Corpus overview


Overview

MeSH Disease

Human Phenotype

Fever (3)

Fatigue (3)

Myalgia (3)

Arthralgia (3)

Cough (3)


Transmission

Seroprevalence

There are no seroprevalence terms in the subcorpus

    displaying 1 - 3 records in total 3
    records per page




    Azithromycin with nitazoxanide, hydroxychloroquine or ivermectin, with or without dutasteride, for early stage COVID-19: an open-label prospective observational study in males TRANS with mild-to-moderate COVID-19 (The Pre-AndroCoV Male TRANS Trial).

    Authors: Flavio A Cadegiani; Andy Goren; Carlos G Wambier; John McCoy

    doi:10.21203/rs.3.rs-88952/v2 Date: 2020-10-07 Source: ResearchSquare

    Background: COVID-19 is a multisystemic disorder MESHD caused by SARS-CoV-2 that has led to more than 1,000,000 deaths until the end of September 2020. Besides aging, obesity HP obesity MESHD, and metabolic diseases MESHD, males TRANS, in particular those affected by androgenetic alopecia HP (AGA), are at higher risk to develop complications. While policies for diagnosis of COVID-19 still focus on the presence of fever HP fever MESHD or shortness of breath MESHD, these symptoms tend to appear only in later and more severe stages of the disease, when viral infectivity is already, hampering potential antiviral approaches. In addition, clinical characterization of early COVID-19 stages still lacks. The objective of the present observational study was to characterize prospectively clinical features and predictors in males TRANS during early COVID-19, and to evaluate whether the combination of more sensitive case-detection, early diagnosis and early pharmacological approaches would lead to improved clinical outcomes.Material and methods: Males TRANS confirmed for COVID-19 through positive real-time polymerase chain reaction (rtPCR) for SARS-CoV-2 with less than seven days of symptoms and three days of COVID-19 confirmation were divided into non-AGA, AGA not using dutasteride (AGA no-5ARi), and AGA using dutasteride (AGA-5ARi) groups. Patients were actively characterized for baseline and lifestyle characteristics, 22 different diseases, 42 drug classes and vaccines, 26 different symptoms, and 10 different parameters to measure COVID-19 related clinical outcomes. Azithromycin plus hydroxychloroquine, nitazoxanide 500mg or ivermectin, with or without dutasteride or spironolactone were used. Patients were then evaluated for COVID-19 clinical course, duration, and progression.Results:  A total of 305 males TRANS were enrolled, including 192 non-AGA, 71 AGA non-ARi and 52 AGA-5ARi. The prevailing symptoms were anosmia HP (68.9%), ageusia (61.2%), headache (37.5%), hyporexia (37.5%), fatigue HP (35.2%), dry cough (35.2%), fever HP or “feverish” (33.9%), thoracic pain HP (32.4%), conjunctival hyperemia (29.5%), weakness (29.5%), nasal congestion or rhinorrhea HP (28.6% and myalgia HP (26.3%). ARi users remained asymptomatic TRANS throughout COVID-19 treatment in 82.7% (43 of 52 males TRANS), and the only symptoms present in more than two AGA-5ARi patients were anosmia HP and ageusia. Thoracic, upper back, lower back pain HP, arthralgia HP affected a higher percentage of AGA no-5ARi than non-AGA males TRANS (all p < 0.01), but had similar durations (p = n/s). Anosmia HP, ageusia, headache HP, fatigue HP, myalgia HP and conjunctival hyperemia HP were more commonly present and lasted for longer periods in AGA no 5ARi patients (all p < 0.01). Self-reported perception of “sinusitis” and “sore throat”, dry cough HP and weakness were equally present (p = n/s) but had longer duration in AGA no-5ARi males TRANS (all p < 0.01).The different drug combinations were equally distributed (p > 0.05). AGA males TRANS were more severely affected than non-AGA in terms of duration of clinical manifestations (9.4 ± 6.0 vs 14.2 ± 7.3 days, p < 0.0001) and viral shedding (14.0 ± 5.2 vs 17.8 ± 6.2 days; p < 0.0001), which has been fully mitigated by the chronic use of dutasteride (p < 0.0001 and < 0.0001 vs non-AGA and AGA no-5ARi, respectively, for both clinical manifestations and viral shedding duration. Non-AGA, AGA no-5ARi and AGA-5ARi achieved 95% clinical recovery in seven, 14, and two days, respectively. In regards functional capacity, AGA no -5ARi males TRANS at Days 30, 14, 7, and 3 after treatment initiation were similar than non-AGA at Days 14, 7, 3, and 0, respectively (all p > 0.9). None of the patients required hospitalization and mechanical ventilation, or progressed to more severe states.Conclusion: The combination of more sensitive and earlier diagnosis of COVID-19 with  a variety of drug combinations with preliminary demonstration of direct or indirect antiviral activity against SARS-CoV-2 demonstrated indisputable improved COVID-19 related clinical outcomes compared to the extensively described COVID-19 clinical course, and avoided the progression to more severe state in all patients included in the present analysis, independently of risk factors, demonstrating that any additional risk factor can be completely mitigated by the combination of more sensitive clinical suspect with early pharmacological approaches.The overwhelming differences indicate that full placebo control RCTs for early COVID-19 may be ethically questionable. Instead, double blind therapies with different options, or mixed open label placebo control for COVID-19 should be considered.

    Azithromycin with nitazoxanide, hydroxychloroquine or ivermectin, with or without dutasteride, for early stage COVID-19: an open-label prospective observational study in males TRANS with mild-to-moderate COVID-19 (The Pre-AndroCoV Male TRANS Trial).

    Authors: Flavio A Cadegiani; Andy Goren; Carlos G Wambier; John McCoy

    doi:10.21203/rs.3.rs-88952/v1 Date: 2020-10-07 Source: ResearchSquare

    Background: COVID-19 is a multisystemic disorder MESHD caused by SARS-CoV-2 that has led to more than 1,000,000 deaths until the end of September 2020. Besides aging, obesity HP obesity MESHD, and metabolic diseases MESHD, males TRANS, in particular those affected by androgenetic alopecia HP (AGA), are at higher risk to develop complications. While policies for diagnosis of COVID-19 still focus on the presence of fever HP fever MESHD or shortness of breath MESHD, these symptoms tend to appear only in later and more severe stages of the disease, when viral infectivity is already, hampering potential antiviral approaches. In addition, clinical characterization of early COVID-19 stages still lacks. The objective of the present observational study was to characterize prospectively clinical features and predictors in males TRANS during early COVID-19, and to evaluate whether the combination of more sensitive case-detection, early diagnosis and early pharmacological approaches would lead to improved clinical outcomes. Material and methods: Males confirmed for COVID-19 through positive real-time polymerase chain reaction (rtPCR) for SARS-CoV-2 with less than seven days of symptoms and three days of COVID-19 confirmation were divided into non-AGA, AGA not using dutasteride (AGA no-5ARi), and AGA using dutasteride (AGA-5ARi) groups. Patients were actively characterized for baseline and lifestyle characteristics, 22 different diseases, 42 drug classes and vaccines, 26 different symptoms, and 10 different parameters to measure COVID-19 related clinical outcomes. Azithromycin plus hydroxychloroquine, nitazoxanide 500mg or ivermectin, with or without dutasteride or spironolactone were used. Patients were then evaluated for COVID-19 clinical course, duration and progression.Results:  A total of 305 males TRANS were enrolled, including 192 non-AGA, 71 AGA non-ARi and 52 AGA-5ARi. The prevailing symptoms were anosmia HP (68.9%), ageusia (61.2%), headache  (37.5%), hyporexia  (37.5%), fatigue HP (35.2%), dry cough  (35.2%), fever HP or “feverish” (33.9%), thoracic pain HP (32.4%), conjunctival hyperemia  (29.5%), weakness (29.5%), nasal congestion or rhinorrhea (28.6% and myalgia HP (26.3%). ARi users remained asymptomatic TRANS throughout COVID-19 treatment in 82.7% (43 of 52 males TRANS), and the only symptoms present in more than two patients were anosmia HP and ageusia. Thoracic, upper back, lower back pain HP, arthralgia HP affected a higher percentage of AGA no-5ARi than non-AGA males TRANS (all p < 0.01), but had similar durations (p = n/s). Anosmia HP, ageusia, headache HP, fatigue HP, myalgia HP and conjunctival hyperemia HP were more commonly present and lasted for longer periods in AGA no 5ARi patients (all p < 0.01). Self-reported perception of “sinusitis” and “sore throat”, dry cough HP and weakness were equally present (p = n/s) but had longer duration in AGA no-5ARi males TRANS (all p < 0.01).The different drug were equally distributed. AGA males TRANS were more severely affected than non-AGA in terms of duration of clinical manifestations (9.4 ± 6.0 vs 14.2 ± 7.3 days, p < 0.0001) and viral shedding (14.0 ± 5.2 vs 17.8 ± 6.2 days; p < 0.0001), which has been fully mitigated by the chronic use of dutasteride (p < 0.0001 and < 0.0001 vs non-AGA and AGA no-5ARi, respectively, for both clinical manifestations and viral shedding duration. Non-AGA, AGA no-5ARi and AGA-5ARi achieved 95% clinical recovery in seven, 14, and two days, respectively. In regards functional capacity, AGA no -5ARi males TRANS at Days 30, 14, 7, and 3 after treatment initiation were similar than non-AGA at Days 14, 7, 3, and 0, respectively (all p > 0.9). None of the patients required hospitalization and mechanical ventilation, or progressed to more severe states. Conclusion: The combination of more sensitive and earlier diagnosis of COVID-19 with  a variety of drug combinations with preliminary demonstration of direct or indirect antiviral activity against SARS-CoV-2 demonstrated indisputable improved COVID-19 related clinical outcomes compared to the extensively described COVID-19 clinical course, and avoided the progression to more severe state in all patients included in the present analysis, independently of risk factors, demonstrating that any additional risk factor can be completely mitigated by the combination of more sensitive clinical suspect with early pharmacological approaches.The overwhelming differences indicate that full placebo control RCTs for early COVID-19 may be ethically questionable. Instead, double blind therapies with different options, or mixed open label placebo control for COVID-19 should be considered.

    Epidemiological and clinical features of 2019-nCoV acute respiratory disease cases in Chongqing municipality, China: a retrospective, descriptive, multiple-center study

    Authors: Di Qi; Xiaofeng Yan; Xumao Tang; Junnan Peng; Qian Yu; Longhua Feng; Guodan Yuan; An Zhang; Yaokai Chen; Jing Yuan; Xia Huang; Xianxiang Zhang; Peng Hu; Yuyan Song; Chunfang Qian; Qiangzhong Sun; Daoxin Wang; Jin Tong; Jianglin Xiang

    doi:10.1101/2020.03.01.20029397 Date: 2020-03-03 Source: medRxiv

    BackgroundIn January 19, 2020, first case of 2019 novel coronavirus (2019-nCoV) pneumonia HP (COVID-19) was confirmed in Chongqing municipality, China. MethodsIn this retrospective, descriptive, multiple-center study, total of 267 patients with COVID-19 confirmed by real-time RT-PCR in Chongqing from Jan 19 to Feb 16, 2020 were recruited. Epidemiological, demographic, clinical, radiological characteristics, laboratory examinations, and treatment regimens were collected on admission. Clinical outcomes were followed up until Feb 16, 2020. Results267 laboratory-confirmed COVID-19 patients admitted to 3 designated-hospitals in Chongqing provincial municipality from January 19 to February 16, 2020 were enrolled and categorized on admission. 217 (81.27%) and 50 (18.73%) patients were categorized into non-severe and severe subgroups, respectively. The median age TRANS of patients was 48.0 years (IQR, 35.0-65.0), with 129 (48.3%) of the patients were more than 50 years of age TRANS. 149 (55.8%) patients were men. Severe patients were significantly older (median age TRANS, 71.5 years [IQR, 65.8-77.0] vs 43.0 years [IQR, 32.5-57.0]) and more likely to be male TRANS (110 [50.7%] vs 39 [78.0%]) and have coexisting disorders (15 [30.0%] vs 26 [12.0%]). 41 (15.4%) patients had a recent travel TRANS to Hubei province, and 139 (52.1%) patients had a history of contact with patients from Hubei. On admission, the most common symptoms of COVID-19 were fever HP 225(84.3%), fatigue HP (208 [77.9%]), dry cough HP (189 [70.8%]), myalgia HP or arthralgia HP (136 [50.9%]). Severe patients were more likely to present dyspnea HP (17 [34.0%] vs 26 [12.0%]) and confusion HP (10 [20.0%] vs 15 [6.9%]). Rales (32 [12.0%]) and wheezes (20 [7.5%]) are not common noted for COVID-19 patients, especially for the non-severe (11 [5.1%], 10 [4.6%]). 118 (44.2%). Most severe patients demonstrated more laboratory abnormalities. 231 (86.5%), 61 (22.8%) patients had lymphopenia HP, leukopenia HP and thrombocytopenia HP, respectively. CD4+ T cell counts decrease HP was observed in 77.1 % of cases, especially in the severe patients (45, 100%). 53.1% patients had decreased CD+3 T cell counts, count of CD8+T cells was lower than the normal range in part of patients (34.4%). More severe patients had lower level of CD4+ T cells and CD+3 T cells (45 [100.0%] vs 29[56.9%], 31 [68.9%] vs 20 [39.2%]). Most patients had normal level of IL-2, IL-4, TNF- and INF-{gamma}, while high level of IL-6 and IL-17A was common in COVID-19 patients (47 [70.1%], 35 [52.2%]). Level of IL-6, IL-17A and TNF- was remarkably elevated in severe patients (32 [84.2%] vs 15 [51.7%], 25 [65.8%] vs 10 [34.5%], 17 [44.7%] vs 5 [17.2%]). All patients received antiviral therapy (267, 100%). A portion of severe patients (38, 76.0%) received systemic corticosteroid therapy. Invasive mechanical ventilation in prone position, non-invasive mechanical ventilation, high-flow nasal cannula oxygen therapy was adopted only in severe patients with respiratory failure HP (5[10.0%], 35[70.0%], 12[24.0%]). Traditional Chinese medicine was adopted to most of severe patients (43,86.0%). Conclusion:Our study firstly demonstrated the regional disparity of COVID-19 in Chongqing municipality and further thoroughly compared the differences between severe and non-severe patients. The 28-day mortality of COVID-19 patients from 3 designed hospitals of Chongqing is 1.5%, lower than that of Hubei province and mainland China including Hubei province. However, the 28-mortality of severe patients was relatively high, with much higher when complications occurred. Notably, the 28-mortality of critically severe patients complicated with severe ARDS is considerably as high as 44.4%. Therefore, early diagnosis and intensive care of critically severe COVID-19 cases, especially those combined with ARDS, will be considerably essential to reduce mortality.

The ZB MED preprint Viewer preVIEW includes all COVID-19 related preprints from medRxiv and bioRxiv, from ChemRxiv, from ResearchSquare, from arXiv and from Preprints.org and is updated on a daily basis (7am CET/CEST).
The web page can also be accessed via API.

Sources


Annotations

All
None
MeSH Disease
Human Phenotype
Transmission
Seroprevalence


Export subcorpus as...

This service is developed in the project nfdi4health task force covid-19 which is a part of nfdi4health.

nfdi4health is one of the funded consortia of the National Research Data Infrastructure programme of the DFG.