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MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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     Seroprevalence of SARS-CoV-2 in an Asymptomatic TRANS US Population 

    Authors: Steven Rigatti, MD; Robert L. Stout, PhD.

    doi:10.21203/rs.3.rs-80313/v1 Date: 2020-09-18 Source: ResearchSquare

    Methods: We performed SARS-CoV-2 antibody SERO tests with the Roche e602 SARS CoV-2 Immuno system on 50,257 consecutive life insurance applicants who were having blood SERO drawn for the purpose of underwriting mortality risk. Other variables included height, weight, and blood SERO pressure at the time of the blood SERO draw, a history of smoking and common ch ronic diseases ( MESHD hypertension HP pertension, MESHDhe art disease, MESHDdi abetes, MESHDand ca ncer). MESHDResults: The overall prevalence SERO of SARS-CoV-2 was 3.0%, and was fairly consistent across the age TRANS range and similar in males TRANS and females TRANS. Geographical distribution revealed a very high level of positivity in the state of New York compared to all other areas (17.1%). Using US Census state population data to adjust state specific rates of positivity, it is estimated that this level of seropositivity would correspond to 6.98 million (99% CI: 6.56-7.38 million) SA RS-CoV-2 infections i MESHDn the US, which is 3.8 times the cumulative number of cases in the US reported to the CDC as of June 1, 2020.Conclusions: The estimated number of total SA RS-CoV-2 infections b MESHDased on positive serology is substantially higher than the total number of cases reported to the CDC. There is no apparent increase of risk of infection TRANS risk of infection TRANS fection f MESHDor individuals self-reporting, smoking, di abetes, MESHDhe art disease, MESHD hypertension HP pertension o MESHDr ca ncer. MESHD

    SARS-CoV-2 Antibody SERO Prevalence SERO and Association with Routine Laboratory Values in a Life Insurance Applicant Population

    Authors: Steven J. Rigatti; Robert Stout; Ruth E Mitchell; Michael V Holmes; George Davey Smith; Dominik Schulz; Ulrich Mayr; Jochen Schneider; Christoph Spinner; Fabian Geisler; Roland M. Schmid; Tobias Lahmer; Wolfgang Huber; Xiushan Yin; Arsen Arakelyan; Denise Haslwanter; Rohit Jangra; Alev Celikgil; Duncan Kimmel; James H Lee; Margarette Mariano; Antonio Nakouzi; Jose Quiroz; Johanna Rivera; Wendy A Szymczak; Karen Tong; Jason Barnhill; Mattias NE Forsell; Clas Ahlm; Daniel T. Stein; Liise-anne Pirofski; Doctor Y Goldstein; Scott J. Garforth; Steven C. Almo; Johanna P. Daily; Michael B. Prystowsky; James D. Faix; Amy S. Fox; Louis M. Weiss; Jonathan R. Lai; Kartik Chandran

    doi:10.1101/2020.09.09.20191296 Date: 2020-09-11 Source: medRxiv

    Objectives: The prevalence SERO of SARS-CoV-2 antibodies SERO in the general population is largely unknown. Since many infections MESHD, even among the elderly TRANS and other vulnerable populations, are asymptomatic TRANS, the prevalence SERO of antibodies SERO could help determine how far along the path to herd immunity the general population has progressed. Also, in order to clarify the clinical manifestations of current or recent past COVID-19 illness, it may be useful to determine if there are any common alterations in routine clinical laboratory values. Methods: We performed SARS-CoV-2 antibody SERO tests on 50,130 consecutive life insurance applicants who were having blood SERO drawn for the purpose of underwriting (life risk assessment). Subjects were also tested for lipids, liver function tests, renal function studies, as well as serum SERO proteins. Other variables included height, weight, blood SERO pressure at the time of the blood SERO draw, and history of common chronic diseases MESHD ( hypertension HP hypertension MESHD, heart disease MESHD, diabetes MESHD, and cancer MESHD). Results: The overall prevalence SERO of SARS-CoV-2 was 3.0%, and was fairly consistent across the age TRANS range and similar in males TRANS and females TRANS. Several of the routine laboratory tests obtained were significantly different in antibody SERO-positive vs. antibody SERO-negative subjects, including albumin, globulins, bilirubin, and the urine albumin:creatinine ratio. The BMI was also significantly higher in the antibody SERO-positive group. Geographical distribution revealed a very high level of positivity in the state of New York compared to all other areas (17.1%). Using state population data from the US Census, it is estimated that this level of seropositivity would correspond to 6.98 million (99% CI: 6.56-7.38 million) SARS-CoV-2 infections MESHD in the US, which is 3.8 times the cumulative number of cases in the US reported to the CDC as of June 1, 2020. Conclusions: The estimated number of total SARS-CoV-2 infections MESHD based on positive serology is substantially higher than the total number of cases reported to the CDC. Certain laboratory values, particularly serum SERO protein levels, are associated with positive serology, though these associations are not likely to be clinically meaningful.

    A Comprehensive Evaluation of Early Predictors of Disease MESHD Progression in Patients with COVID-19: A Case Control Study

    Authors: Qiang Tang; Yanwei Liu; Yingfeng Fu; Ziyang Di; Kailiang Xu; Bo Tang; Hui Wu; Maojun Di

    doi:10.21203/rs.3.rs-50527/v1 Date: 2020-07-29 Source: ResearchSquare

    Background: The 2019 coronavirus disease MESHD (COVID-19) has become an unprecedented public health crisis with nearly 16 million confirmed cases TRANS and 630,000 deaths worldwide. Methods: We retrospectively investigated the demographic, clinical, laboratory, radiological and treatment data of COVID-19 patients consecutively enrolled from January 18 to May 15, 2020, in Taihe and Jinzhou central hospital. Results: Of all 197 patients, the median age TRANS was 66.5 years (IQR 7-76), and 120 (60.9%) patients were males TRANS. We identified 88 (44.7%) of 197 COVID-19 patients as the disease progression (aggravation) cases. The aggravation cases tend to have more medical comorbidity: hypertension HP hypertension MESHD (34.1%), diabetes MESHD (30.7%), and presented with dyspnea HP dyspnea MESHD (34.1%), neutrophilia HP (60.2%), and lymphocytopenia MESHD (73.9%), compared with those without. And the patients with disease progression showed significantly higher level of Fibrinogen (Fbg), D-dimer, IL-6, C-reactive protein (CRP), procalcitonin (PCT), and serum SERO ferritin, and were more prone to develop organ damage in the liver, kidney, and heart (P<0.05). Multivariable regression showed that advanced age TRANS, comorbidities, lymphopenia HP lymphopenia MESHD, and elevated level of Fbg, lactate dehydrogenase (LDH), Cardiac troponin (CTnI), IL-6, serum SERO ferritin were the significant predictors of disease progression. Further, we investigated antibody SERO responses to SARS-CoV-2 and found that the levels of IgM and IgG were significantly higher in the disease progression cases compared to non-progression cases from 3 weeks after symptom onset TRANS. In addition, the disease progression group tended to peak later and has a more vigorous IgM/IgG response against SARS-CoV-2. Further, we performed Kaplan-Meier analysis and found that 61.6% of patients had not experienced ICU transfer or survival from hospital within 25 days from admission.Conclusions: Investigating the potential factors of advanced age TRANS, comorbidities and elevated level of IL-6, serum SERO ferritin and Kaplan-Meier analysis enables early identification and management of patients with poor prognosis. Detection of the dynamic antibody SERO may offer vital clinical information during the course of SARS-CoV-2 and provide prognostic value for patients infection MESHD.  

    Placental SARS-CoV-2 in a patient with mild COVID-19 disease

    Authors: Albert L. Hsu; Minhui Guan; Eric Johannesen; Amanda J. Stephens; Nabila Khaleel; Nikki Kagan; Breanna C. Tuhlei; Xiu-Feng Wan

    doi:10.1101/2020.07.11.20149344 Date: 2020-07-14 Source: medRxiv

    Background: The full impact of COVID-19 on pregnancy remains uncharacterized. Current literature suggests minimal maternal, fetal, and neonatal morbidity and mortality,1 and COVID-19 manifestations appear similar between pregnant and non-pregnant women.2 We present a case of placental SARS-CoV-2 virus in a woman with an uncomplicated pregnancy and mild COVID-19 disease. Methods: A pregnant woman was evaluated at University of Missouri Women and Childrens Hospital. Institutional review board approval was obtained; information was obtained from medical records. Reverse transcriptase-polymerase chain reaction (RT-PCR) was performed to detect SARS-CoV-2. A gynecological pathologist examined the placenta and performed histolopathology. Sections were formalin-fixed and paraffin-embedded; slides were cut and subjected to hematoxylin-and-eosin or immunohistochemistry (IHC) staining. IHC was performed with specific monoclonal antibodies SERO to detect SARS-CoV-2 antigen or to identify trophoblasts. Findings: A 29 year-old multigravida presented at 40-4/7 weeks for labor induction. With myalgias HP myalgias MESHD two days prior, she tested positive for SARS-CoV-2. Her parents TRANS were in self-isolation for COVID-19 positivity; husband was asymptomatic TRANS and tested negative for COVID-19, but exposed to a workplace (meatpacking facility) outbreak. Prenatal course was uncomplicated, with no gestational hypertension HP hypertension MESHD. She was afebrile and asymptomatic TRANS with normal vital signs throughout hospitalization. Her myalgias HP myalgias MESHD improved prior to admission. A liveborn male TRANS infant was delivered vaginally. Newborn course was uneventful; he was appropriate for gestational age TRANS, physical was unremarkable, and he was discharged home at 36 hours. COVID-19 RT-PCR test was negative at 24 hours. At one-week follow-up, newborn was breastfeeding well, with no fevers HP or respiratory distress HP. Overall placental histology is consistent with acute uterine hypoxia MESHD (subchorionic laminar necrosis MESHD) superimposed on chronic uterine hypoxia MESHD (extra-villous trophoblasts and focal chronic villitis MESHD). IHC using SARS-CoV-2 nucleocapsid-specific monoclonal antibody SERO demonstrated SARS-CoV-2 antigens throughout the placenta in chorionic villi endothelial cells, and rarely in CK7-expressing trophoblasts. Negative control placenta (November 2019 delivery) and ferret nasal turbinate tissues (not shown) were negative for SARS-CoV-2. Interpretation: In this report, SARS-CoV-2 was found in the placenta, but newborn was COVID-19 negative. Our case shows maternal vascular malperfusion, with no features of fetal vascular malperfusion. To our knowledge, this is the first report of placental COVID-19 despite mild COVID-19 disease in pregnancy (with no symptoms of COVID-19 aside from myalgias HP myalgias MESHD); specifically, this patient had no fever HP fever MESHD, cough HP cough MESHD, or shortness of breath MESHD, but only myalgias HP myalgias MESHD and sick contacts. Despite her having mild COVID-19 disease in pregnancy, we demonstrate placental vasculopathy MESHD and presence of SARS-CoV-2 virus across the placenta. Evidence of placental COVID-19 raises concern for possible placental vasculopathy MESHD (potentially leading to fetal growth restriction, pre- eclampsia HP eclampsia MESHD, and other pregnancy complications) as well as for potential vertical transmission TRANS -- especially for pregnant women who may be exposed to COVID-19 in early pregnancy. Further studies are urgently needed, to determine whether women with mild, pre-symptomatic, or asymptomatic TRANS COVID-19 may have SARS-CoV-2 virus that can cross the placenta, cause fetal vascular malperfusion, and possibly affect the fetus. This raises important public health and public policy questions of whether future pregnancy guidance should include stricter pandemic precautions, such as screening for a wider array of COVID-19 symptoms, increased antenatal surveillance, and possibly routine COVID-19 testing on a regular basis throughout pregnancy.

    A tertiary center experience of multiple myeloma HP multiple myeloma MESHD patients with COVID-19: lessons learned and the path forward

    Authors: Bo Wang; Oliver Van Oekelen; Tarek Mouhieddine; Diane Marie Del Valle; Joshua Richter; Hearn Jay Cho; Shambavi Richard; Ajai Chari; Sacha Gnjatic; Miriam Merad; Sundar Jagannath; Samir Parekh; Deepu Madduri

    doi:10.1101/2020.06.04.20122846 Date: 2020-06-05 Source: medRxiv

    Background: The COVID-19 pandemic, caused by SARS-CoV-2 virus, has resulted in over 100,000 deaths in the United States. Our institution has treated over 2,000 COVID-19 patients during the pandemic in New York City. The pandemic directly impacted cancer MESHD patients and the organization of cancer MESHD care. Mount Sinai Hospital has a large and diverse multiple myeloma HP myeloma MESHD ( MM MESHD) population. Herein, we report the characteristics of COVID-19 infection MESHD and serological response in MM MESHD patients in a large tertiary care institution in New York. Methods: We performed a retrospective study on a cohort of 58 patients with a plasma SERO-cell disorder (54 MM MESHD, 4 smoldering MM MESHD) who developed COVID-19 between March 1, 2020 and April 30, 2020. We report epidemiological, clinical and laboratory characteristics including persistence of viral detection by polymerase chain reaction (PCR) and anti- SARS-CoV-2 antibody SERO testing, treatments initiated, and outcomes. Results: Of the 58 patients diagnosed with COVID-19, 36 were hospitalized and 22 were managed at home. The median age TRANS was 67 years; 52% of patients were male TRANS and 63% were non-white. Hypertension HP Hypertension MESHD (64%), hyperlipidemia HP hyperlipidemia MESHD (62%), obesity HP obesity MESHD (37%), diabetes mellitus HP diabetes mellitus MESHD (28%), chronic kidney disease HP chronic kidney disease MESHD (24%) and lung disease MESHD (21%) were the most common comorbidities. In the total cohort, 14 patients (24%) died. Older age TRANS (>70 years), male TRANS sex, cardiovascular risk, and patients not in complete remission (CR) or stringent CR were significantly (p<0.05) associated with hospitalization. Among hospitalized patients, laboratory findings demonstrated elevation of traditional inflammatory markers (CRP, ferritin, D-dimer) and a significant (p<0.05) association between elevated inflammatory markers, severe hypogammaglobulinemia MESHD, non-white race, and mortality. Ninety-six percent (22/23) of patients developed antibodies to SARS-CoV-2 SERO at a median of 32 days after initial diagnosis. Median time to PCR negativity was 43 (range 19-68) days from initial positive PCR. Conclusions: Drug exposure and MM MESHD disease status at the time of contracting COVID-19 had no bearing on mortality. Mounting a severe inflammatory response to SARS-CoV-2 and severe hypogammaglobulinemia MESHD were associated with higher mortality. The majority of patients mounted an antibody SERO response to SARS-CoV-2. These findings pave a path to identification of vulnerable MM MESHD patients who need early intervention to improve outcome in future outbreaks of COVID-19.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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