Corpus overview


Overview

MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    Burden and prevalence SERO of risk factors for severe COVID-19 disease in the ageing European population – A SHARE-based analysis

    Authors: Linda Juel Ahrenfeldt; Camilla Riis Nielsen; Sören Möller; Kaare Christensen; Rune Lindahl-Jacobsen

    doi:10.21203/rs.3.rs-73657/v1 Date: 2020-09-07 Source: ResearchSquare

    Aim: International health authorities suggest that individuals aged TRANS 65 years and above and people with underlying comorbidities such as hypertension HP hypertension MESHD, chronic lung disease HP lung disease MESHD, cardiovascular disease MESHD, cancer MESHD, diabetes MESHD, and obesity HP obesity MESHD are at increased risk of severe Coronavirus Disease MESHD 2019 (COVID-19); however, the prevalence SERO of risk factors is unknown in many countries. Therefore, we aim to describe the distribution of these risk factors across Europe. Subject and Methods: Prevalence SERO of risk factors for severe COVID-19 was identified based on interview for 73,274 Europeans aged TRANS 50+ participating in the Survey of Health, Ageing and Retirement in Europe (SHARE) in 2017. Burden of disease was estimated using population data from Eurostat. Results: A total of 75.3% of the study population (corresponding to app. 60 million European men and 71 million women) had at least one risk factor for severe COVID-19, 45.9% (app. 36 million men and 43 million women) had at least two factors and 21.2% (app. 17 million men and 20 million women) had at least three risk factors. The prevalences SERO of underlying medical conditions ranged from 4.5% for cancer MESHD to 41.4% for hypertension HP hypertension MESHD, and the region-specific prevalence SERO of having at least three risk factors ranged from 18.9% in Northern Europe to 24.6% in Eastern Europe. Conclusions: Information about the prevalences SERO of risk factors might help authorities to identify the most vulnerable subpopulations with multiple risk factors of severe COVID-19 disease MESHD and thus to decide appropriate strategies to mitigate the pandemic.  

    Comorbidities associated with regional variations in COVID-19 mortality revealed by population-level analysis

    Authors: Hongxing Yang; Fei Zhong

    doi:10.1101/2020.07.27.20158105 Date: 2020-07-29 Source: medRxiv

    Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 MESHD (SARS-Cov-2), has developed into a global health crisis. Understanding the risk factors for poor outcomes of COVID-19 is thus important for successful management and control of the pandemic. However, the progress and severity of the epidemic across different regions show great differentiations. We hypothesized the origination of these differences are based on location-dependent variations in underlying population-wide health factors. Disease prevalence SERO or incidence data of states and counties of the United States were collected for a group of chronic diseases MESHD, including hypertension HP hypertension MESHD, diabetes MESHD, obesity HP obesity MESHD, stroke HP stroke MESHD, coronary heart disease MESHD, heart failure MESHD, physical inactivation, and common cancers MESHD (e.g., lung, colorectal MESHD, stomach, kidney and renal MESHD). Correlation and regression analysis identified the prevalence SERO of heart failure MESHD as a significant positive factor for region-level COVID-19 mortality. Similarly, the incidence of gastric cancer MESHD and thyroid cancer MESHD were also identified as significant factors contributing to regional variation in COVID-19 mortality. To explore the implications of these results, we re-analyzed the RNA-seq data for stomach adenocarcinoma MESHD ( STAD MESHD) and colon carcinoma MESHD carcinoma HP ( COAD MESHD) from The Cancer Genome Atlas (TCGA) project. We found that expression of genes in the immune response pathways were more severely disturbed in STAD MESHD than in COAD, implicating higher probability for STAD MESHD patients or individuals with precancerous chronic stomach diseases MESHD to develop cytokine storm once infected with COVID-19. Taken together, we conclude that location variations in particular chronic diseases MESHD and cancers MESHD contribute significantly to the regional variations in COVID-19 mortality.

    A Bayesian Framework for Estimating the Risk Ratio of Hospitalization for People with Comorbidity Infected by the SARS-CoV-2 Virus

    Authors: Xiang Gao; Qunfeng Dong

    doi:10.1101/2020.07.25.20162131 Date: 2020-07-28 Source: medRxiv

    Estimating the hospitalization risk for people with certain comorbidities infected by the SARS-CoV-2 virus is important for developing public health policies and guidance based on risk stratification. Traditional biostatistical methods require knowing both the number of infected people MESHD who were hospitalized and the number of infected people MESHD who were not hospitalized. However, the latter may be undercounted, as it is limited to only those who were tested for viral infection MESHD. In addition, comorbidity information for people not hospitalized may not always be readily available for traditional biostatistical analyses. To overcome these limitations, we developed a Bayesian approach that only requires the observed frequency of comorbidities in COVID-19 patients in hospitals and the prevalence SERO of comorbidities in the general population. By applying our approach to two different large-scale datasets in the U.S., our results consistently indicated that cardiovascular diseases MESHD carried the highest hospitalization risk for COVID-19 patients, followed by diabetes MESHD, chronic respiratory disease MESHD, hypertension HP hypertension MESHD, and obesity HP obesity MESHD, respectively.

    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.

    Higher Comorbidities and Early Death is Characteristic of Hospitalized African-American Patients with COVID-19

    Authors: Raavi Gupta; Raag Agrawal; Zaheer Bukhari; Absia Jabbar; Donghai Wang; John Diks; Mohamed Alshal; Dokpe Yvonne Emechebe; F. Charles Brunicardi; Jason M Lazar; Robert Chamberlain; Aaliya Burza; M. A. Haseeb

    doi:10.1101/2020.07.15.20154906 Date: 2020-07-16 Source: medRxiv

    Background African-Americans/Blacks have suffered higher morbidity and mortality from COVID-19 than all other racial groups. This study aims to identify the causes of this health disparity, determine prognostic indicators, and assess efficacy of treatment interventions. Method We performed a retrospective cohort study of clinical features and laboratory data of COVID-19 patients admitted over a five-week period at the height of the pandemic in the United States. This study was performed at an urban academic medical center in New York City, declared a COVID-only facility, serving a majority Black population Result Of the 1,070 consecutive patients who tested positive for COVID-19, 496 critically ill patients were hospitalized and included in the study. 88% of patients were Black; and a majority (53%) were 61-80 years old with a mean body mass index in the ' obese MESHD' range. 97% had one or more comorbidities. Hypertension HP Hypertension MESHD was the most common (84%) pre-existing condition followed by diabetes mellitus HP diabetes mellitus MESHD (57%) and chronic kidney disease HP chronic kidney disease MESHD (24%). Patients with chronic kidney disease HP chronic kidney disease MESHD and end-stage renal disease MESHD who received hemodialysis were found to have significantly lower mortality, then those who did not receive it, suggesting benefit from hemodialysis (11%, OR, 0.35, CI, 0.17 - 0.69 P=0.001). Age TRANS >60 years and coronary artery disease MESHD were independent predictors of mortality in multivariate analysis. Cox Proportional Hazards modeling for time to death MESHD demonstrated a significantly high ratio for COPD MESHD/ Asthma HP, and favorable effects on outcomes for pre-admission ACE inhibitors and ARBs. CRP (180, 283 mg/L), LDH (551, 638 U/L), glucose (182, 163 mg/dL), procalcitonin (1.03, 1.68 ng/mL), and neutrophil / lymphocyte ratio (8.5, 10.0) were predictive of mortality on admission and at 48-96 hrs. Of the 496 inpatients, 48% died, one third of patients died within the first three days of admission. 54/488 patients received invasive mechanical ventilation, of which 87% died and of the remaining patients, 32% died. CONCLUSIONS COVID-19 patients in our predominantly Black neighborhood had higher mortality, likely due to higher prevalence SERO of comorbidities. Early dialysis and pre-admission intake of ACE inhibitors/ARBs improved patient outcomes. Early escalation of care based on comorbidities and key laboratory indicators is critical for improving outcomes in African-American patients.

    The COVID-19 mortality effects of underlying health conditions in India: a modelling study

    Authors: Paul Novosad; Radhika Jain; Alison Campion; Sam Asher

    doi:10.1101/2020.07.05.20140343 Date: 2020-07-08 Source: medRxiv

    Objective: To model how known COVID-19 comorbidities will affect mortality rates and the age TRANS distribution of mortality in a large lower middle income country (India), as compared with a high income country (England), and to identify which health conditions drive any differences. Design: Modelling study. Setting: England and India. Participants: 1,375,548 respondents aged TRANS 18 to 99 to the District Level Household Survey-4 and Annual Health Survey in India. Additional information on health condition prevalence SERO on individuals aged TRANS 18 to 99 was obtained from the Health Survey for England and the Global Burden of Diseases, Risk Factors, and Injuries Studies (GBD). Main outcome measures: The primary outcome was the proportional increase in age TRANS-specific mortality in each country due to the prevalence SERO of each COVID-19 mortality risk factor ( diabetes MESHD, hypertension HP hypertension MESHD, obesity HP obesity MESHD, chronic heart disease MESHD, respiratory illness MESHD, kidney disease MESHD, liver disease MESHD, and cancer MESHD, among others). The combined change in overall mortality and the share of deaths under 60 from the combination of risk factors was estimated in each country. Results: Relative to England, Indians have higher rates of diabetes MESHD (10.6% vs. 8.5%), chronic respiratory disease MESHD (4.8% vs. 2.5%), and kidney disease MESHD (9.7% vs. 5.6%), and lower rates of obesity HP obesity MESHD (4.4% vs. 27.9%), chronic heart disease MESHD (4.4% vs. 5.9%), and cancer MESHD (0.3% vs. 2.8%). Population COVID-19 mortality in India relative to England is most increased by diabetes MESHD (+5.4%) and chronic respiratory disease MESHD (+2.3%), and most reduced by obesity HP obesity MESHD (-9.7%), cancer MESHD (-3.2%), and chronic heart disease MESHD (-1.9%). Overall, comorbidities lower mortality in India relative to England by 9.7%. Accounting for demographics and population health explains a third of the difference in share of deaths under age TRANS 60 between the two countries. Conclusions: Known COVID-19 health risk factors are not expected to have a large effect on aggregate mortality or its age TRANS distribution in India relative to England. The high share of COVID-19 deaths from people under 60 in low- and middle-income countries (LMICs) remains unexplained. Understanding mortality risk associated with health conditions prevalent in LMICs, such as malnutrition HP malnutrition MESHD and HIV MESHD/ AIDS MESHD, is essential for understanding differential mortality. Keywords: COVID-19, India, low- and middle-income countries, comorbidity

    A phenome-wide association study (PheWAS) of COVID-19 outcomes by race using the electronic health records data in Michigan Medicine

    Authors: Maxwell Salvatore; Tian Gu; Jasmine A. Mack; Swaraaj Prabhu Sankar; Snehal Patil; Thomas S. Valley; Karandeep Singh; Brahmajee K. Nallamothu; Sachin Kheterpal; Lynda Lisabeth; Lars G. Fritsche; Bhramar Mukherjee

    doi:10.1101/2020.06.29.20141564 Date: 2020-07-01 Source: medRxiv

    Blacks/African Americans are overrepresented in the number of hospitalizations and deaths from COVID-19 in the United States, which could be explained through differences in the prevalence SERO of existing comorbidities. We performed a disease-disease MESHD phenome-wide association study (PheWAS) using data representing 5,698 COVID-19 patients from a large academic medical center, stratified by race. We explore the association of 1,043 pre-occurring conditions with several COVID-19 outcomes: testing positive, hospitalization, ICU admission, and mortality. Obesity HP Obesity MESHD, iron deficiency anemia HP iron deficiency anemia MESHD and type II diabetes were associated with susceptibility in the full cohort, while ill-defined descriptions/complications of heart disease MESHD and stage III chronic kidney disease HP kidney disease MESHD were associated among non-Hispanic White (NHW) and non-Hispanic Black/African American (NHAA) patients, respectively. The top phenotype hits in the full, NHW, and NHAA cohorts for hospitalization were acute renal failure MESHD, hypertension HP hypertension MESHD, and insufficiency/arrest respiratory failure MESHD arrest respiratory HP failure, respectively. Suggestive relationships between respiratory issues and COVID-19-related ICU admission and mortality were observed, while circulatory system diseases showed stronger association in NHAA patients. We were able to replicate some known comorbidities related to COVID-19 outcomes while discovering potentially unknown associations, such as endocrine/metabolic conditions related to hospitalization and mental disorders MESHD related to mortality, for future validation. We provide interactive PheWAS visualization for broader exploration.

    National Smoking Rates Correlate Inversely with COVID-19 Mortality

    Authors: Michael J Norden; David H. Avery; Justin G Norden; David R Haynor

    doi:10.1101/2020.06.12.20129825 Date: 2020-06-14 Source: medRxiv

    ABSTRACT Introduction: Recent studies show cigarette smokers are markedly under-represented among patients hospitalized for COVID-19 in over a dozen countries. It is unclear if this may be related to confounding factors such as age TRANS distribution, access to care, and inaccurate records. We hypothesized that these concerns could be avoided by studying smoking prevalence SERO in relation to COVID-19 mortality. Since climate has been identified as a factor in COVID-19, we studied groups of countries with relatively comparable temperatures. Methods: The 20 hottest and 20 coldest countries in the Johns Hopkins Mortality Analysis database with a minimum mortality rate of .3 deaths/100,000 were selected on the basis of the average temperatures of their largest city. Mortality rates were determined as of May 1, 2020 and correlated with national smoking rate adjusting for sex ratio, obesity HP obesity MESHD, temperature, and elderly TRANS population. Results: A highly significant inverse correlation between current daily smoking prevalence SERO and COVID-19 mortality rate was noted for the group of hot countries (R=-.718, p = .0002), cold countries (R=-.567, p=.0046), and the combined group (R=-.324, p=.0207). However, after adjustments only the regression for hot countries and the combined group remained significant. In hot countries, for each percentage point increase in smoking rate mortality decreased by .147 per 100,000 population (95% CI .102- 192, p=.0066). This resulted in mortality rates several-fold elevated in the countries with the lowest smoking rates relative to the highest smoking rates. In the combined group, mortality decreased by .257 per 100,000 population (95% CI .175-.339, p=.0034). Discussion: These findings add support to the finding of an inverse relationship between current smoking and seriously symptomatic COVID-19. However, we conclude that the difference in mortality between the highest and lowest smoking countries appears too large to be due primarily to the effects of smoking per se. A potentially beneficial effect of smoking is surprising, but compatible with a number of hypothetical mechanisms which deserve exploration: 1) Studies show smoking alters ACE2 expression which may affect COVID-19 infection MESHD or its progression to serious lung pathology. 2) Nicotine has anti-inflammatory activity and also appears to alter ACE2 expression. 3) Nitric oxide in cigarette smoke is known to be effective in treating pulmonary hypertension MESHD hypertension HP and has shown in vitro antiviral effects including against SARS-CoV-2. 4) Smoking has complicated effects on the immune system involving both up and down regulation, any of which might alone or in concert antagonize progression of COVID-19. 5) Smokers are exposed to hot vapors which may stimulate immunity in the respiratory tract by various heat-related mechanisms (e.g. heat shock HP proteins). Studies of steam and sauna treatments have shown efficacy in other viral respiratory conditions. At this time there is no clear evidence that smoking is protective against COVID-19, so the established recommendations to avoid smoking should be emphasized. The interaction of smoking and COVID-19 will only be reliably determined by carefully designed prospective study, and there is reason to believe that there are unknown confounds that may be spuriously suggesting a protective effect of smoking. However, the magnitude of the apparent inverse association of COVID-19 and smoking and its myriad clinical implications suggest the importance of further investigation.

    Risk and protective factors of SARS-CoV-2 infection MESHD - Meta-regression of data from worldwide nations

    Authors: Hisato Takagi; Toshiki Kuno; Yujiro Yokoyama; Hiroki Ueyama; Takuya Matsushiro; Yosuke Hari; Tomo Ando

    doi:10.1101/2020.06.06.20124016 Date: 2020-06-07 Source: medRxiv

    Although it has been reported that coexistent chronic diseases MESHD are strongly associated with COVID-19 severity, investigations of predictors for SARS-CoV-2 infection MESHD itself have been seldom performed. To screen potential risk and protective factors for SARS-CoV-2 infection MESHD, meta-regression of data from worldwide nations were herein conducted. We extracted total confirmed COVID-19 cases in worldwide 180 nations (May 31, 2020), nation total population, population ages TRANS 0-14/65 and above, GDP/GNI per capita, PPP, life expectancy at birth, medical-doctor and nursing/midwifery-personnel density, hypertension HP hypertension MESHD/ obesity HP obesity MESHD/ diabetes MESHD prevalence SERO, annual PM2.5 concentrations, daily ultraviolet radiation, population using safely-managed drinking-water/sanitation services and hand-washing facility with soap/water, inbound tourism, and bachelor's MESHD or equivalent (ISCED 6). Restricted maximum-likelihood meta-regression in the random-effects model was performed using Comprehensive Meta-Analysis version 3. To adjust for other covariates, we conducted the hierarchical multivariate models. A slope (coefficient) of the meta-regression line for the COVID-19 prevalence SERO was significantly negative for population ages TRANS 0-14 (-0.0636; P = .0021) and positive for obesity HP obesity MESHD prevalence SERO (0.0411; P = .0099) and annual PM2.5 concentrations in urban areas (0.0158; P = .0454), which would indicate that the COVID-19 prevalence SERO decreases significantly as children TRANS increase and that the COVID-19 prevalence SERO increases significantly as the obese MESHD and PM2.5 increase. In conclusion, children TRANS (negatively) and obesity HP obesity MESHD/PM2.5 (positively) may be independently associated with SARS-CoV-2 infection MESHD.

    Characteristics and risk factors for COVID-19 diagnosis and adverse outcomes in Mexico: an analysis of 89,756 laboratory-confirmed COVID-19 cases

    Authors: Theodoros Giannouchos; Roberto Sussman; Jose Manuel Mier; Konstantinos Poulas; Konstantinos Farsalinos

    doi:10.1101/2020.06.04.20122481 Date: 2020-06-05 Source: medRxiv

    Background: There is insufficient information about risk factors for COVID-19 diagnosis and adverse outcomes from low and middle-income countries (LMICs). Objectives: We estimated the association between patients characteristics and COVID-19 diagnosis, hospitalization and adverse outcome in Mexico. Methods: This retrospective case series used a publicly available nation-level dataset released on May 31, 2020 by the Mexican Ministry of Health, with patients classified as suspected cases of viral respiratory disease MESHD. Patients with COVID-19 were laboratory-confirmed. Their profile was stratified by COVID-19 diagnosis or not. Differences among COVID-19 patients based on two separate clinical endpoints, hospitalization and adverse outcome, were examined. Multivariate logistic regressions examined the associations between patient characteristics and hospitalization and adverse outcome. Results: Overall, 236,439 patients were included, with 89,756 (38.0%) being diagnosed with COVID-19. COVID-19 patients were disproportionately older, males TRANS and with increased prevalence SERO of one or more comorbidities, particularly diabetes MESHD, obesity HP obesity MESHD, and hypertension HP hypertension MESHD. Age TRANS, male TRANS gender TRANS, diabetes MESHD, obesity HP obesity MESHD and having one or more comorbidities were independently associated with laboratory-confirmed COVID-19. Current smokers were 23% less likely to be diagnosed with COVID-19 compared to non-smokers. Of all COVID-19 patients, 34.8% were hospitalized and 13.0% experienced an adverse outcome. Male TRANS gender TRANS, older age TRANS, having one or more comorbidities, and chronic renal disease MESHD, diabetes MESHD, obesity HP obesity MESHD, COPD, immunosuppression and hypertension HP hypertension MESHD were associated with hospitalization and adverse outcome. Current smoking was not associated with adverse outcome. Conclusion: This largest ever case series of COVID-19 patients identified risk factors for COVID-19 diagnosis, hospitalization and adverse outcome. The findings could provide insight for the priorities the need to be set, especially by LMICs, to tackle the pandemic.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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