Corpus overview


MeSH Disease

Human Phenotype


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    Association of Initial Symptoms or Comorbidities With Pneumonia HP Pneumonia MESHD Lesions in COVID-19 Patients: Based on Artificial Intelligence-Enabled CT Quantitation

    Authors: Fangzhengyuan Yuan; Chuan Liu; Jie Yang; Hu Tan; Shizhu Bian; Xubin Gao; Jihang Zhang; Mingdong Hu; Renzheng Chen; Yang Shen; Jingbin Ke; Yuanqi Yang; Chunyan He; Ran Cheng; Lan Huang

    doi:10.21203/ Date: 2020-09-15 Source: ResearchSquare

    Background: Coronavirus disease 2019 (COVID-19) patients with a larger ratio of pneumonia HP pneumonia MESHD lesions are more likely to progress to acute respiratory distress syndrome MESHD respiratory distress HP syndrome and death MESHD. This study aimed to investigate the relationship of baseline parameters with pneumonia HP pneumonia MESHD lesions on admission, as quantified by an artificial intelligence (AI) algorithm using computed tomography (CT) images. Methods: This retrospective study quantitatively assessed lung lesions on CT using an AI algorithm in 1630 consecutive patients confirmed with COVID-19 on admission and classified the patients into none (0%), mild (>0–25%), intermediate (>25–50%), and severe (>50%) groups, according to the lesion ratio of the whole lung. A multivariate linear regression model was established to explore the relationship between the lesion ratio and laboratory parameters. The baseline parameters associated with lung lesions MESHD, including demographics, initial symptoms, and comorbidities, were determined using a multivariate ordinal regression model. Results: The 1630 patients confirmed with COVID-19 had a median whole lung lesion ratio of 4.1%, and the right lower lung lobe had the most lesions among the five lung lobes based on the evaluation of CT using AI algorithm. The whole lung lesion ratio was associated with the levels of plasma SERO fibrinogen (r=0.280, p<0.001), plasma SERO D-dimer (r=0.248, p<0.001), serum SERO α-hydroxybutyrate dehydrogenase (r=0.363, p<0.001), serum SERO albumin (r=-0.300, p<0.001), and peripheral blood SERO leukocyte count (r=0.194, p<0.001). Among the four patients groups categorised by whole lung lesion ratio, the highest frequency of cough HP (p<0.001) and shortness of breath MESHD (p<0.001) were found in the severe group, and the highest frequency of hypertension HP hypertension MESHD (p<0.001), diabetes MESHD (p<0.001) and anemia HP anemia MESHD (p=0.039) were observed in the intermediate group. Based on baseline ordinal regression analysis, cough HP (p=0.009), shortness of breath MESHD (p<0.001), hypertension HP hypertension MESHD (p=0.002), diabetes MESHD (p=0.005), and anemia HP anemia MESHD (p=0.006) were independent risk factors for more severe lung lesions MESHD. Conclusions: Based on AI-enabled CT quantitation, patients with initial symptoms of cough HP cough MESHD/ shortness of breath MESHD, or with comorbidities of hypertension HP hypertension MESHD, diabetes MESHD, or anemia HP anemia MESHD, had a higher risk for more severe lung lesions on admission in COVID-19 patients.

    Respiratory Rehabilitation After Blood SERO Transfusion in a COVID-19 Patient: A Case Report

    Authors: Mohammad Javad Mousavi; Narges Obeidi; Saeed keshmiri; Farzan Azodi; Jamile Kiyani; Farhad Abbasi

    doi:10.21203/ Date: 2020-09-15 Source: ResearchSquare

    Background: The coronavirus disease MESHD 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2), has been identified as the most crucial threat of the century. Due to severe pneumonia HP pneumonia MESHD and acute respiratory distress syndrome MESHD respiratory distress HP syndrome ( ARDS MESHD), the SARS-CoV-2 can cause shortness of breath MESHD, hypoxemia HP hypoxemia MESHD, and the need to mechanical ventilation, intensive care unit (ICU) management, and eventual death MESHD. We have tried to use a non-invasive approach to prevent patient from needing respiratory support with invasive ventilation (IV). Here, for the first time, improvement of oxygen delivery and oxygen saturation levels were observed in a COVID-19 patient using packed red blood SERO cells (PRBCs) transfusion.Case presentation: A 63-year-old man with a history of smoking and addiction who came to our hospital facility with fever HP fever MESHD, shortness of breath MESHD and decreased blood SERO oxygen saturation. High-resolution chest CT revealed bilateral and multifocal ground-glass opacities consistent with COVID-19. Subsequently, the COVID-19 infection was confirmed TRANS infection was confirmed MESHD by real-time polymerase chain reaction (qRT-PCR) assay of the upper respiratory tract. Conclusions: Oxygen delivery and oxygen saturation improvement were observed in the COVID-19 patient, after PRBCs transfusions.

    Proposal of selective wedge instillation of pulmonary surfactant for COVID-19 pneumonia HP pneumonia MESHD based on computational fluid dynamics simulation

    Authors: Hiroko Kitaoka; Hisato Kobayashi; Takayuki Takimoto; Takashi Kijima

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

    Background: The most important target cell of SARS-CoV-2 is Type II pneumocyte which produces and secretes pulmonary MESHD surfactant (PS) that prevents alveolar MESHD collapse. PS instillation therapy is dramatically effective for infant respiratory distress HP respiratory distress MESHD syndrome but has been clinically ineffective for ARDS. Nowadays, ARDS is regarded as non-cardiogenic pulmonary edema HP pulmonary edema MESHD with vascular hyper-permeability regardless of direct relation to PS dysfunction. However, there is a possibility that the ineffectiveness of PS instillation for ARDS is due to insufficient delivery MESHD. Then, we performed PS instillation simulation with realistic human airway models by the use of computational fluid dynamics, and investigated how instilled PS would move in the liquid layer covering the airway wall and reach to alveolar regions MESHD.Methods: Two types of 3D human airway model were prepared: One was from the trachea to lobular bronchi and the other was from a sub-segmental bronchus to respiratory bronchioles. Thickness of the liquid layer covering the airway was assigned as 14 % of the inner radius of the airway segment. Initially existing liquid layer was assumed to be replaced by instilled PS. Flow rate of instilled PS was assigned a constant value, which was determined by the total amount and instillation time in clinical use. The PS concentration of the liquid layer during instillation was computed by solving advective-diffusion equation.Results: The driving pressure from the trachea to respiratory bronchioles was calculated at 317 cmH2O, which is about 20 times of a standard value in conventional PS instillation method where the driving pressure is given by difference between inspiratory and end-expiratory pressures of a ventilator. It means that almost all PS would not reach alveolar MESHD regions but move to and fro within the airway according to the change of ventilator pressure. On the other hand, the driving pressure from sub-segmental bronchus was calculated at 273 cm H2O, that is clinically possible by wedge instillation under bronchoscopic observation. Conclusions: The simulation study has revealed that selective wedge instillation under bronchoscopic observation should be tried for COVID-19 pneumonia HP pneumonia MESHD even before ARDS. It will be also useful for preventing secondary lung fibrosis MESHD

    Bacterial pulmonary superinfections are associated with unfavourable outcomes in critically ill COVID-19 patients

    Authors: Philipp K Buehler; Annelies S Zinkernagel; Daniel Andrea Hofmaenner; Pedro David Wendel Garcia; Claudio T Acevedo; Alejandro Gomez-Mejia; Srikanth Mairpady Shambat; Federica Andreoni; Maibach Maibach; Jan Bartussek; Matthias Hilty; Pascal M Frey; Reto A Schuepbach; Silvio Daniel Brugger

    doi:10.1101/2020.09.10.20191882 Date: 2020-09-11 Source: medRxiv

    Objectives While superinfections are associated with unfavourable disease course, their impact on clinical outcomes in critically ill COVID-19 patients remains largely unknown. We aimed to investigate the burden of superinfections in COVID-19 patients. Methods In this prospective single centre cohort study in an intensive care setting patients aged TRANS [≥] 18 years with COVID-19 acute respiratory distress syndrome MESHD respiratory distress HP syndrome were assessed for concomitant microbial infections by longitudinal analysis of tracheobronchial secretions, bronchoalveolar lavages and blood SERO. Our primary outcome was ventilator-free survival on day 28 in patients with and without clinically relevant superinfection. Further outcomes included the association of superinfection with ICU length of stay, incidence of bacteremia HP bacteremia MESHD, viral reactivations, and fungal colonization MESHD. Results In 45 critically ill COVID-19 patients, we identified 19 patients with superinfections (42.2%) by longitudinal analysis of 433 TBS, 35 BAL and 455 blood SERO samples, respectively. On average, superinfections were detected on day 10 after ICU admission. The most frequently isolated clinically relevant bacteria were Enterobacteriaceae, Streptococcus pneumoniae HP, and Pseudomonas aeruginosa. Ventilator-free survival was substantially lower in patients with superinfection (subhazard ratio 0.37, 95%-CI 0.15-0.90, p=0.028). Patients with pulmonary superinfections more often had bacteraemia, virus reactivations, yeast colonization, and needed ICU treatment for a significantly longer time. Conclusions The detection of superinfections was frequent and associated with reduced ventilator-free survival. Despite empirical antibiotic therapy, superinfections lead to an extended ICU stay in COVID 19 patients. Longitudinal microbiological sampling in COVID-19 patients could allow targeted antimicrobial therapy, and therefore minimize the use of broad-spectrum and reserve antibiotics.

    G6PD deficiency MESHD and severity of COVID19 pneumonia HP pneumonia MESHD and acute respiratory distress syndrome MESHD respiratory distress HP syndrome: tip of the iceberg?

    Authors: Jihad G. Youssef; Faisal Zahiruddin; George Youssef; Sriram Padmanabhan; Joe Ensor; Sai Ravi Pingali; Youli Zu; Sandeep Sahay; Swaminathan P. Iyer

    doi:10.21203/ Date: 2020-09-05 Source: ResearchSquare

    The severe pneumonia HP pneumonia MESHD caused by human coronavirus (hCoV)-SARS-CoV-2 has inflicted heavy causalities, especially among the elderly TRANS and those with comorbid illnesses irrespective of age TRANS. The high mortality in African Americans and males TRANS, in general, raises concern for a possible X-linked mediated process that could affect viral pathogenesis and the immune system. We hypothesized that G6PD, the most common X-linked enzyme deficiency MESHD associated with redox status, may have a role in the severity of pneumonia HP pneumonia MESHD. A retrospective chart review was performed in hospitalized patients with COVID19 pneumonia HP pneumonia MESHD needing supplemental oxygen. A total of 17 patients were evaluated: six with G6PD deficiency MESHD and 11 with normal levels. The two groups (normal and G6PD def) were comparable in terms of age TRANS, sex and comorbidities and laboratory parameters LDH, IL-6, CRP, and ferritin. Thirteen patients needed ventilatory support, with 6 in the G6PD group (83% vs. 72%). The main differences indicating increasing severity in the G6PD def group included G6PD levels (12.2 vs. 5.6, P=0.0002), PaO2/FiO2 ratio (159 vs. 108, P=0.05), days before intubation (2.5 vs. 4.8 P= 0.03), days on mechanical ventilation (10.25 vs. 21 days P=0.04), hemoglobin level (10 vs. 8.1 P=0.03) and hematocrit (32 vs. 26 P=0.015). Only one patient with G6PD deficiency MESHD died; 16 were discharged home. Our clinical series ascribes a possible biological role for G6PD deficiency MESHD in SARS-CoV2 viral proliferation. It is imperative that further studies be performed to understand the interplay between the viral and host factors in G6PD deficiency MESHD that may lead to disparity in outcomes. 

    COVID-19 and Multisystem Inflammatory Syndrome MESHD in Latin American children TRANS: a multinational study

    Authors: Omar Yassef Antunez-Montes; Maria Isabel Escamilla; Augusto Flavio Figueroa-Uribe; Erick Arteaga-Menchaca; Manuel Lavariega-Sarachaga; Perla Salcedo-Lozada; Priscilla Melchior; Rodrigo Berea de Oliveira; Juan Carlos Tirado Caballero; Hernando Pinzon Redondo; Laura Vanessa Montes Fontalvo; Roger Hernandez; Carolin Chavez; Francisco Eduardo Campos; Fadia Uribe; Olguita del Aguila; JORGE ALBERTO RIOS AIDA; Andrea Parra Buitrago; Lina Maria Betancur Londono; Leon Felipe Mendoza Vega; Carolina Almeida Hernandez; Michela Sali; JULIAN HIGUITA PALACIO; Jessica Gomez-Vargas; Adriana Yock Corrales; Danilo Buonsenso

    doi:10.1101/2020.08.29.20184242 Date: 2020-09-02 Source: medRxiv

    Background To date, there are no comprehensive data on pediatric COVID19 from Latin America. This study aims to assess COVID-19 and Multisystem Inflammatory Syndrome MESHD (MIS C) in Latin American children TRANS, in order to appropriately plan and allocate resources to face the pandemic on a local and International lever Methods Ambispective multicentre cohort study from five Latin American countries. Children TRANS aged TRANS 18 years or younger with microbiologically confirmed SARS CoV 2 infection MESHD were included. Findings 409 children TRANS were included, with a median age TRANS of 53.0 years (IQR 0.6 9.0). Of these, 95 191 (23.2%) were diagnosed with MIS C. 191 (46.7%) children TRANS were admitted to hospital and 52 (12.7%) required admission to a Pediatric Intensive Care Unite (PICU). 92 (22.5%) patients required oxygen support: 8 (2%) were started on continuous positive airway pressure (CPAP) and 29 (7%) on mechanical ventilation. 35 (8.5%) patients required inotropic support. The following factors were associated with PICU admission: pre-existing medical condition (P < 0.0001), immunodeficiency HP immunodeficiency MESHD (P = 0.01), lower respiratory tract infection HP respiratory tract infection MESHD (P< 0.0001), gastrointestinal symptoms MESHD (P = 0.006), radiological changes suggestive of pneumonia HP pneumonia MESHD and acute respiratory distress syndrome MESHD respiratory distress HP syndrome (P< 0.0001), low socioeconomic conditions (P 0.009). Conclusions This study shows a generally more severe form of COVID 19 and a high number of MIS C in Latin American children TRANS, compared with studies from China, Europe and North America, and support current evidence of a more severe disease in Latin/Hyspanic children TRANS or in people of lower socioeconomic level. The findings highlight an urgent need of more data of COVID 19 in South America.

    Machine Learning and Meta-Analysis Approach to Identify Patient Comorbidities and Symptoms that Increased Risk of Mortality in COVID-19

    Authors: Sakifa Aktar; Ashis Talukder; Md. Martuza Ahamad; A. H. M. Kamal; Jahidur Rahman Khan; Md. Protikuzzaman; Nasif Hossain; Julian M. W. Quinn; Mathew A. Summers; Teng Liaw; Valsamma Eapen; Mohammad Ali Moni

    id:2008.12683v1 Date: 2020-08-21 Source: arXiv

    Background: Providing appropriate care for people suffering from COVID-19, the disease caused by the pandemic SARS-CoV-2 virus is a significant global challenge. Many individuals who become infected have pre-existing conditions that may interact with COVID-19 to increase symptom severity and mortality risk. COVID-19 patient comorbidities are likely to be informative about individual risk of severe illness and mortality. Accurately determining how comorbidities are associated with severe symptoms and mortality would thus greatly assist in COVID-19 care planning and provision. Methods: To assess the interaction of patient comorbidities with COVID-19 severity and mortality we performed a meta-analysis of the published global literature, and machine learning predictive analysis using an aggregated COVID-19 global dataset. Results: Our meta-analysis identified chronic obstructive pulmonary disease HP obstructive pulmonary disease MESHD ( COPD MESHD), cerebrovascular disease MESHD ( CEVD MESHD), cardiovascular disease MESHD ( CVD MESHD), type 2 diabetes MESHD, malignancy MESHD, and hypertension HP hypertension MESHD as most significantly associated with COVID-19 severity in the current published literature. Machine learning classification using novel aggregated cohort data similarly found COPD MESHD, CVD MESHD, CKD, type 2 diabetes MESHD, malignancy MESHD and hypertension HP hypertension MESHD, as well as asthma HP, as the most significant features for classifying those deceased versus those who survived COVID-19. While age TRANS and gender TRANS were the most significant predictor of mortality, in terms of symptom-comorbidity combinations, it was observed that Pneumonia HP Pneumonia MESHD- Hypertension HP, Pneumonia HP Pneumonia MESHD-Diabetes and Acute Respiratory Distress HP Respiratory Distress MESHD Syndrome ( ARDS MESHD)- Hypertension HP Hypertension MESHD showed the most significant effects on COVID-19 mortality. Conclusions: These results highlight patient cohorts most at risk of COVID-19 related severe morbidity and mortality which have implications for prioritization of hospital resources.

    Acute Tuberculosis pneumonia MESHD pneumonia HP and COVID-19 in a patient vaccinated with Bacille Calmette-Guérin (BCG)

    Authors: Michelangelo Luciani; Enrico Bentivegna; Valerio Spuntarelli; Ludovica Guerritore; Dario Chiappino; Gabriele Nalli; Maria Proietta; Flavia Del Porto; Paolo Martelletti; Giorgio Sesti

    doi:10.21203/ Date: 2020-08-14 Source: ResearchSquare

    COVID-19 is a respiratory tract infection HP respiratory tract infection MESHD caused by the new coronavirus SARS-COV2, that can be complicated by acute distress respiratory syndrome MESHD distress respiratory HP syndrome and multiorgan failure MESHD. In light of the high rate of mortality associated with COVID-19, pharmacological and non-pharmacological strategies to prevent the infection MESHD are currently being tested. Among non-pharmacological preventive measures, vaccines represent one of the main resources for public health. It has been suggested that Bacille Calmette-Guérin (BCG) vaccine may protect individuals against infection from COVID-19 virus, and two clinical trials addressing this question are underway. Here, we report the case of a 32-year old woman, vaccinated with BCG when she was 1 year old, who was diagnosed with apical tuberculous pneumonia MESHD pneumonia HP of the right lung along with COVID 19 pneumonia HP pneumonia MESHD.

    Clinical characteristics and post-intensive care outcomes of COVID-19 pneumonia HP pneumonia MESHD.

    Authors: Neil MD Cody; Samuel M Lakey; Sean M McMahon; Megan K Downey; Megan S Duncan; Julie-Anne Hewitt; Calum B Simpson; Martin J Duffy; Rosalind F O’Reilly; Paul Johnston; Jonathan A Silversides; Belfast COVID ICU Group

    doi:10.21203/ Date: 2020-08-13 Source: ResearchSquare

    Background: COVID-19 can result in a severe viral pneumonia MESHD pneumonia HP, with high reported mortality rates in patients requiring mechanical ventilation. There is controversy as to whether established therapeutic approaches to acute respiratory distress syndrome MESHD respiratory distress HP syndrome are optimal in this condition, and numerous novel therapies have been used, often outside the context of randomised trials. In addition, longer term quality of life outcomes associated with COVID-19 are as yet unknown. The aim of this case series is to describe demographic, physiological and outcome data of patients with COVID-19 admitted to our intensive care units who were treated according to evidence-based guidelines for acute respiratory distress syndrome MESHD respiratory distress HP syndrome.Methods: We retrospectively reviewed the records of all patients admitted to intensive care units in our institution with COVID-19 between March and June, 2020. Physiological and laboratory data were recorded at baseline and daily until intensive care discharge or death MESHD. Quality of life was assessed at a virtual post-intensive care follow-up clinic around 10 weeks after ICU discharge.Results: 45 patients with COVID-19 were included, 37 (82.2%) of whom were male TRANS, with a mean age TRANS of 55 years. 42 (93.3%) of this cohort met criteria for acute respiratory distress syndrome MESHD respiratory distress HP syndrome at time of admission. Clinical management was consistent with evidence based institutional guidelines introduced for acute respiratory distress syndrome MESHD respiratory distress HP syndrome. Median length of intensive care stay was 14 days. The intensive care mortality rate was 8.9%. Functional and psychological morbidity post intensive care was significant: 45.2% of respondents had at least moderate impairment of mobility and 35.5% described at least moderate symptoms of anxiety HP anxiety MESHD or depression MESHD at the time of follow up.Conclusions : This case series demonstrates low mortality in a cohort of patients treated according to an established evidence-based approach for acute respiratory distress syndrome MESHD respiratory distress HP syndrome. However, COVID-19 survivors have a marked functional and psychological morbidity impacting quality of life following ICU admission. The therapeutic goal in the future will be to achieve similar survival outcomes while minimizing the significant morbidity associated with COVID-19 related critical care admission.

    Clinical course, biomarkers, management and outcomes of patients hospitalised due to COVID-19 in Colombia

    Authors: Nancy Yomayusa; Kelly Rocío Chacón Acevedo; Adriana Janeth Avila Reina; Karen Lorena Rincón; Carlos Hernando Toloza; Olga Gomez Gomez; Eduardo Low Padilla; Juan Felipe Combariza Vallejo; Johana Vargas Rodriguez; Emilio Herrera Molina; Sandra Yadira Moreno Marin; Carlos Arturo Álvarez Moreno

    doi:10.21203/ Date: 2020-08-12 Source: ResearchSquare

    Background: Coronavirus disease (COVID-19) represents an unprecedented challenge for both people and health systems. Latin America is the current epicentre of the pandemic; however, there is little published clinical information on the clinical characteristics and outcomes.Objective: To analyse the clinic characteristics, risk factors and evolution of the first cohort of hospitalised patients with confirmed infection TRANS by COVID-19 in 5 Colombian institutions.Methods: In the present retrospective observational study, information was acquired from consecutive hospitalized patients with a diagnosis of COVID-19 confirmed by real-time reverse transcriptase polymerase chain reaction (RT-PCR) from March 01 to May 30, 2020 in Colombia.Results: A total of 44 patients were included. The median age TRANS was 62 years, and 65.9% of the patients were male TRANS. A total of 69.8% of the patients were overweight HP or obese MESHD, and 13.6% of the patients had high blood SERO pressure and diabetes MESHD. The presence of systemic symptoms and cough HP cough MESHD were the most common. Ground-glass opacity was frequent finding upon chest imaging. The 30-day mortality rate was 47.7% with a median of 11 days. The composite outcome (critical care requirement, mechanical ventilation and death MESHD) occurred in 36.4% of the patients. The biomarkers associated with mortality risk included troponin higher than 14 ng/L (RR: 5.25; 95% CI 1.37-20.1, p = 0.004) and D-dimer higher than 1000 ng/ml (RR: 3.0; 95% CI 1.4-6.3, p = 0.008). Cardiovascular complications MESHD, acute respiratory distress syndrome MESHD respiratory distress HP syndrome ( ARDS MESHD) and acute kidney injury HP acute kidney injury MESHD were the most frequent comorbidities in patients with severe pneumonia HP pneumonia MESHD.Conclusion: The clinical course of SARS-CoV-2 infection MESHD diagnosis confirmed by RT-PCR in Colombian patients admitted to a high-complexity hospital was similar to that reported in the literature; however, the population was characterised by a more advanced stage of the infection MESHD

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MeSH Disease
Human Phenotype

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