Corpus overview


Overview

MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    Clinical Course and Risk Factors for severe Disease MESHD and Death of Adult Critically MESHD Adult TRANS Critically Ill Inpatients with COVID-19 in Toulouse, France: A Retrospective Cohort Study

    Authors: William Buffières; Benjamine Sarton; Charline Zadro; Fanny Vardon Bounes; Vincent Minville; Bernard Georges; Thierry Seguin; Jean Marie Conil; Stephanie Ruiz; Samia Collot; Guillaume Ducos; Marie Virtos; Diane Osinski; David Rousset; Thomas Geeraerts; Thomas Filleron; Benoit Bataille; Jacques Izopet; Jean Ruiz; Veronique Ramonda; Olivier Fourcade; Beatrice Riu; Damien Guinault; Stein Silva

    doi:10.21203/rs.3.rs-66770/v1 Date: 2020-08-27 Source: ResearchSquare

    BackgroundTo explore risk factors for unfavorable outcome ( death MESHD or requiring invasive mechanical ventilation at 28 days from ICU admission) of critically ill COVID-19 patients hospitalized in the Toulouse regionMethodsRetrospective cohort of critically ill COVID-19 patients sequentially admitted to 12 ICUs in Toulouse region (March 9, 2020, to April 8, 2020). All patients had laboratory confirmed SARS-CoV-2 infection MESHD and required invasive mechanical ventilation. Baseline characteristics, pathophysiological respiratory data, clinical outcomes, viral shredding, and chest CT scan were collected.ResultsA total of 150 patients were included (median age TRANS, 68 years (interquartile range, (IQR), 58-72; 81% male TRANS). The most common comorbidities were hypertension HP (77, 51%) and obesity HP (42, 28%). At ICU admission, the median PaO2/FiO2 ratio was 138 (IQR,112-178). During hospitalization, the rate of ventilator-acquired pneumonia HP (VAP) was 61% and 51 (34%) patients had acute kidney injury HP (AKI) with a Kidney Disease Improving Global Outcomes (KDIGO) score > 1. The 28-day mortality was 15.3%, and 50 (33%) patients had unfavorable outcome. We found that VAP (5.91; 2.10-10.03; p value = 0.002) and AKI with a KDIGO score > 1 (4.71; 1.69-14.41; p value = 0.004) were associated with increased odds of unfavorable outcome. Neither, chest CT scan data on admission, nor pathophysiological respiratory data during ICU stay were associated to patient’s outcome.ConclusionThe potential risk factors of AKI and VAP could help clinicians to identify patients with poor prognosis at an early stage. Targeted care of these factors might have a significant impact on COVID-19 patient’s outcome.

    Clinical course and severity outcome indicators among COVID 19 hospitalized patients in relation to comorbidities distribution Mexican cohort

    Authors: Genny Carrillo; Nina Mendez Dominguez; Kassandra D Santos Zaldivar; Andrea Rochel Perez; Mario Azuela Morales; Osman Cuevas Koh; Alberto Alvarez Baeza

    doi:10.1101/2020.07.31.20165480 Date: 2020-08-04 Source: medRxiv

    Introduction: COVID-19 affected worldwide, causing to date, around 500,000 deaths. In Mexico, by April 29, the general case fatality was 6.52%, with 11.1% confirmed case TRANS mortality and hospital recovery rate around 72%. Once hospitalized, the odds for recovery and hospital death rates depend mainly on the patients' comorbidities and age TRANS. In Mexico, triage guidelines use algorithms and risk estimation tools for severity assessment and decision-making. The study's objective is to analyze the underlying conditions of patients hospitalized for COVID-19 in Mexico concerning four severity outcomes. Materials and Methods: Retrospective cohort based on registries of all laboratory-confirmed patients with the COVID-19 infection MESHD that required hospitalization in Mexico. Independent variables were comorbidities and clinical manifestations. Dependent variables were four possible severity outcomes: (a) pneumonia HP pneumonia MESHD, (b) mechanical ventilation (c) intensive care unit, and (d) death; all of them were coded as binary Results: We included 69,334 hospitalizations of laboratory-confirmed and hospitalized patients to June 30, 2020. Patients were 55.29 years, and 62.61% were male TRANS. Hospital mortality among patients aged TRANS<15 was 9.11%, 51.99% of those aged TRANS >65 died. Male TRANS gender TRANS and increasing age TRANS predicted every severity outcome. Diabetes MESHD and hypertension HP hypertension MESHD predicted every severity outcome significantly. Obesity HP did not predict mortality, but CKD, respiratory diseases MESHD, cardiopathies were significant predictors. Conclusion: Obesity HP increased the risk for pneumonia HP pneumonia MESHD, mechanical ventilation, and intensive care admittance, but it was not a predictor of in-hospital death. Patients with respiratory diseases MESHD were less prone to develop pneumonia HP pneumonia MESHD, to receive mechanical ventilation and intensive care unit assistance, but they were at higher risk of in-hospital death.

    Sex-specificity of mortality risk factors among hospitalized COVID-19 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 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 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 TRANS (59.6%). Men were younger (median 64 vs. 70, p<0.001) and less likely to have comorbidities such as hypertension HP hypertension MESHD (32.5% vs. 39.9%, p<0.001), diabetes MESHD (22.6% vs. 26%, p=0.03), and obesity HP 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 SERO 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 (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 TRANS 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 HP 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 TRANS 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 HP obesity MESHD, and hypoxia MESHD. These new findings highlight patient subgroups for further study and help explain the recognized sex differences in COVID-19 outcomes.

    Risk Factors for COVID-19-associated hospitalization: COVID-19-Associated Hospitalization Surveillance Network and Behavioral Risk Factor Surveillance System

    Authors: Jean Y. Ko; Melissa L. Danielson; Machell Town; Gordana Derado; Kurt J. Greenland; Pam Daily Kirley; Nisha B. Alden; Kimberly Yousey-Hindes; Evan J. Anderson; Patricia A. Ryan; Sue Kim; Ruth Lynfield; Salina M. Torres; Grant R. Barney; Nancy M. Bennett; Melissa Sutton; H. Keipp Talbot; Mary Hill; Aron J. Hall; Alicia M. Fry; Shikha Garg; Lindsay Kim; - COVID-NET Investigation Group

    doi:10.1101/2020.07.27.20161810 Date: 2020-07-29 Source: medRxiv

    Background: Identification of risk factors for COVID-19-associated hospitalization is needed to guide prevention and clinical care. Objective: To examine if age TRANS, sex, race/ethnicity, and underlying medical conditions is independently associated with COVID-19-associated hospitalizations. Design: Cross-sectional. Setting: 70 counties within 12 states participating in the Coronavirus Disease MESHD 2019-Associated Hospitalization Surveillance Network (COVID-NET) and a population-based sample of non-hospitalized adults TRANS residing in the COVID-NET catchment area from the Behavioral Risk Factor Surveillance System. Participants: U.S. community-dwelling adults TRANS ([≥]18 years) with laboratory-confirmed COVID-19-associated hospitalizations, March 1- June 23, 2020. Measurements: Adjusted rate ratios (aRR) of hospitalization by age TRANS, sex, race/ethnicity and underlying medical conditions ( hypertension HP hypertension MESHD, coronary artery disease MESHD, history of stroke HP stroke MESHD, diabetes MESHD, obesity HP obesity MESHD [BMI [≥]30 kg/m2], severe obesity HP obesity MESHD [BMI[≥]40 kg/m2], chronic kidney disease HP chronic kidney disease MESHD, asthma HP asthma MESHD, and chronic obstructive pulmonary disease HP chronic obstructive pulmonary disease MESHD). Results: Our sample included 5,416 adults TRANS with COVID-19-associated hospitalizations. Adults TRANS with (versus without) severe obesity HP obesity MESHD (aRR:4.4; 95%CI: 3.4, 5.7), chronic kidney disease HP chronic kidney disease MESHD (aRR:4.0; 95%CI: 3.0, 5.2), diabetes MESHD (aRR:3.2; 95%CI: 2.5, 4.1), obesity HP obesity MESHD (aRR:2.9; 95%CI: 2.3, 3.5), hypertension HP hypertension MESHD (aRR:2.8; 95%CI: 2.3, 3.4), and asthma HP asthma MESHD (aRR:1.4; 95%CI: 1.1, 1.7) had higher rates of hospitalization, after adjusting for age TRANS, sex, and race/ethnicity. In models adjusting for the presence of an individual underlying medical condition, higher hospitalization rates were observed for adults TRANS [≥]65 years, 45-64 years (versus 18-44 years), males TRANS (versus females TRANS), and non-Hispanic black and other race/ethnicities (versus non-Hispanic whites). Limitations: Interim analysis limited to hospitalizations with underlying medical condition data. Conclusion: Our findings elucidate groups with higher hospitalization risk that may benefit from targeted preventive and therapeutic interventions.

    Trends in Angiotensin Receptor Blocker Use Among those at Risk for COVID-19 Morbidity and Mortality in the United States

    Authors: Alexandra Perez; Robert Speth; Juan Saavedra

    doi:10.1101/2020.07.24.20161851 Date: 2020-07-27 Source: medRxiv

    Importance: Assessment of the use of angiotensin receptor blockers (ARBs) in the United States provides insight into prescribing practices, and may inform guidelines, policy measures and research during the COVID-19 pandemic. Objective: To evaluate trends in ARB use among adults TRANS in the United States who have preexisting conditions and sociodemographic risk factors that put them at a higher risk of SARS-CoV-2 infection MESHD and COVID-19-related complications and mortality. Design, setting and participants: This study uses the nationally representative cross-sectional data from the 2005-2018 National Health and Nutrition Examination Survey (NHANES). Participants included 39,749 non-institutionalized U.S. civilian adults TRANS who were 20 years and older and those with the most common preexisting conditions and risk factors reported among patients with COVID-19. Main outcomes and measures: Use of ARBs in the prior 30 days from survey interview. Results: ARB use ranged from 7.4% [95% CI, 6.5%-8.4%] to 26.2% [95% CI, 19.4%-34.4%] among those with one or two metabolic, renal, respiratory, and/or cardiovascular diseases MESHD. Among individuals with the three most common preexisting conditions in patients with COVID-19 including hypertension HP hypertension MESHD, diabetes MESHD and obesity HP obesity MESHD, ARB use was higher among the elderly TRANS, females TRANS, non-Hispanic whites, and those with health insurance coverage. Conclusions and relevance: In this nationally representative survey, ARB use was found to be widespread, but unevenly distributed among individuals with conditions and sociodemographic risk factors that place them at a higher risk of COVID-19 morbidity and mortality.

    The impact of previous history of bariatric surgery on outcome of Covid-19: A nationwide medico-administrative French study.

    Authors: Antonio Iannelli; Samir Bouam; Anne-Sophie Schneck; Sébastien Frey; Jean Gugenheim; Marco Alifano

    doi:10.21203/rs.3.rs-48313/v1 Date: 2020-07-24 Source: ResearchSquare

    Purpose: To determine the risk of invasive mechanical ventilation and death MESHD in obese MESHD individuals with history of bariatric surgery compared to standard ones admitted for Covid-19 infection MESHD.Methods: Nationwide retrospective observational study based on electronic health data. 4 248 253 individuals aged TRANS 15 to 75 years with a diagnosis of obesity HP obesity MESHD were included. All obese MESHD inpatients, undergoing bariatric surgery or not, recorded during a hospital stay by the French National Health Insurance were followed, during a mean observation time of 5.43 ± 2.93 years. This exposition was bariatric surgery (n=389,671) including adjustable gastric banding, sleeve gastrectomy, gastric bypass versus no bariatric surgery (n=3,858,582). The primary outcome was Covid-19 related death MESHD and the secondary outcome was the need for invasive mechanical ventilation.Results: 8 286 (0.2%) obese MESHD individuals were admitted for Covid-19 infection between January 1st and May 15th 2020 with a diagnosis of Covid-19 infection MESHD. 541 (0.14%) had a history of bariatric surgery and 7,745 (0.2%) did not. Invasive mechanical ventilation was necessary in 14.54% of patients and death MESHD occurred in 13.58% of cases. The need for an invasive mechanical ventilation and death MESHD occurred in 7% and 3.5% in the bariatric surgery group versus 15% and 14.2% in the non-bariatric surgery group, respectively (both p<0.0001). After a logistic regression, the risk of invasive mechanical ventilation significantly increased with age TRANS being higher in the age TRANS class 61-75, male TRANS gender TRANS, and hypertension HP hypertension MESHD, whereas bariatric surgery showed an independent protective effect. Mortality was independently associated with increasing age TRANS, male TRANS gender TRANS, known history of heart failure MESHD, cancer MESHD, and diabetes MESHD, whereas BS was in favor with a protective effect. Conclusion: This nationwide administrative study showed that bariatric surgery is independently associated with a reduced risk of death MESHD and invasive mechanical ventilation in obese MESHD individuals with Covid-19 infection MESHD.

    The impact of COVID-19 on patients with asthma HP asthma MESHD: A Big Data analysis

    Authors: Jose Luis Izquierdo; Carlos Almonacid; Yolanda Gonzalez; Carlos Del Rio-Bermudez; Julio Ancochea; Remedios Cardenas; Joan B Soriano

    doi:10.1101/2020.07.24.20161596 Date: 2020-07-24 Source: medRxiv

    Background: From the onset of the COVID-19 pandemic, an association between the severity of COVID-19 and the presence of certain medical chronic conditions has been suggested. However, unlike influenza and other viruses, the burden of the disease in patients with asthma HP asthma MESHD has been less evident. Objective: This study aims at a better understanding of the burden of COVID-19 in patients with asthma HP asthma MESHD and the impact of asthma HP, its related comorbidities, and treatment on the prognosis of COVID-19. Methods: We analyzed clinical data from patients with asthma HP asthma MESHD from January 1st to May 10th, 2020 using big data analytics and artificial intelligence through the SAVANA Manager clinical platform. Results: Out of 71,192 patients with asthma HP asthma MESHD, 1,006 (1.41%) suffered from COVID-19. Compared to asthmatic individuals without COVID-19, patients with asthma HP asthma MESHD and COVID-19 were significantly older (55 vs. 42 years), predominantly female TRANS (66% vs. 59%), had higher prevalence SERO of hypertension HP hypertension MESHD, dyslipidemias MESHD, diabetes MESHD, and obesity HP obesity MESHD, and smoked more frequently. Contrarily, allergy HP allergy MESHD-related factors such as rhinitis HP rhinitis MESHD and eczema HP eczema MESHD were less frequent in asthmatic patients with COVID-19 (P < .001). Higher prevalence SERO of hypertension HP hypertension MESHD, dyslipidemia MESHD, diabetes MESHD, and obesity HP obesity MESHD was also confirmed in those patients with asthma HP asthma MESHD and COVID-19 who required hospital admission. The percentage of individuals using inhaled corticosteroids ( ICS MESHD) was lower in patients who required hospitalization due to COVID-19, as compared to non-hospitalized patients (48.3% vs. 61.5%; OR: 0.58: 95% CI 0.44-0.77). During the study period, 865 (1.21%) patients with asthma HP asthma MESHD were being treated with biologics. Although these patients showed increased severity and more comorbidities at the ear, nose, and throat (ENT) level, their hospital admission rates due to COVID-19 were relatively low (0.23%). COVID-19 increased inpatient mortality in asthmatic patients (2.29% vs 0.54%; OR 2.29: 95% CI 4.35-6.66). Conclusion: Our results indicate that the number of COVID-19 cases in patients with asthma HP has been low, although higher than the observed in the general population. Patients with asthma HP asthma MESHD and COVID-19 were older and were at increased risk due to comorbidity-related factors. ICS and biologics are generally safe and may be associated with a protective effect against severe COVID-19 infection MESHD.

    Modeling the progression of SARS-CoV-2 infection MESHD in patients with COVID-19 risk factors through predictive analysis

    Authors: Juan Alonso Leon-Abarca

    doi:10.1101/2020.07.14.20154021 Date: 2020-07-19 Source: medRxiv

    With almost a third of adults TRANS being obese MESHD, another third hypertense MESHD and almost a tenth affected by diabetes MESHD, Latin American countries could see an elevated number of severe COVID-19 outcomes. We used the Open Dataset of Mexican patients with COVID-19 suspicion who had a definite RT-PCR result to develop a statistical model that evaluated the progression of SARS-CoV-2 infection MESHD in the population. We included patients of all ages TRANS with every risk factor provided by the dataset: asthma HP, chronic obstructive pulmonary disease HP chronic obstructive pulmonary disease MESHD, smoking, diabetes MESHD, obesity HP obesity MESHD, hypertension HP hypertension MESHD, immunodeficiencies HP immunodeficiencies MESHD, chronic kidney disease HP chronic kidney disease MESHD, cardiovascular diseases MESHD, and pregnancy. The dataset also included an unspecified category for other risk factors that were not specified as a single variable. To avoid excluding potential patients at risk, that category was included in our analysis. Due to the nature of the dataset, the calculation of a standardized comorbidity index was not possible. Therefore, we treated risk factors as a categorical variable with two categories: absence of risk factors and the presence of at least one risk factor in accordance with previous epidemiological reports. Multiple logistic regressions were carried out to associate sex, risk factors, and age TRANS as a continuous variable (and the interaction that accounted for increasing diseases with older ages TRANS); and SARS-CoV-2 infection MESHD as the dependent zero-one binomial variable. Post estimation predictive marginal analysis was performed to generate probability trends along 95% confidence bands. This analysis was repeated several times through the course of the pandemic since the first record provided in their repository (April 12, 2020) to one month after the end of the state of sanitary emergency (the last date analyzed: June 27, 2020). After processing, the last measurement included 464,389 patients. The baseline analysis on April 12 revealed that people 35 years and older with at least one risk factor had a lower risk of SARS-CoV-2 infection MESHD in comparison to patients without risk factors (Figure 1). One month before the end of the nationwide state of emergency this age TRANS threshold was found at 50 years (May 2, 2020) and it shifted to 65 years on May 30. Two weeks after the end of the public emergency (June 13, 2020) the trends converged at 80 years and one week later (June 27, 2020) every male TRANS and female TRANS patient with at least one risk factor had a higher risk of SARS-CoV-2 infection MESHD compared to people without risk factors. Through the course of the COVID-19 pandemic, all four probability curves shifted upwards as a result of progressive disease spread TRANS. In conclusion, we found our model could monitor accurately the probability of SARS-CoV-2 infection MESHD in relation to age TRANS, sex, and the presence of at least one risk factor. Also, because the model can be applied to any particular political region within Mexico, it could help evaluate the contagion spread in specific vulnerable populations. Further studies are needed to determine the underlying nature of the mechanisms behind such observations.

    The natural history of symptomatic COVID-19 in Catalonia, Spain: a multi-state model including 109,367 outpatient diagnoses, 18,019 hospitalisations, and 5,585 COVID-19 deaths among 5,627,520 people

    Authors: Edward Burn; Cristian Tebe; Sergio Fernandez-Bertolin; Maria Aragon; Martina Recalde; Elena Roel; Albert Prats-Uribe; Daniel Prieto-Alhambra; Talita Duarte-Salles

    doi:10.1101/2020.07.13.20152454 Date: 2020-07-14 Source: medRxiv

    Background The natural history of Coronavirus Disease MESHD 2019 (COVID-19) has yet to be fully described, with most previous reports focusing on hospitalised patients. Using linked patient-level data, we set out to describe the associations between age TRANS, gender TRANS, and comorbidities and the risk of outpatient COVID-19 diagnosis, hospitalisation, and/or related mortality. Methods A population-based cohort study including all individuals registered in Information System for Research in Primary Care (SIDIAP). SIDIAP includes primary care records covering > 80% of the population of Catalonia, Spain, and was linked to region-wide testing, hospital and mortality records. Outpatient diagnoses of COVID-19, hospitalisations with COVID-19, and deaths with COVID-19 were identified between 1st March and 6th May 2020. A multi-state model was used, with cause-specific Cox survival models estimated for each transition. Findings A total of 5,664,652 individuals were included. Of these, 109,367 had an outpatient diagnosis of COVID-19, 18,019 were hospitalised with COVID-19, and 5,585 died after either being diagnosed or hospitalised with COVID-19. Half of those who died were not admitted to hospital prior to their death. Risk of a diagnosis with COVID-19 peaked first in middle- age TRANS and then again for oldest ages TRANS, risk for hospitalisation after diagnosis peaked around 70 years old, with all other risks highest at oldest ages TRANS. Male TRANS gender TRANS was associated with an increased risk for all outcomes other than outpatient diagnosis. The comorbidities studied (autoimmune condition, chronic kidney disease HP chronic kidney disease MESHD, chronic obstructive pulmonary disease HP chronic obstructive pulmonary disease MESHD, dementia HP dementia MESHD, heart disease MESHD, hyperlipidemia HP hyperlipidemia MESHD, hypertension HP hypertension MESHD, malignant neoplasm HP neoplasm MESHD, obesity HP obesity MESHD, and type 2 diabetes MESHD) were all associated with worse outcomes. Interpretation There is a continued need to protect those at high risk of poor outcomes, particularly the elderly TRANS, from COVID-19 and provide appropriate care for those who develop symptomatic disease. While risks of hospitalisation and death MESHD are lower for younger populations, there is a need to limit their role in community transmission TRANS. These findings should inform public health strategies, including future vaccination campaigns.

    COVID-19 among people living with HIV MESHD: A systematic review

    Authors: Hossein Mirzaei; Willi McFarland; Mohammad Karamouzian; Hamid Sharifi

    doi:10.1101/2020.07.11.20151688 Date: 2020-07-14 Source: medRxiv

    This systematic review summarizes the evidence on the earliest patients with COVID-19-HIV co-infection MESHD. We searched PubMed, Scopus, Web of Science, Embase, preprint databases, and Google Scholar from December 01, 2019 to June 1, 2020. From an initial 547 publications and 75 reports, 25 studies provided specific information on COVID-19 patients living with HIV MESHD. Studies described 252 patients, 80.9% were male TRANS, mean age TRANS was 52.7 years, and 98% were on ART. Co-morbidities in addition to HIV and COVID-19 (multimorbidity) included hypertension HP hypertension MESHD (39.3%), obesity HP obesity MESHD or hyperlipidemia HP (19.3%), chronic obstructive pulmonary disease HP chronic obstructive pulmonary disease MESHD (18.0%), and diabetes MESHD (17.2%). Two-thirds (66.5%) had mild to moderate symptoms, the most common being fever HP fever MESHD (74.0%) and cough HP (58.3%). Among patients who died, the majority (90.5%) were over 50 years old, male TRANS (85.7%), and had multimorbidity (64.3%). Our findings highlight the importance of identifying co-infections MESHD, addressing co-morbidities, and ensuring a secure supply of ART for PLHIV during the COVID-19 pandemic.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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