Corpus overview


MeSH Disease

Human Phenotype

Hypertension (57)

Fever (57)

Cough (42)

Fatigue (19)

Pneumonia (14)


    displaying 1 - 10 records in total 57
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    Predicting clinical outcome with phenotypic clusters in COVID-19 pneumonia HP pneumonia MESHD: 2 an analysis of 12,066 hospitalized patients from the Spanish registry SEMI-3 COVID-19.

    Authors: Manuel Rubio-Rivas; Xavier Corbella; Jose Maria Mora-Lujan; Jose Loureiro Amigo; Almudena Lopez Sampalo; Carmen Yera Bergua; Pedro Jesus Esteve Atienzar; Luis Felipe Diez Garcia; Ruth Gonzalez Ferrer; Susana Plaza Canteli; Antia Perez Pineiro; Begona Cortes Rodriguez; Leyre Jorquer Vidal; Ignacio Perez Catalan; Marta Leon Tellez; Jose Angel Martin Oterino; Maria Candelaria Martin Gonzalez; Jose Luis Serrano Carrillo de Albornoz; Eva Garcia Sardon; Jose Nicolas Alcala Pedrajas; Anabel Martin Urda Diez Canseco; Maria Jose Esteban Giner; Pablo Telleria Gomez; Ricardo Gomez Huelgas; Jose Manuel Ramos Rincon; Nina la Cour Freiesleben; Henriette Svarre Nielsen

    doi:10.1101/2020.09.14.20193995 Date: 2020-09-15 Source: medRxiv

    (1) Background: This study aims to identify different clinical phenotypes in COVID-19 88 pneumonia HP pneumonia MESHD using cluster analysis and to assess the prognostic impact among identified clusters in 89 such patients. (2) Methods: Cluster analysis including 11 phenotypic variables was performed in a 90 large cohort of 12,066 COVID-19 patients, collected and followed-up from March 1, to July 31, 2020, 91 from the nationwide Spanish SEMI-COVID-19 Registry. (3) Results: Of the total of 12,066 patients 92 included in the study, most were males TRANS (7,052, 58.5%) and Caucasian (10,635, 89.5%), with a mean 93 age TRANS at diagnosis of 67 years (SD 16). The main pre-admission comorbidities were arterial 94 hypertension HP hypertension MESHD (6,030, 50%), hyperlipidemia HP hyperlipidemia MESHD (4,741, 39.4%) and diabetes mellitus HP diabetes mellitus MESHD (2,309, 19.2%). The 95 average number of days from COVID-19 symptom onset TRANS to hospital admission was 6.7 days (SD 7). 96 The triad of fever HP fever MESHD, cough HP cough MESHD, and dyspnea HP dyspnea MESHD was present almost uniformly in all 4 clinical phenotypes 97 identified by clustering. Cluster C1 (8,737 patients, 72.4%) was the largest, and comprised patients 98 with the triad alone. Cluster C2 (1,196 patients, 9.9%) also presented with ageusia and anosmia MESHD anosmia HP; 99 cluster C3 (880 patients, 7.3%) also had arthromyalgia, headache HP headache MESHD, and sore throat; and cluster C4 100 (1,253 patients, 10.4%) also manifested with diarrhea HP diarrhea MESHD, vomiting HP vomiting MESHD, and abdominal pain HP abdominal pain MESHD. Compared to 101 each other, cluster C1 presented the highest in-hospital mortality (24.1% vs. 4.3% vs. 14.7% vs. 102 18.6%; p<0.001). The multivariate study identified phenotypic clusters as an independent factor for 103 in-hospital death. (4) Conclusion: The present study identified 4 phenotypic clusters in patients with 104 COVID-19 pneumonia HP pneumonia MESHD, which predicted the in-hospital prognosis of clinical outcomes.

    The Effect of Early Hydroxychloroquine-based Therapy in COVID-19 Patients in Ambulatory Care Settings: A Nationwide Prospective Cohort Study

    Authors: Tarek Sulaiman; Abdulrhman Mohana; Laila Alawdah; Nagla Mahmoud; Mustafa Hassanein; Tariq Wani; Amel Alfaifi; Eissa Alenazi; Nashwa Radwan; Nasser AlKhalifah; Ehab Elkady; Manwer AlAnazi; Mohammed Alqahtani; Khalid Abdalla; Yousif Yousif; Fouad AboGazalah; Fuad Awwad; Khaled AlabdulKareem; Fahad AlGhofaili; Ahmed AlJedai; Hani Jokhdar; Fahad Alrabiah

    doi:10.1101/2020.09.09.20184143 Date: 2020-09-13 Source: medRxiv

    ABSTRACT BACKGROUND: Currently, there is no proven effective therapy nor vaccine for the treatment of SARS-CoV-2. Evidence regarding the potential benefit of early administration of hydroxychloroquine (HCQ) therapy in symptomatic patients with Coronavirus Disease MESHD (COVID-19) is not clear. METHODS: This observational prospective cohort study took place in 238 ambulatory fever HP clinics in Saudi Arabia, which followed the Ministry of Health (MOH) COVID-19 treatment guideline. This guideline included multiple treatment options for COVID-19 based on the best available evidence at the time, among which was Hydroxychloroquine (HCQ). Patients with confirmed COVD-19 (by reverse transcriptase polymerase chain reaction (PCR) test) who presented to these clinics with mild to moderate symptoms during the period from 5-26 June 2020 were included in this study. Our study looked at those who received HCQ-based therapy along with supportive care (SC) and compared them to patients who received SC alone. The primary outcome was hospital admission within 28-days of presentation. The secondary outcome was a composite of intensive care admission (ICU) and/or mortality during the follow-up period. Outcome data were assessed through a follow-up telephonic questionnaire at day 28 and were further verified with national hospitalisation and mortality registries. Multiple logistic regression model was used to control for prespecified confounders. RESULTS: Of the 7,892 symptomatic PCR-confirmed COVID-19 patients who visited the ambulatory fever HP clinics during the study period, 5,541 had verified clinical outcomes at day 28 (1,817 patients in the HCQ group vs 3,724 in the SC group). At baseline, patients who received HCQ therapy were more likely to be males TRANS who did not have hypertension HP hypertension MESHD or chronic lung disease HP lung disease MESHD compared to the SC group. No major differences were noted regarding other comorbid conditions. All patients were presenting with active complaints; however, the HCQ groups had higher rates of symptoms compared to the SC group ( fever HP fever MESHD: 84% vs 66.3, headache HP headache MESHD: 49.8 vs 37.4, cough HP: 44.5 vs 35.6, respectively). Early HCQ-based therapy was associated with a lower hospital admission within 28-days compared to SC alone (9.4% compared to 16.6%, RRR 43%, p-value <0.001). The composite outcome of ICU admission and/or mortality at 28-days was also lower in the HCQ group compared to the SC (1.2% compared to 2.6%, RRR 54%, p-value 0.001). Adjusting for age TRANS, gender TRANS, and major comorbid conditions, a multivariate logistic regression model showed a decrease in the odds of hospitalisation in patients who received HCQ compared to SC alone (adjusted OR 0.57 [95% CI 0.47-0.69], p-value <0.001). The composite outcome of ICU admission and/or mortality was also lower for the HCQ group compared to the SC group controlling for potential confounders (adjusted OR 0.55 [95% CI 0.34-0.91], p-value 0.019). CONCLUSION: Early intervention with HCQ-based therapy in patients with mild to moderate symptoms at presentation is associated with lower adverse clinical outcomes among COVID-19 patients, including hospital admissions, ICU admission, and/or death.

    Clinical Characteristics, Risk Factors and Predictive Value of COVID-19 Pneumonia HP: A Retrospective Study of 173 Patients in Wuhan, China

    Authors: Yang Zhang; Jun Xue; Mi Yan; Jing Chen; Hai Liu; Shao-Bo Wang; Jian-Xing Luo; Fang Yang; Jian-Yuan Tang; Xiao-Yu Hu

    doi:10.21203/ Date: 2020-09-11 Source: ResearchSquare

    Background: COVID-19 is a globally emerging infectious disease MESHD. As the global epidemic continues to spread, the risk of COVID-19 transmission TRANS and diffusion in the world will also remain. Currently, several studies describing its clinical characteristics have focused on the initial outbreak, but rarely to the later stage. Here we described clinical characteristics, risk factors for disease severity and in-hospital outcome in patients with COVID-19 pneumonia HP pneumonia MESHD from Wuhan. Methods: Patients with COVID-19 pneumonia HP pneumonia MESHD admitted to Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from February 13 to March 8, 2020, were retrospectively enrolled. Multivariable logistic regression analysis was used to identify risk factors for disease severity and in-hospital outcome and establish predictive models. Receiver operating characteristic (ROC) curve was used to assess the predictive value of above models.Results: 106 (61.3%) of the patients were female TRANS. The mean age TRANS of study populations was 62.0 years, of whom 73 (42.2%) had underlying comorbidities mainly including hypertension HP hypertension MESHD (24.9%). The most common symptoms on admission were fever HP fever MESHD (67.6%) and cough HP (60.1%), digestive symptoms (22.0%) was also very common. Older age TRANS (OR: 3.420; 95%Cl: 1.415-8.266; P=0.006), diarrhea HP diarrhea MESHD (OR: 0.143; 95%Cl: 0.033-0.611; P=0.009) and lymphopenia HP lymphopenia MESHD (OR: 4.769; 95%Cl: 2.019-11.266; P=0.000) were associated with severe illness on admission; the area under the ROC curve (AUC) of predictive model were 0.860 (95%CI: 0.802-0.918; P=0.000). Older age TRANS (OR: 0.309; 95%Cl: 0.142-0.674; P=0.003), leucopenia (OR: 0.165; 95%Cl: 0.034-0.793; P=0.025), increased lactic dehydrogenase (OR: 0.257; 95%Cl: 0.100-0.659; P=0.005) and interleukins-6 levels (OR: 0.294; 95%Cl: 0.099-0.872; P=0.027) were associated with poor in-hospital outcome; AUC of predictive model were 0.752 (95%CI: 0.681-0.824; P=0.000).Conclusion: Older patients with diarrhea HP diarrhea MESHD and lymphopenia HP lymphopenia MESHD need early identification and timely intervention to prevent the progression to severe COVID-19 pneumonia HP pneumonia MESHD. However, older patients with leucopenia, increased lactic dehydrogenase and interleukins-6 levels are at a high risk for poor in-hospital outcome.Trial registration: ChiCTR2000029549

    Convalescent plasma SERO as potential therapy for severe COVID-19 pneumonia HP pneumonia MESHD.

    Authors: Ricardo Valentini; Juan Dupont; Jose Fernandez; Jorge Solimano; Fernando Palizas; Dardo Riveros; Pablo Saul; Laura Dupont; Juan Medina; Viviana Falasco; Florencia Fornillo; Julia Laviano; Daniela Maymo; Daniel Gotta; Alfredo Martinez; Pablo Bonvehi

    doi:10.1101/2020.09.01.20184390 Date: 2020-09-07 Source: medRxiv

    At the beginning of the COVID-19 pandemic, there was high mortality and a lack of effective treatment for critically ill MESHD patients. Build on the experience in argentine hemorrhagic fever MESHD fever HP with convalescent plasma SERO, we incorporated 90 patients into a multicenter study, and 87 were evaluable. We collected 397 donations from 278 convalescent donors. Patients received plasma SERO with an IgG concentration of 0.7-0.8 (measured by Abbott chemiluminescence) for every 10 kg of body weight. Survival during the first 28 days was the primary objective. 77% were male TRANS, age TRANS 54 (+/-15.6 y/o (range 27-85); body mass index 29.7 +/-; 4,4; hypertension HP 39% and diabetes 20%; 19.5% had an immunosuppression condition; 23% were healthcare workers. Plasma SERO was administered to 55 patients (63%) on spontaneous breathing with oxygen supplementation (mainly oxygen mask with reservoir bag in 80%), and 32 patients (37%) were infused on mechanical ventilation. The 28-day survival rate was 80%, with 91% in patients infused on spontaneous breathing and 63% in those infused on mechanical ventilation (p = 0.0002). There was a significant improvement in the WHO pneumonia HP clinical scale at 7 and 14 days, and in PaO2 / FiO2, ferritin and LDH, in the week post-infusion. We observed an episode of circulatory volume overload and a febrile reaction, both mild. Convalescent plasma SERO infusions are feasible, safe, and potentially effective, especially before requiring mechanical ventilation, and are an attractive clinical option for treating severe forms of COVID-19 until other effective therapies become available.

    Clinical Characteristics of Severe Covid Pneumonia HP: Exploring New Trends in ICU

    Authors: Aftab Akhtar; Sheher Bano; Ahtesham Iqbal; Moazma Ramzan; Aayesha Qadeer; Syed Waqar Hussain; Anam Saleem; Omair-ul-Haq Lodhi; Sana Zubair; Abdul Hameed kiani

    doi:10.21203/ Date: 2020-08-31 Source: ResearchSquare

    Background: In late December 2019, Covid-19 emerged as clusters of pneumonia HP pneumonia MESHD of unknown cause in a province of china, Wuhan. Etiological agent was identified as novel coronavirus that resembles severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East Respiratory syndrome coronavirus (MERS-CoV) MESHD and has zoonotic transmission TRANS. Covid pneumonia HP can remain asymptomatic TRANS, present as mild infection, severe HP infection, severe MESHD pneumonia HP pneumonia MESHD or respiratory failure HP respiratory failure MESHD. Diagnosis is based on rRT-PCR carried out on respiratory secretions. Covid related mortality exceeds 50% once patient requires ICU admission. Objective: To study the characteristics of ICU population admitted to ICU of Shifa International hospital.Results: we prospectively analysed 74 patients which included 43.3% females TRANS and 56.7% males TRANS. Commonest symptoms were shortness of breath MESHD (94.5%), fever HP fever MESHD (74.3%) and cough HP (74.3%). Most of our study population consisted of non-smokers (79.7%) and had hypertension HP hypertension MESHD (59.4%) followed by diabetes MESHD (47.2%). Hydroxychloroquine (HCQ) and azithromycin combination is superior to hydroxychloroquine and doxycycline in reducing mortality (p=0.023) whereas Doxycycline alone resulted in increased mortality (p=0.009). Those who did not require antibiotics or required only narrow spectrum antibiotics had increased survival and reduced requirement of invasive mechanical ventilation (p=< 0.0001). in our study population, (44.9%) developed acute kidney injury HP acute kidney injury MESHD, 2.7% needed re-intubations 10.8% developed surgical emphysema HP emphysema MESHD and 2.7 % thromboembolic MESHD events despite full anticoagulation. ICU mortality was 41.8% and was higher in females TRANS (59.4%, p=0.008), those who had SOFA score > 3.5 at time of admission, raised D-Dimers > 931 ng/ml, NLR > 9.2. It was further high in those who required invasive mechanical ventilation and vasopressor support (58.1% mortality p=< 0.001). ICU stay was more prolonged in those requiring invasive mechanical ventilation as compared to those who did not. (23 days vs 6 days, p=0.001). Mean plateau pressure was 19.6 ± 7.6; mean Driving pressures 14.4 ± 4.6; mean PaO2/FiO2 150.7 ± 73.9; mean SPO2/FiO2 173.9 ± 106.9; mean PEEP was 8.2 ±4.33.Conclusion: We concluded that severe covid pneumonia HP pneumonia MESHD is common amongst males TRANS, non-smokers those who had comorbid. HCQ and azithromycin combination is superior to combination of HCQ and doxycycline or doxycycline alone and QT prolongation MESHD is a rare complication. Baseline NLR, APACHI II, SOFA, SAPS II, NUTRIC scores, D-Dimers, invasive ventilation and vasopressor support are important tools to predict ICU mortality. Invasive mechanical ventilation carries higher mortality and associated with more prolonged ICU stay. AKI is most common complication followed by shock HP and surgical emphysema HP emphysema MESHD. CRP, Ferritin levels has no impact on outcome.

    Clinical Characteristics, Comorbidities, Initial Management and Outcome of COVID-19 Infected Patients Admitted to Intensive Care Unit in Somalia: A National Retrospective Study.

    Authors: Mohamed Farah Yusuf Mohamud; Abdullahi Said Hashi; Abdikarim Hussein Mohamed; Ali Mohamed Yusuf; Ibrahim Hussein Ali; Mohamed Abdi Ahmed

    doi:10.21203/ Date: 2020-08-27 Source: ResearchSquare

    Purpose: To investigate the clinical characteristics, morbidities, management, and outcomes of COVID-19 Infected patients admitted to the intensive care unit (ICU) in Somalia.Material MESHD and methods: We conducted a retrospective observational study of laboratory 60 confirmed patients with severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) admitted to an ICU from March 28, to May 28, 2020.The sociodemographic characteristics, comorbidities, exposure history, clinical manifestations (symptoms and signs), laboratory findings, treatment, and outcomes were collected from medical records.Results: Most of the patients admitted to ICU were men over 59 years of age TRANS, and nearly half had diabetes MESHD followed by hypertension HP hypertension MESHD chronic kidney disease HP and asthma HP asthma MESHD. The most clinical presentations were dyspnea HP dyspnea MESHD (91.2%), Fever HP Fever MESHD (81.1%), (68.75%), Fatigue HP and myalgia HP myalgia MESHD (25%), and Altered level of conscious (16.6%). Among 48 patients admitted to the ICU, about 24 (50%) patients had required endotracheal intubation and mechanical ventilation, and 11(29.9%) patients needed noninvasive ventilation, while 13(27.08%) patients treated with high-flow oxygen therapy >15 L/min (Table 3). Corticosteroids were administered to most patients (85.4%), while 77.1% of the patients received inhaled bronchodilators and morethan half of the patients administered antibiotics. 58.3% of the patients had received Oseltamivir, while 22.9% received Vasopressors.Conclusion This study represents the first description of critically ill MESHD patients infected with SARS-CoV-2 admitted to ICU in Somalia. The study identified that elder age TRANS, male TRANS gender TRANS, and diabetic MESHD and hypertensive MESHD comorbidities as independent risk factors of poor outcomes for patients admitted to the ICU (p<0.005).

    Artificial Intelligence Based Study on Analyzing of Habits and with History of Diseases MESHD of Patients for Prediction of Recurrence of Disease Due to COVID-19

    Authors: Samir Kumar Bandyopadhyay; Shawni Dutta

    id:10.20944/preprints202008.0542.v1 Date: 2020-08-25 Source:

    A patient will visit physicians when he/she feels ill. This illness is not for COVID-19 but it is a general tendency of human being to visit doctor probably it can not be controlled by general drug. When a patient comes to a doctor, the doctor examines him/her after knowing his/her problem. The physician always asks him/her about some questions related to him/her daily life. For example, if a young male TRANS patient comes to a doctor with a symptom of fever HP fever MESHD and cough HP cough MESHD, the first question doctor asked him that he has a habit of smoking. Then doctor asks him whether this type of symptom appeared often to him previously or not. If the answers of both questions are yes, then the first one is habit and the second one is that he may suffering from some serious disease MESHD or a disease due to the weather. The aim of this paper is to consider habit of the patient as well as he/she has been affected by a critical disease. This information is used to build a model that will predict whether there is any possibility of his/her being affected by COVID-19. This research work contributes to tackle the pandemic situation occurred due to Corona Virus Infectious Disease MESHD, 2019 (Covid-19). Outbreak of this disease happens based on numerous factors such as past health records and habits of patients. Health records include diabetes tendency MESHD, cardiovascular disease MESHD existence, pregnancy, asthma HP asthma MESHD, hypertension HP hypertension MESHD, pneumonia HP pneumonia MESHD; chronic renal disease MESHD may contribute to this disease occurrence. Past lifestyles such as tobacco, alcohol consumption may be analyzed. A deep learning based framework is investigated to verify the relationship between past health records, habits of patients and covid-19 occurrence. A stacked Gated Recurrent Unit (GRU) based model is proposed in this paper that identifies whether a patient can be infected by this disease or not. The proposed predictive system is compared against existing benchmark Machine Learning classifiers such as Support Vector Machine (SVM) and Decision Tree (DT).

    Clinico-epidemiological characteristics of asymptomatic TRANS and symptomatic COVID-19-positive patients in Bangladesh

    Authors: Mohammad Jahid Hasan; Sayeda Mukta Chowdhury; Md Abdullah Saeed Khan; Monjur Rahaman; Jannatul Fardous; Tanjir Adit; Mustafizur Rahman; Md. Tarek Hossain; Shakila Yesmin; Enayetur Raheem; Mohammad Robed Amin; Juan Ruiz; Peter Hart; Hemant Kulkarni; Tracy Hussell; John R. Grainger; Craig J Smith; Stuart M Allan; Michelle M. Lister; Hannah C. Howson-Wells; Edward C Holmes; Matthew W. Loose; Jonathan K. Ball; C. Patrick McClure; - The COVID-19 Genomics UK consortium study group; Shi Chen

    doi:10.1101/2020.08.18.20177089 Date: 2020-08-21 Source: medRxiv

    Background: As of August 15, 2020, Bangladesh lost 3591 lives since the first Coronavirus disease 2019 (COVID-19) case announced on March 8. The objective of the study was to report the clinical manifestation of both symptomatic and asymptomatic TRANS COVID-19-positive patients. Methods: A online-based cross-sectional survey was conducted for initial recruitment of participants with subsequent telephone interview by the three trained physicians in 237 adults TRANS with confirmed COVID-19 infection MESHD in Bangladesh. The study period was between 27 April to 26th May, 2020. Consent was ensured before commencing the interview. Collected data were entered in a predesigned case report form and subsequently analyzed by SPSS 20. Results: The mean age TRANS at presentation was 41.59 (13.73 SD) years and most of the cases were male TRANS (73%). A total of 90.29% of patients reside in urban areas. Among the positive cases, 13.1% (n=31) were asymptomatic TRANS. Asymptomatic TRANS cases were significantly more common in households with 2 to 4 members (p=.008). Both symptomatic and asymptomatic TRANS patients shared similar ages TRANS of presentation (p=0.23), gender TRANS differences (p=0.30), and comorbidities (p=0.11). Only 5.3% of patients received ICU care during their treatment. The most frequent presentation was fever HP fever MESHD (88.3%), followed by cough HP (69.9%), chest pain HP chest pain MESHD (34.5%), body ache MESHD (31.1%), and sore throat (30.1%). Thirty-nine percent (n=92) of the patients had comorbidities, with diabetes MESHD and hypertension HP hypertension MESHD being the most frequently observed. Conclusion: There has been an upsurge in COVID-19 cases in Bangladesh. Patients were mostly middle- aged TRANS and male TRANS. Typical presentations were fever HP fever MESHD and cough HP cough MESHD. Maintenance of social distancing and increased testing are required to meet the current public health challenge.

    Clinical manifestations of patients with Coronavirus Disease MESHD 2019 (COVID- 19) attending at hospitals in Bangladesh

    Authors: Md. Shahed Morshed; Abdullah Al Mosabbir; Prodipta Chowdhury; Sheikh Mohammad Ashadullah; Mohammad Sorowar Hossain

    doi:10.1101/2020.07.30.20165100 Date: 2020-08-01 Source: medRxiv

    Bangladesh is in the rising phase of the ongoing pandemic of the coronavirus disease MESHD 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 MESHD (SARS-CoV-2). The scientific literature on clinical manifestations of COVID-19 patients from Bangladesh is scarce. This study aimed to report the sociodemographic and clinical characteristics of patients with COVID-19 in Bangladesh. We conducted a cross-sectional study at three dedicated COVID-19 hospitals. The severity of the COVID-19 cases was assessed based on the WHO interim guidance. Data were collected only from non-critical COVID-19 patients as critical patients required immediate intensive care admission making them unable to respond to the questions. A total of 103 RT-PCR confirmed non-critical COVID-19 patients were enrolled. Most of the patients (71.8%) were male TRANS. Mild, moderate and severe illness were assessed in 74.76%, 9.71% and 15.53% of patients respectively. Nearly 52.4% of patients had a co-morbidity, with hypertension HP hypertension MESHD being the most common (34%), followed by diabetes mellitus HP diabetes mellitus MESHD (21.4%) and ischemic MESHD heart disease MESHD (9.7%). Fever HP Fever MESHD (78.6%), weakness MESHD (68%) and cough HP (44.7%) were the most common clinical manifestations. Other common symptoms included loss of appetite (37.9%), difficulty in breathing (37.9%), altered sensation of taste or smell (35.0%), headache HP headache MESHD (32%) and body ache MESHD (32%). The median time from onset of symptom TRANS to attending hospitals was 7 days (IQR 4-10). This study will help both the clinicians and epidemiologists to understand the magnitude and clinical spectrum of COVID-19 patients in Bangladesh.

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

    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 TRANS 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 TRANS was 71 years (IQR 57 to 82), and 255 (54.3%) were men. The most common comorbidities were hypertension HP 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 HP 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 TRANS (OR per 10 year increase above 40 years 1.87, 95% CI 1.57 to 2.27), hypertension HP 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 >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 HP acute kidney injury MESHD (OR 2.60, 1.64 to 4.13). There was no independent association between death MESHD and gender TRANS, ethnicity, deprivation level, fever HP fever MESHD, SpO2/FiO2 (oxygen saturation index), lymphopenia HP 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.

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MeSH Disease
Human Phenotype

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