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MeSH Disease

Pneumonia (29)

Fever (29)

COVID-19 (28)

Fatigue (10)

Cough (9)


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

    Randomized, Comparative, Clinical Trial to Evaluate Efficacy and Safety of PNB001 in Moderate COVID-19 MESHD Patients

    Authors: Eric Lattman; Pradnya Bhalerao; ShashiBhushan BL; Neeta Nargundkar; Pornthip Lattmann; Sadasivan Pillai K; P.N. Balaram

    doi:10.1101/2021.04.16.21255256 Date: 2021-04-16 Source: medRxiv

    Objective: To evaluate the efficacy and safety of PNB001 a CCK-A HGNC agonist and CCK-B HGNC antagonist, a new chemical entity with anti-inflammatory and immune stimulation properties, along with Standard of Care (SOC) in patients with moderate COVID-19 MESHD infection. Design: Multi-center, randomized, parallel group, comparative, open label study. Setting: Two tertiary-care hospitals in India. Participants: Patients with laboratory-confirmed SARS-CoV-2 infection MESHD as determined by polymerase chain reaction (PCR) within 2 days of randomization, having pneumonia MESHD with no signs of severe disease MESHD (severe disease means SpO2<=94% on room air), and any two of the following signs or symptoms suggestive of COVID-19 MESHD: fever MESHD, cough MESHD, dyspnea MESHD, or hypoxia MESHD. Interventions: Patients were randomized 1:1 to receive PNB001 at an oral dose of 100 mg three times daily for 14 days with Standard of Care (PNB001+SOC) or only SOC. Main outcome measures: The primary endpoints were mean change in the 8-point WHO Ordinal Scale score from baseline by Day 14 and mortality rate by Day 28. The key secondary endpoints were percentage of patients showing change in clinical status using the ordinal scale, improvement in inflammatory segments in X-ray chest, reduction of days of hospitalization, duration of supplemental oxygen use, days to negative PCR for COVID-19 MESHD and change in inflammation MESHD markers Interlukin-6 ( IL6 HGNC) and C-reactive protein HGNC ( CRP HGNC) from baseline by Day 14. Results: A total of 40 (20 in PNB 001+SOC arm and 20 in SOC arm) patients were randomized and received treatment. The primary endpoint showed significant clinical improvement from baseline to Day 14 with PNB001+SOC (0.22 Vs 1.12; P=0.0421). One patient in PNB001+SOC arm and two patients in SOC arm died (1 Vs 2; HR: 2.0 [95%CI=0.18, 22.05]; P=0.5637) by Day 28. At the end of the treatment by Day 14, more patients achieved zero ordinal scale in PNB001+SOC arm (17 Vs 12; P=0.0766). In the PNB001+SOC arm, change in mean chest X-ray score showed significant improvement (2.05 Vs 1.16; P=0.0321), and more patients quickly showed complete improvement (10 Vs 7; HR: 1.48 [95%CI=0.64, 3.44]; P=0.4309). In the PNB001+SOC arm, patients needed shorter duration of hospitalization in days (9.45 Vs 9.80) and more patients attained earlier discharge from the hospital (19 Vs 15; P=0.0486) with respect to days. The mean duration of supplemental oxygen requirement in days was shorter (5.45 Vs 7.10) and complete withdrawal from supplemental oxygen was more frequent with PNB001+SOC compared to SOC by Day 14 (17 Vs 13; P=0.1441). All patients in both the arms had negative PCR by the end of the study (18 Vs 17; P=0.6265) by similar time (7.6 Vs 7.0). Exploratory analysis done for IL-6 HGNC, CRP HGNC, Neutrophil-Lymphocyte-Ratio (NLR), Platelet-Lymphocyte-Ratio (PLR) and Erythrocyte Sedimentation Rate (ESR) showed statistically significant reduction by Day 14 demonstrating PNB001's anti-inflammatory and immunomodulatory properties. Lymphocyte and neutrophil counts also improved by Day 14. 11 adverse events (AE) in 8 patients were observed with PNB001+SOC compared to 13 AEs in 10 patients with SOC; none of the AEs in PNB001+SOC arm were related to PNB001. The most common AE were tachycardia MESHD and acute respiratory distress syndrome MESHD; there were isolated cases of hepatic enzyme elevation and hyperglycemia MESHD. Overall, safety profile was similar between PNB001+SOC and SOC arms. Conclusions: PNB001 with standard of care showed significant clinical improvement in moderate COVID-19 MESHD patients when compared to standard of care and was well tolerated by moderate COVID-19 MESHD patients.

    Clinical characteristics of COVID-19 MESHD in children and adolescents: a systematic review and meta-analysis

    Authors: Lixiang Lou Sr.; Hui Zhang Sr.; Baoming Tang Sr.; Ming Li; Zeqing Li; Haifang Cao; Jian Li; Yuliang Chong; Zhaowei Li

    doi:10.1101/2021.03.12.21253472 Date: 2021-03-13 Source: medRxiv

    Background: Although the number of COVID-19 MESHD ( coronavirus disease 2019 MESHD) cases continues to increase globally, there are few studies on the clinical characteristics of children and adolescents with COVID-19 MESHD. Objective: To conduct a comprehensive systematic evaluation and meta-analysis of the clinical characteristics of COVID-19 MESHD in children and adolescents to better guide the response to the current epidemic. Methods: We searched PubMed, Embase, the Cochrane Library, Web of Science, CNKI (Chinese database), Clinical Trials.gov and chictr.org.cn (China). The methodological quality of the included literature was evaluated using the Quality Assessment Tool for Case Series Studies. Meta-analysis was performed using STATA 14.0. Heterogeneity was assessed by the Q statistic and quantified using I2. We used fixed-effects or random-effects models to pool clinical data in the meta-analysis. Publication bias was evaluated by the Begg's test. Results: We analyzed 49 studies involving 1627 patients. In the pooled data, the most common clinical symptoms were fever MESHD (56% [0.50-0.61]) and cough (45% [0.39-0.51]). The most common laboratory abnormalities were elevated procalcitonin (40% [0.23-0.57]), elevated lactate dehydrogenase (31% [0.19-0.43]), increased lymphocyte count (28% [0.17-0.42]), increased creatine kinase (28% [0.18- 0.40]), and elevated C-reactive protein HGNC (26% [0.17-0.36]). The most common abnormalities determined by computed tomography were lower-lobe involvement (56% [0.42- 0.70]), ground-glass opacities (33% [0.25-0.42]), bilateral pneumonia MESHD (32% [0.24- 0.40]), patchy shadowing (31% [0.18- 0.45]), and upper lobe involvement MESHD (30% [0.20- 0.41]). Conclusion: Disease severity among children and adolescents with COVID-19 MESHD was milder than that among adult patients, with a greater proportion of mild and asymptomatic cases, and thus, the diagnosis of COVID-19 MESHD and control of the infection source are more challenging.

    Foistar(Camostat mesylate) associated with the significant decrease in CRP HGNC levels compared to Kaletra(Lopinavir/Ritonavir) treatment in Korean mild COVID-19 MESHD pneumonic patients.

    Authors: Jae-Phil Choi; Jae-Phil Choi; Hyoung-Jun Kim; Jumi Han; Sujung Park; JinJoo Han

    doi:10.1101/2020.12.10.20240689 Date: 2020-12-15 Source: medRxiv

    Background There is limited information due to absence of virus titer MESHD and symptom related changes. Nonetheless, this is the first comparative study between the use of Foistar (Camostat mesilate) and Kaletra (lopinavir/ritonavir) on COVID-19 MESHD infection. Methods Patients with confirmed SARS-CoV-2 infection MESHD by positive polymerase chain reaction (PCR) testing that were admitted to Seoul Medical Center (Seoul, South Korea) where is the largest public medical center in South Korea between August 1 and September 20, 2020 were included The data of the patients with pneumonia MESHD who received Foistar (Foistar group) during their hospitalization period were primarily collected, and the patients who received Kaletra (Kaletra group) during their hospitalization period were matched to have a similar age group to that of Foistar group so that three times the number of Foistar group patients were randomly selected into Kaletra group and their body temperature, CRP HGNC level, WBC count, and event of diarrhea MESHD were collected, accordingly. Results A total of 29 patients (7 Foistar group and 22 Kaletra group) was included. The median age was 69, and all had mild COVID-19 MESHD (WHO ordinal scale 3 or 4) on admission. 6 patients out of 7 patients (85.71%) from Foistar group who exhibited elevated CRP HGNC levels ( CRP HGNC >0.4mg/dL) on admission have controlled their CRP HGNC levels to the normal range. In Kaletra group, 11 out of 18 patients (61.11%) have controlled their CRP HGNC levels to the normal range, and only 1 of 2 patients (50.00%) who had normal CRP HGNC level has maintained his or her normal CRP HGNC level. The difference in the white blood cell counts was not significant between two groups. None of the patients in the study had hyperkalemia MESHD. Conclusion This study has found a probable association of controlling inflammatory reactions and fever MESHD in COVID-19 MESHD patients with Foistar (camostat mesilate) use. In addition, there was no significant adverse drug event found from this study upon the Foistar use. These results may encourage the use of Foistar as a treatment option for the patients with mild to moderate COVID-19 MESHD.

    Clinical, Laboratory, and Chest CT Features of Severe Versus Non-Severe Pediatric Patients with COVID‐19 Infection Among Different Age Groups

    Authors: Meisam Hoseinyazdi; Saeid Esmaeilian; Reza Jahankhah; Arash Teimouri; Farzaneh ghazi sherbaf; Faranak Rafiee; Reza Jalli; Sedighe Hooshmandi

    doi:10.21203/rs.3.rs-126200/v1 Date: 2020-12-10 Source: ResearchSquare

    Background: The aim of this study was to compare the clinical, laboratory, and chest computed tomography (CT) findings between severe and non-severe patients as well as between different age groups of pediatric patients with confirmed COVID-19 MESHD.Method: This study was performed on 55 pediatric patients with confirmed COVID-19 MESHD hospitalized in Namazi and Ali Asghar Hospitals, Shiraz, Iran. Patients were divided into severe (n=27) and non-severe (n=28) groups. Also, they were categorized into three age groups: aged less than two years, 3-12 years and 13-17 years.  CT scans, laboratory, and clinical features were taken from all patients at the admission time. Abnormal chest CT in COVID-19 MESHD pneumonia MESHD was found to show one of the following findings: ground-glass opacities (GGO), bilateral involvement, peripheral and diffuse distribution.Result:  Fever MESHD (79.2%) and dry cough MESHD (75.5%) were the most common clinical symptoms. Severe COVID-19 MESHD patients showed lymphocytosis MESHD compared to non-severe ones (P = 0.028). C-reactive protein HGNC ( CRP HGNC) was shown to be significantly lower in patients aged less than two years than those aged 3-12 and 13-17 years old (P = 0.009). It was also shown that O2 saturation was significantly increased, as age increased (P = 0.015). Also, severe patients had significantly higher CT abnormalities compared to non-severe ones (48.0% compared to 17.9%, respectively) (P = 0.019).Conclusion: Lymphocytosis and abnormal CT findings are among the factors most associated with COVID-19 MESHD severity. It was, moreover, showed that the severity of the COVID-19 MESHD, O2 saturation, and respiratory distress MESHD were improved as the age of confirmed COVID-19 MESHD pediatric patients increased.

    Tocilizumab is associated with reduction in inflammation and improvement in P/F ratio in critically sick COVID19 MESHD patients

    Authors: Muhammad Asim Rana; Mubashar Sultan Hashmi; Muhammad Muneeb Ullah Saif; Muhammad Faisal Munir; Ahad Qayyum; Rizwan Pervaiz; Muhammad Mansoor Hafeez

    doi:10.1101/2020.10.20.20210195 Date: 2020-10-21 Source: medRxiv

    Introduction: Coronavirus disease 2019 MESHD was initially detected in China and has been declared a global pandemic by World Health Organization on March 11, 2020. In the majority of patients, SARS-CoV-2 causes a mild to moderate illness characterized by fever MESHD and respiratory symptoms MESHD, with or without evidence of pneumonia MESHD. The recent studies suggest that anti-cytokine targeted therapies might be associated with benefit for patients with severe COVID-19 MESHD especially in improving respiratory failure MESHD. Tocilizumab, a monoclonal antibody against interleukin 6 HGNC (IL6) receptor, is associated with clinical benefit for COVID-19 MESHD patients as it inhibits IL6 HGNC and decreases inflammation MESHD. Methods: As Tocilizumab has been an important part of our treatment and a strict criterion was followed to administer Tocilizumab, a retrospective study design used to assess the beneficial effects of Tocilizumab in improvement of ratio partial pressure of arterial Oxygen and fraction of inspired Oxygen (PaO2/FiO2 or P/F ratio) and C- reactive protein HGNC ( CRP HGNC) in COVID19 MESHD patients has been done. 60 patients were taken for this study by using convenient sampling technique the data of demographics, laboratory results, and clinical outcomes i.e. improvement of respiratory failure MESHD depicted in the form of PF Ratio were obtained from the medical records, Statistical analysis was done with SPSS, version 21.0. Results: Sixty patients (47 males and 13 females) with COVID-19 MESHD were included in this study, the mean age of patients was 53.83 (14-81) years. After administration of Tocilizumab the lab parameters were changed as CRP HGNC decreased down to .40 (9.6-73) mg/L but other parameters were not affected. The PF ratio improved in COVID-19 MESHD patients after administration of Tocilizumab the median of PF Ratio before treatment was 108 (52-362) and improved up to 128 (37-406) after Tocilizumab therapy. Conclusion: In summary, Tocilizumab appears to be associated with improvement in P/F Ratio and CRP HGNC in COVID19 MESHD patients but other markers did not improve in response to Tocilizumab therapy in severely ill COVID-19 MESHD patients.

    Characterization of Confirmed and Suspected COVID-19 MESHD Pneumonia Patients in a Retrospective Cohort Study in Wuhan

    Authors: Maomao Xi; Dan Cui; Qiaomei Liu; Lili Li; Yilin Yin; Fang Dong; Di Xiong; Yuwei Wu; Hongrong Guo; Min Bao; Zhanghua Li; Man Luo; Juan Wu; Weiguo Xie; Qingming Wu; Anlin Peng; Jinhu Wu; Yiqing Tan; Jianbin Sun; Pengcheng Luo; Zan Huang; Xiaodong Huang

    doi:10.21203/rs.3.rs-92239/v1 Date: 2020-10-13 Source: ResearchSquare

    Background: A methodical comparison of confirmed and suspected COVID-19 MESHD patients has not been previously reported. Therefore, we thoroughly analyzed the demographic and clinical characteristics between these groups to identify mortality risk factors.Methods: A retrospective cohort of 1,276 hospitalized COVID-19 MESHD pneumonia MESHD patients at Tongren Hospital (Wuhan, China; January 27 to March 3, 2020) was studied. Cox regression analyses were performed to evaluate multiple mortality risk factors. Results: Both cohorts of confirmed (n=797) and suspected (n=479) patients exhibited typical demographic, clinical, and radiological characteristics. Treatment methods were consistent and both groups shared similarities in many demographic and clinical characteristics: age (≥65, 45.9% vs 41.8%, P=0.378) and lung disease MESHD (12.5% vs 14.6%, P=0.293). However, confirmed patients exhibited more severe disease manifestations than those in suspected patients: a higher incidence of fever MESHD (65.4% vs 58.0%, P<0.01), lower lymphocyte count (1.12×109/L vs 1.22×109/L, P=0.022), higher C-reactive protein HGNC ( CRP HGNC) (11.60 mg/L vs 7.61mg/L, P=0.021), and more severe radiographic manifestations ( lung infection MESHD incidence, 3.8% vs 3.0%, P=0.014; ground-glass opacity lesion incidence, 2.3% vs 2.0%, P=0.033). The dynamic profiles of lymphocytes, monocytes, D-dimer, and CRP HGNC, clearly delineated confirmed patients from suspected patients exhibiting critical illness. Cox regression analysis demonstrated that lung disease MESHD (adjusted hazard ratio 8.972, 95% CI: 3.782-21.283), cardiovascular disease MESHD (3.083, 1.347-7.059), neutrophil count (1.189, 1.081-1.307), age (1.068, 1.027-1.110), and ground-glass opacity lesions MESHD (1.039, 95% 1.013-1.065), were the main risk factors for mortality in confirmed patients; lung disease MESHD (14.725, 2.187-99.147), age (1.076, 1.004-1.153), and CRP HGNC level (1.012, 95% CI 1.004-1.020) were the primary factors in suspected patients.Conclusions: Suspected patients with serious illness should seek medical attention to reduce mortality. Multiple factors must be assessed to determine the mortality risk and the appropriate treatment. 

    Clinical Characteristics of 10 Children With a Pediatric Inflammatory Multisystem Syndrome Associated with COVID-19 MESHD In Iran

    Authors: Leila Shahbaznejad; Mohammad Reza Navaifar; Ali Abbaskhanian; Fatemeh Hosseinzadeh; Golnar Rahimzadeh; Mohammad Sadegh Rezai

    doi:10.21203/rs.3.rs-51157/v3 Date: 2020-07-30 Source: ResearchSquare

    Background: Although symptoms and signs of COVID-19 MESHD ( Coronavirus disease 2019 MESHD) in children are milder than adults, there are reports of more severe cases which were defined as pediatric inflammatory multisystem syndrome MESHD ( PIMS MESHD). The purpose of this report was to describe the possible association between COVID-19 MESHD and PIMS in children.  Methods: From 28 March to 24 June 2020, 10 febrile children were admitted with COVID-19 MESHD infection showing characteristics of PIMS in Buali tertiary hospital of Sari, in Mazandaran province, northern Iran. Demographic and clinical characteristics, laboratory and imaging findings, and therapeutic modalities were recorded and analyzed. Results: The mean age of the patients was 5.37±3.9 years (13 months to 12 years). Six of them were boys. Kawasaki disease MESHD, myocarditis MESHD, toxic shock syndrome MESHD, appendicitis MESHD, sepsis MESHD, urosepsis, prolonged febrile seizure MESHD, acute hemorrhagic edema MESHD of infancy, and COVID-19 MESHD-related pneumonia MESHD were their first presentation. All of them had increased C-reactive protein HGNC levels, and most of them had elevated erythrocyte sedimentation rate, lymphopenia, anemia MESHD, and hypoalbuminemia MESHD. Three of them had thrombocytopenia MESHD(PLT<106). Six of them were serologically or polymerase chain reaction positive for COVID-19 MESHD, and 4 of them were diagnosed as COVID-19 MESHD just by chest computed tomography scan. Most of the patients improved without a residual sequel, except one who died with multiorgan failure MESHD and another case was discharged with a giant coronary aneurysm MESHD.Conclusion: Children with COVID-19 MESHD may present symptoms similar to Kawasaki disease MESHD and inflammatory syndromes. PIMS should be considered in children with fever MESHD, rash MESHD, seizure MESHD, cough, tachypnea MESHD, and gastrointestinal symptoms such as vomiting MESHD, diarrhea MESHD, and abdominal pain MESHD.

    Efficacy and tolerability of bevacizumab in patients with severe Covid -19

    Authors: Jiaojiao Pang; Feng Xu; Gianmarco Aondio; Yu Li; Alberto Fumagalli; Ming Lu; Giuseppe Valmadre; Jie Wei; Yuan Bian; Margherita Canesi; Giovanni Damiani; Yuan Zhang; Dexin Yu; Jun Chen; Xiang Ji; Wenhai Sui; Bailu Wang; Shuo Wu; Attila Kovacs; Miriam Revera; Hao Wang; Ying Zhang; Yuguo Chen; Yihai Cao

    doi:10.1101/2020.07.26.20159756 Date: 2020-07-29 Source: medRxiv

    On the basis of Covid-19 MESHD-induced pulmonary pathological and vascular changes, we hypothesized that the anti- VEGF HGNC drug bevacizumab might be beneficial for treating Covid-19 MESHD patients. We recruited 26 patients from 2-centers (China and Italy) with confirmed severe Covid-19 MESHD, with respiratory rate [≥]30 times/min, oxygen saturation [≤]93% with ambient air, or partial arterial oxygen pressure to fraction of inspiration O2 ratio (PaO2/FiO2) >100mmHg and [≤]300 mmHg, and diffuse pneumonia MESHD confirmed by chest radiological imaging. This trial was conducted from Feb 15 to April 5, 2020, and followed up for 28 days. Relative to comparable control patients with severe Covid-19 MESHD admitted in the same centers, bevacizumab showed clinical efficacy by improving oxygenation and shortening oxygen-support duration. Among 26 hospitalized patients with severe Covid-19 MESHD (median age, 62 years, 20 [77%] males), bevacizumab plus standard care markedly improved the PaO2/FiO2 ratios at days 1 and 7 (elevated values, day 1, 50.5 [4.0,119.0], p<0.001; day 7, 111.0 [85.0,165.0], p<0.001). By day 28, 24 (92%) patients showed improvement in oxygen-support status, 17 (65%) patients were discharged, and none showed worsen oxygen-support status nor died. Significant reduction of lesion areas and ratios were shown in chest CT or X-ray analysis within 7 days. Of 14 patients with fever MESHD, body temperature normalized within 72 hours in 13 (93%) patients. Lymphocyte counts in peripheral blood were significantly increased and CRP HGNC levels were markedly decreased as shown in available data. Our findings suggested bevacizumab plus standard care was highly beneficial for treating patients with severe Covid-19 MESHD. Clinical efficacy of bevacizumab warrants double blind, randomized, placebo-controlled trials.

    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.

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MeSH Disease
HGNC Genes
SARS-CoV-2 Proteins


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