; Runqing Li; Zekun Wang; Fen Li; Jie Zhou; Shubo Cai; Yang Liu; Hao Li; Zhongyi Li; Yukun Liang; Heping Zhou; Xibin Wang; Zhuanqin Ren; Jian Yang

    doi:10.1101/2020.05.19.20107409 Date: 2020-05-25 Source: medRxiv

    Purpose As global healthcare system is overwhelmed by novel coronavirus disease MESHD ( COVID-19 MESHD), early identification of risks of adverse outcomes becomes the key to optimize management and improve survival. This study aimed to provide a CT-based pattern categorization to predict outcome of COVID-19 MESHD pneumonia MESHD. Methods 165 patients with COVID-19 MESHD (91 men, 4-89 years) underwent chest CT were retrospectively enrolled. CT findings were categorized as Pattern0 (negative), Pattern1 ( bronchopneumonia MESHD), Pattern2 (organizing pneumonia MESHD), Pattern3 (progressive organizing pneumonia MESHD) and Pattern4 (diffuse alveolar damage MESHD). Clinical findings were compared across different categories. Time-dependent progression of CT patterns and correlations with clinical outcomes, i.e. discharge or adverse outcome (admission to ICU, requiring mechanical ventilation, or death MESHD), with pulmonary sequelae (complete absorption or residuals) on CT after discharge were analyzed. Results Of 94 patients with outcome, 81(86.2%) were discharged, 3(3.2%) were admitted to ICU, 4(4.3%) required mechanical ventilation, 6(6.4%) died. 31(38.3%) had complete absorption at median day 37 after symptom-onset. Significant differences between pattern-categories were found in age, disease-severity, comorbidity and laboratory results (all P<0.05). Remarkable evolution was observed in Pattern0-2 and Pattern3-4 within 3 and 2 weeks after symptom-onset, respectively; most of patterns remained thereafter. After controlling for age, CT pattern significantly correlated with adverse outcomes (Pattern4 vs. Pattern0-3 [reference]; hazard-ratio[95%CI], 18.90[1.91-186.60], P=0.012). CT pattern (Pattern3-4 vs. Pattern0-2 [reference]; 0.26[0.08-0.88], P=0.030) and C-reactive protein HGNC (>10 vs. [≤]10mg/L [reference]; 0.31[0.13-0.72], P=0.006) were risk-factors associated with pulmonary residuals. Conclusion CT pattern categorization allied with clinical characteristics within 2 weeks after symptom-onset would facilitate early prognostic stratification in COVID-19 MESHD pneumonia MESHD.

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MeSH Disease
HGNC Genes
SARS-CoV-2 Proteins


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