Corpus overview


MeSH Disease

Human Phenotype


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    The involvement of Central Nervous System and sequence variability of Severe Adult Respiratory Syndrome MESHD Adult TRANS Respiratory Syndrome – Coronavirus-2 revealed in autopsy tissue samples: a case report.

    Authors: Lis Høy Marbjerg; Christina Jacobsen; Jannik Fonager; Claus Bøgelund; Morten Rasmussen; Anders Fomsgaard; Jytte Banner; Veronika Vorobieva Solholm Jensen

    doi:10.21203/ Date: 2020-08-18 Source: ResearchSquare

    Background: The case presented here illustrates that interdisciplinary teamwork can be essential for the understanding of the COVID-19 disease presentation and enlightening of the pathophysiology. Case presentation: A 60-years-old overweight HP woman without any comorbidities was found dead in her apartment after 14 days of home isolation due to suspicion on the Coronavirus disease MESHD 2019 (COVID-19). She had reported symptoms of tachycardia HP tachycardia MESHD, fever HP fever MESHD, and increasing respiratory difficulty one day before her death MESHD. Due to the Danish legal act on sudden deaths a forensic autopsy was performed including a thorough examination and biosampling. The results of the forensic autopsy displayed sever densified, almost airless, firm lungs, and an unspecific reactive minimal focal perivascular inflammation MESHD consisting of macrophages of the brain tissue. The final diagnosis, COVID-19 with involvement of the central nervous system was established by use of the RT-RNA analysis on cerebrospinal fluid, as well as by serologic detection of the specific antibodies for SARS-CoV-2 SERO in cerebrospinal fluid and serum SERO. The genetic analysis displayed a 2 % variation between SARS-CoV-2 isolates recovered from the tracheal sample, cerebrospinal fluid, and tissues from both lungs.Conclusion: The combination of all available results revealed that the cause of death MESHD was COVID-19 with severe pulmonary disease MESHD and neuroinvasion, as well as renal affection resulting in hyponatremia HP hyponatremia MESHD. To our knowledge, it was not shown previously that neuroinvasion could be confirmed by the detection of specific antibodies for SARS-CoV-2 SERO and SARS-CoV-2 specific RNA in cerebrospinal fluid. This case supports hypotheses that SARS-CoV-2 may cause central nervous system infection MESHD. The genetic distinction between SARS-CoV-2 isolates was done by whole-genome sequencing, where the isolate recovered from the cerebrospinal fluid was the most different. 

    Identification of Inpatients with Coronavirus Disease MESHD 2019 (COVID-19) at Risk of Clinical Deterioration: A Multicenter, Retrospective Cohort Study

    Authors: Yi Zhang; Xiaojing Wu; Lan Ni; Lei Chen; Changzhi Zhou; Chang Gao; Jingen Xia; Ye Tian; Sichao Gu; Min Li; Yingying Feng; Jun Duan; Yi Wang; Jungang Xie; Qiang Guo; Jianping Zhao; Yi Hu; Zhenshun Cheng; Qingyuan Zhan

    doi:10.21203/ Date: 2020-08-07 Source: ResearchSquare

    Background: Current information is not enough to recognize the risk factors of clinical deterioration and to make medical decisions in COVID-19 patients. Methods: A retrospective study was performed, with collecting data from medical records of COVID-19 patients in three designated hospitals from January 8, 2020 to May 6, 2020. Clinical data were analyzed between the deteriorated and the non-deteriorated patients, which was defined as either a increase of 2 categories on the modified 6-category ordinal scale, or a decline of PaO2-to-FIO2 ratio more than 100mmHg. Results: Total 238 patients with COVID-19 were selected, where 31 were deteriorated and 207 were non-deteriorated. In the deterioration group, the case fatality rate was up to 41.9%. Compared with non-deteriorated patients, the deteriorated were older (65.8[IQR 54.3-72.3] vs 54.4[41.0-66.1], p=0.004) and were more likely to have chronic medical illnesses (17[54.8%]) vs 92[44.4%]). Multivariable regression showed that three variables, neutrophil-lymphocyte ratio (NLR)≥3.66 (OR, 9.85; 95% CI, 1.68-57.57), hyponatremia HP hyponatremia MESHD (OR, 8.35; 95% CI, 1.74-40.16), and presence of ground-glass opacities with consolidation (OR, 5.84; 95% CI, 1.24-27.49) were associated with increased odds of clinical deterioration. The variable that inspiring air or traditional oxygen therapy only within 72 hours after admission, indicated a decreased odd of illness progression (OR, 0.075; 95% CI, 0.012–0.465).Conclusions: COVID-19 patients with clinical deterioration had more common extra-pulmonary organ impair in early stage and high case fatality rate. Three factors, NLR ≥3.66, hyponatremia HP hyponatremia MESHD and presence of ground-glass opacities with consolidation were determined as high risk factors in deterioration. 

    Biological Risk Factors Predict Transfer to Intensive Care Units and Death in Covid-19 Patients

    Authors: Chloé Sauzay; Maïlys Le Guyader; Ophélie Evrard; Rémy Nyga; Alexis Caulier; Jean-Luc Schmit; Claire Andréjak; Antoine Galmiche; Catherine François; Sandrine Castelain; Julien Maizel; Loïc Garçon; Etienne Brochot; Thomas Boyer

    doi:10.21203/ Date: 2020-06-02 Source: ResearchSquare

    Infection with severe HP acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV2), causing the COVID-19, has been declared as pandemic by the World Health Organization. Epidemiological and clinical characteristics of patients with COVID-19 have been largely reported but biological risk factors have not yet been well described. In this retrospective and monocentric study, we explored 35 hematological and biochemical parameters, routinely measured at the Amiens University Hospital laboratory, between February 21, 2020 and March 30, 2020 for patients diagnosed with COVID-19. 154 patients were included in this study. We compared biological parameters collected at hospital admission between patients who survived or not after hospitalization. Non survivor patients displayed lower hemoglobin (p=0.02) and bicarbonate concentrations (p=0.03) and higher potassium concentration (p=0.03) compared to the survivors. We then compared these biological parameters between patients hospitalized in conventional care units and patients hospitalized in intensive care units (ICU). Numerous biological examinations had significant variations, including lymphocyte and neutrophil counts, bicarbonate, calcium and C Reactive Protein concentrations. In multivariate Cox analysis, risk factors for aggravation (defined as ICU admission or death) included low bicarbonate levels and hyponatremia HP hyponatremia MESHD. A significant worse overall survival was associated with hyponatremia HP hyponatremia MESHD, hyperkaliemia and prothrombin time > 16.8 seconds. We then proposed a prognostic score, to be validated in a future prospective study. Thus, these biological parameters, easily available, could help clinicians to identify high risk patients at an early stage of infection.

    Establishment of a clinical nomogram model to predict the progress to severe COVID-19 

    Authors: Changli Tu; Guojie Wang; Cuiyan Tan; Meizhu Chen; Hu Peng; Ying Wang; Yingjian Liang; Yiying Huang; Zhenguo Wang; Jian Wu; Kongqiu Wang; Qinhuan Huang; Jin Huang; Xiaobin Zheng; Qiuyue Chen; Yayuan Geng; Na Guo; Xiaorong Zhou; Xinran Liu; Jing Liu; Hong Shan

    doi:10.21203/ Date: 2020-03-14 Source: ResearchSquare

    Background: Severe acute r espiratory syndrome coronavirus 2 (SARS-CoV-2) infection MESHDis the leading cause of a public health emergency in the world, accompanying with high mortality in severe c orona virus disease MESHD2019(COVID-19 ), thereby early detection and stopping the progress to severe COVID-19 is important. Our aim is to establish a clinical nomogram model to calculate and predict the progress to severe COVID-19 timely and efficiently.Methods: In this study, 65 patients with COVID-19 had been included retrospectively in the Fifth Affiliated Hospital of Sun Yat-sen University from January 17, to February 11, 2020. Patients were randomly assigned to train dataset (n=51 with 15 progressing to severe COVID-19) and test dataset (n=14 with 4 progressing to severe COVID-19). Lasso algorithm was applied to filter the most classification relevant clinical factors. Based on selected factors, logistic regression model was fit to predict the severe from mild/common. Meanwhile in nomogram sensitivity SERO, specificity, AUC (Area under Curve), and calibration curve were depicted and calculated by R language, to evaluate the prediction performance SERO to severe COVID-19.Results:High ratio of sever COVID-19 patients (26.5%) had been found in our retrospective study, and 84% of these cases progress to severe or critical after 5 days from their first clinical examination. In these 65 patients with COVID-19, 77 clinical characteristics in first examination were collected and analyzed, and 37 ones had been found different between non-severe and severe COVID-19. But when all these factors were analyzed in establishment of prediction model, six factors are crucial for predicting progress of severe COVID-19 via Lasso algorithm. Based on these six factors, including increased fibrinogen, hyponatremia HP yponatremia, MESHD decreased PaO2,multiple lung lobes involved, down-regulated CD3(+)T-lymphocyte and fever HP ever, MESHD a logistic regression model was fit to discriminate severe and common COVID-19 patients. The sensitivity SERO, specificity and AUC were 0.93, 0.86, 0.96 in the train dataset and 0.9, 1.0, 1.0 in test dataset respectively. Nomogram-predicted probability was more consistent with actual probability by R language.Conclusions:In summary, an efficient and reliable clinical nomogram model had been established, which indicate increased fibrinogen, hyponatremia HP yponatremia, MESHD decreased PaO2, multiple lung lobes involved, down-regulated CD3(+)T-lymphocyte and fever HP ever MESHDat the first clinical examination, could predict progress of patients to severe COVID-19.

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MeSH Disease
Human Phenotype

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