Corpus overview


Overview

MeSH Disease

Fatigue (148)

Fever (140)

Coronavirus Infections (81)

Cough (75)

Dyspnea (63)


Human Phenotype

Cough (169)

Fatigue (169)

Fever (156)

Pneumonia (48)

Myalgia (47)


Transmission

Seroprevalence
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    Analysis of clinical characteristics, laboratory findings and therapy of 134 cases of COVID-19 in Wuhan, China: a retrospective analysis.

    Authors: Rui Zhang; Jie Zhang; Jiebing Chen

    doi:10.21203/rs.3.rs-79418/v1 Date: 2020-09-17 Source: ResearchSquare

    Background:As everyone knows, the pandemic COVID-19 is spreading in the whole world. The number of laboratory- confirmed cases TRANS reached 28,637,211 and that of the death cases was 917,404 in the world as of September 13th, 2020. We sought to analyse the clinical characteristics, laboratory findings and therapy of some cases with COVID-19.Methods: In this retrospective study, we extracted the data on 134 patients with laboratory-confirmed COVID-19 in Wuhan Xinzhou District People's Hospital from January 16th to April 24th , 2020. Cases were confirmed TRANS by real-time RT-PCR and abnormal radiologic findings. Outcomes were followed up until May 1th , 2020. Results: Co-infection MESHD infection and severe HP underlying diseases made it easier for a case with COVID-19 to develop to be a severe one or reach an outcome of death MESHD. Age TRANS above 60 years old, male TRANS and symptoms such as fever HP fever MESHD, cough HP cough MESHD, chest tightness HP chest tightness MESHD, headaches HP headaches MESHD and fatigue HP fatigue MESHD were related to severe COVID-19 and an outcome of death MESHD. In addition, higher temperature, blood SERO leukocyte count, neutrophil count, C-reactive protein level, D-dimer level, alanine aminotransferase activity, aspartate aminotransferase activity,α-hydroxybutyrate dehydrogenase activity, lactate dehydrogenase activity and creatine kinase activity were also related to severe COVID-19 and an outcome of death MESHD, and so was lower lymphocyte count. Administration of gamma globulin seemed helpful for reducing the mortality of patients with severe COVID-19, however the P value was greater than 0.05 (P=0.180), which mean under the same condition, studies of larger samples are needed in the future.                 Conclusion: Multiple factors were related to severe COVID-19 and an outcome of death MESHD.  Administration of gamma globulin seemed helpful for reducing the mortality of severe cases. More related studies are needed in the future.

    Lower Rate of COVID-19 in Lupus Patients Receiving Immunosuppressive Drug Regimens

    Authors: Mohammadrafi Damirchi; Gholamreza Roshandel; Mehrdad Aghaie; Sima Sedighi; Mohammadjavad Hassani; Nafiseh Abdolahi

    doi:10.21203/rs.3.rs-78704/v1 Date: 2020-09-16 Source: ResearchSquare

    Introduction Recently, due to the COVID-19 pandemic much concern has been raised about chronic diseases, which could possibly make patients more susceptible, and vulnerable to COVID-19. One of them, is Systemic Lupus Erythematosus HP Systemic Lupus Erythematosus MESHD( SLE MESHD). Objective This study has tried to find the prevalence SERO of COVID-19 in SLE MESHD patients in Golestan province of Iran, and to characterize the clinical course of COVID-19 in these patients. This study has also sought to find possible correlation between the incidence of COVID-19, its clinical manifestations and the medication taken by SLE MESHD patients. Methods We investigated patients who had been enrolled in our rheumatologic diseases MESHD registry system. Patients responded to a questionnaire which contained questions about their primary disease, comorbidities, medications, development of new symptoms, and medical services which they received, pertinent to COVID-19, during the period of COVID-19 outbreak. The data were analyzed using SPSS 16 software. Results This investigation found 25 (7%) COVID-19 positive patients out of the 355 responders. 8 (40%) of them were hospitalized, out of which 2 (8%) required intensive care and later expired. COVID-19 incidence was significantly lower in the immunosuppressed group (2.2% vs 10% P-value 0.005). We didn’t find a significant correlation between hydroxychloroquine consumption, and the incidence of COVID-19 in SLE MESHD patients. Fever HP Fever MESHD, fatigue HP fatigue MESHD, dyspnea HP dyspnea MESHD, and dry cough MESHD cough HP were the most common clinical symptoms.Conclusion Our research has shown that COVID-19 prevalence SERO was lower in immunosuppressed patients. However, broader studies should be conducted to clarify the role of immunosuppression in the development of COVID-19. More research is required.

    Clinical course and management of 73 hospitalized moderate patients with COVID-19 outside Wuhan

    Authors: Xiaojuan Peng; Qi Qi Liu; Zhaolin Chen; Guiyan Wen; Qing Li; Yanfang Chen; Jie Xiong; Xinzhou Meng; Yuanjin Ding; Ying Shi; Shaohui Tang

    doi:10.21203/rs.3.rs-76135/v1 Date: 2020-09-11 Source: ResearchSquare

    Background: Moderate cases account for the majority in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection MESHD and can also progress to severe/critical condition. Here, we investigated the clinical course and management of hospitalized moderate SARS-CoV-2 patients.Methods: The medical records and follow-up data were analyzed from the SARS-CoV-2 patients outside Wuhan.Results: A total of 73 moderate patients (38 men, 35 women) were included, with median age TRANS of 47.0 (38.5-57.5) years. Among them, only one patient (1.4%) died using active treatment to improve symptoms. The median duration of the four main symptoms cough HP, fever HP fever MESHD, chest tightness HP chest tightness MESHD, and fatigue HP fatigue MESHD were about 1-2 weeks; the median duration of the positive nucleic acid test (NAT) results for SARS-CoV-2 was slightly more than 2 weeks; the median hospitalization time was almost four weeks in 72 moderate survivors. The duration of cough HP cough MESHD and fever HP fever MESHD was positively correlated with the duration of the positive NAT results. On admission, 50% had lymphopenia HP lymphopenia MESHD; less than 30% had abnormal blood SERO biochemistry findings involving hyperglycemia HP hyperglycemia MESHD, liver function and myocardial enzymes. At discharge, the laboratory indexes were substantially improved. Two weeks after discharge, 5.6% survivors experienced a recurrence of the positive NAT results. Conclusions: Moderate SARS-CoV-2 patients have a good prognosis by the active treatment. After discharge, it is necessary that moderate survivors undergo at least a 2-week collective medical observation in quarantine places, which can identify and treat a proportion of patients with re-positive NAT results and to prevent the spread of the potential sources of infection MESHD.

    Correlation Study of Chest CT Features of Severe/Critical type COVID-19 with Early Renal Damage MESHD and Clinical Prognosis

    Authors: Guan Li; Yongchun Ge; Zhiyuan Sun; Song Luo; Wen Wang; Changsheng Zhou; Fan zhou; Xin Zhang; Jie Dong; Zhiqiang Cao; Longjiang Zhang; Guangming Lu

    doi:10.21203/rs.3.rs-75596/v1 Date: 2020-09-10 Source: ResearchSquare

    Background: Among patients with confirmed severe/critical type COVID-19, we found that although the seurm creatinine (Cr) value is in normal range, patients might have occured early renal damage MESHD. For severe/critical type COVID-19 patients, whether some chest CT features can be used to predict the early renal damage MESHD or clinical prognosis.Methods: 162 patients with severe/critical type COVID-19 were reviewed retrospectively in 13 medical centers from China. According to the level of eGFR, 162 patients were divided into three groups, group A (eGFR < 60 ml/min/1.73m2), group B (60 ml/min/1.73m2 ≤ eGFR < 90 ml/min/1.73m2 group) and group C (eGFR ≥ 90 ml/min/1.73m2). All patients’ baseline clinical characteristics, laboratory data, CT features and clinical outcomes were collected and compared. The eGFR and CT features was assessed using univariate and multivariate Cox regression.Results: Baseline clinical characteristics showed that there were significant differences in age TRANS, hypertension HP hypertension MESHD, cough HP cough MESHD and fatigue HP fatigue MESHD among groups A, B and C. Laboratory data analysis revealed significant differences between the three groups of leukocyte count, platelet count, C-reactive protein, aspartate aminotransferase, creatine kinase. Chest CT features analysis indicated that crazy-paving pattern has significant statistical difference in groups A and B compared with group C. The eGFR of patients with crazy-paving pattern was significant lower than those without crazy-paving pattern (76.73 ± 30.50 vs. 101.69 ± 18.24 ml/min/1.73m2, p < 0.001), and eGFR (OR = 0.962, 95% CI = 0.940-0.985) was the independent risk factor of crazy-paving pattern. The eGFR (HR = 0.549, 95% CI = 0.331-0.909, p = 0.020) and crazy-paving pattern (HR = 2.996, 95% CI = 1.010-8.714, p = 0.048) were independent risk factors of mortality.Conclusions: In patients with severe/critical type COVID-19, the presence of crazy-paving pattern on chest CT are more likely occured the decline of eGFR and poor clinical prognosis. The crazy-paving pattern appeared could be used as an early warning indicator of renal damage MESHD and to guide clinicians to use drugs reasonably.

    Blood SERO neurofilament light concentration at admittance: a potential prognostic marker in COVID-19

    Authors: Anne Hege Aamodt; Einar August Høgestøl; Trine Haug Popperud; Jan Cato Holter; Anne Margarita Dyrhol-Riise; Kristian Tonby; Birgitte Stiksrud; Else Qvist-Paulsen; Tone Berge; Andreas Barratt-Due; Pål Aukrust; Lars Heggelund; Kaj Blennow; Henrik Zetterberg; Hanne Flinstad Harbo; Niclas Johansson; Max Bell; Karin Lore; Anna Farnert; Anna Smed-Sorensen

    doi:10.1101/2020.09.07.20189415 Date: 2020-09-09 Source: medRxiv

    Objective To test the hypotheses that serum SERO concentrations of neurofilament light chain protein (NfL) and glial fibrillary acidic protein (GFAp) can serve as biomarkers for disease severity in COVID-19 patients. Methods Forty-seven inpatients with confirmed COVID-19 had blood SERO samples drawn on admission for assessing serum SERO biomarkers of CNS injury by Single molecule array (Simoa), NfL and GFAp. Concentrations of NfL and GFAp were analyzed in relation to symptoms, clinical signs, inflammatory biomarkers and clinical outcomes. We used multivariate linear models to test for differences in biomarker concentrations in the subgroups, accounting for confounding effects. Results In total, 21 % (n=10) of the patients were admitted to an intensive care unit, whereas the overall mortality rate was 13 % (n=6). Non-survivors had higher serum SERO concentrations of NfL (p<0.001) than patients who were discharged alive both in adjusted analyses (p=2.6 x 10-7) and unadjusted analyses (p=0.001). The concentrations of NfL in non-survivors increased over repeated measurements whereas the concentrations in survivors were stable. Significantly higher concentrations of NfL were found in patients reporting fatigue HP fatigue MESHD, while reduced concentrations were found in patients experiencing cough HP, myalgia HP myalgia MESHD and joint pain MESHD pain HP. The GFAp concentration was also significantly higher in non-survivors than survivors (p=0.02). Conclusion Increased concentrations of NfL and GFAp in COVID-19 patients on admission may indicate increased mortality risk. Measurement of blood SERO biomarkers for nervous system injury MESHD can be useful to detect and monitor CNS injury MESHD in COVID-19.

    The clinical course of COVID-19 in the outpatient setting: a prospective cohort study

    Authors: Paul W Blair; Diane M Brown; Minyoung Jang; Annukka AR Antar; Jeanne C Keruly; Vismaya Bachu; Jenny L Townsend; Jeffrey A Tornheim; Sara C Keller; Lauren Sauer; David L Thomas; Yukari C Manabe; - Ambulatory COVID Study Team; Graham Medley; Michael Hohle; John Edmunds; Chris Fitzsimmons; Tim Harris; Fiona Lecky; Andrew Lee; Ian Maconochie; Darren Walter; Dilek Telci; Fikrettin Sahin; Koray Yalcin; Ercument Ovali

    doi:10.1101/2020.09.01.20184937 Date: 2020-09-03 Source: medRxiv

    Background: Outpatient COVID-19 has been insufficiently characterized. Objective: To determine the progression of disease and subsequent determinants of hospitalization. Design: A prospective outpatient cohort. Setting: Outpatients were recruited by phone between April 21 to June 23, 2020 after receiving outpatient or emergency department testing within a large health network in Maryland, USA. Participants: Outpatient adults TRANS with positive RT-PCR results for SARS-CoV-2. Measurements: Symptoms, portable pulse oximeter oxygen saturation (SaO2), heart rate, and temperature were collected by participants on days 0, 3, 7, 14, 21, and 28 after enrollment. Baseline demographics, comorbid conditions were evaluated for risk of subsequent hospitalization using negative binomial, logistic, and random effects logistic regression. Results: Among 118 SARS-CoV-2 infected MESHD outpatients, the median age TRANS was 56.0 years (IQR, 50.0 to 63.0) and 50 (42.4%) were male TRANS. Among those reporting active symptoms, the most common symptoms during the first week since symptom onset TRANS included weakness/fatigue MESHD fatigue HP (67.3%), cough HP (58.0%), headache HP headache MESHD (43.8%), and sore throat (34.8%). Participants returned to their usual health a median of 20 days (IQR, 13 to 38) from the symptom onset TRANS, and only 65.5% of respondents were at their usual health during the fourth week of illness. Over 28 days, 10.9% presented to the emergency department and 7.6% required hospitalization. Individuals at the same duration of illness had a 6.1 times increased adjusted odds of subsequent hospitalization per every percent decrease in home SaO2 (95% confidence interval [CI]: 1.41 to 31.23, p=0.02). Limitations: Severity and duration of illness may differ in a younger population. Conclusion: Symptoms often persisted but uncommonly progressed to hospitalization. Home SaO2 might be an important adjunctive tool to identify progression of COVID-19.

    Association factors with severe cases and antiviral drug assessment in patients with COVID-19

    Authors: Xiaowei Gong; Xianfeng Guo; Shiwei Kang; Yan Li; Haixiang Gao; Yadong Yuan

    doi:10.21203/rs.3.rs-70914/v1 Date: 2020-09-02 Source: ResearchSquare

    Background Due to the latent onset of novel coronavirus disease MESHD 2019 (COVID-19), it is important to identify patients with increased probabilities for disease progression early in order to implement timely medical strategies. This study aimed to identify the factors associated with severe COVID-19 and evaluate the current antiviral drugs, especially in severe patients.Methods This was a retrospective observational study performed at the No. 7 Hospital of Wuhan (Wuhan, China) with hospitalized patients confirmed with COVID-19 from January 11 to March 13, 2020. Multivariable logistic regression analysis was used to identify the associated factors of severe COVID. Treatment of antivirus drugs were collected and evaluated.Results Of the 550 patients, 292 (53.1%) were female TRANS and 277 (50.4%) were ≥ 60 years old. The most common symptom was fever HP fever MESHD (n = 372, 67.7%), followed by dry cough MESHD cough HP (n = 257, 46.7%), and dyspnea HP dyspnea MESHD (n = 237, 43.1%), and fatigue HP fatigue MESHD (n = 224, 40.7%). Among the severe patients, 20.2% required invasive ventilator support and 18.0% required non-invasive ventilator. The identified risk factors for severe cases were: age ≥ 60 years (odds ratio (OR) = 3.02, 95% confidence interval (CI): 1.13–8.08, P = 0.028), D-dimer > 0.243 µg/ml (OR = 2.734, 95%CI: 1.012–7.387, P = 0.047), and low oxygenation index (OR = 0.984, 95%CI: 0.980–0.989, P < 0.001). In severe cases, the benefits of arbidol alone was 73.3%, which was better than ribavirin (7/17, 41.2%, P = 0.029).Conclusions Age ≥ 60 years, D-dimer > 0.243 µg/ml, and lower oxygenation index were associated with severe cases. Arbidol might provide more clinical benefits in treating patients with severe COVID-19 compared with other antiviral drugs.

    Automatic analysis system of COVID-19 radiographic lung images (XrayCoviDetector)

    Authors: Juan Nicolas Schlotterbeck; Carlos E Montoya; Patricia Bitar; Jorge A Fuentes; Victor Dinamarca; Gonzalo M Rojas; Marcelo Galvez; Andreas Limmer; Jia Liu; Xin Zheng; Thorsten Brenner; Marc M. Berger; Oliver Witzke; Mirko Trilling; Mengji Lu; Dongliang Yang; Nina Babel; Timm Westhoff; Ulf Dittmer; Gennadiy Zelinskyy; Kelly M Schiabor Barrett; Stephen Riffle; Alexandre Bolze; Simon White; Francisco Tanudjaja; Xueqing Wang; Jimmy M Ramirez III; Yan Wei Lim; James T Lu; Nicole L Washington; Eco JC de Geus; Patrick Deelen; H Marike Boezen; Lude H Franke

    doi:10.1101/2020.08.20.20178723 Date: 2020-08-23 Source: medRxiv

    COVID-19 is a pandemic infectious disease MESHD caused by the SARS-CoV-2 virus, having reached more than 210 countries and territories. It produces symptoms such as fever HP fever MESHD, dry cough MESHD cough HP, dyspnea HP dyspnea MESHD, fatigue HP fatigue MESHD, pneumonia HP pneumonia MESHD, and radiological manifestations. The most common reported RX and CT findings include lung consolidation and ground-glass opacities. In this paper, we describe a machine learning-based system (XrayCoviDetector; www.covidetector.net), that detects automatically, the probability that a thorax radiological image includes COVID-19 lung patterns. XrayCoviDetector has an accuracy of 0.93, a sensitivity SERO of 0.96, and a specificity of 0.90.

    Prevalence SERO and correlation of symptoms and comorbidities in COVID-19 patients: A systematic review and meta-analysis

    Authors: Mohammad Meshbahur Rahman; Badhan Bhattacharjee; Zaki Farhana; Mohammad Hamiduzzaman; Muhammad Abdul Bake Chowdhury; Mohammad Sorowar Hossain; Mahbubul H Siddiqee; Md. Ziaul Islam; Enayetur Raheem; Md. Jamal Uddin

    doi:10.1101/2020.08.19.20177980 Date: 2020-08-22 Source: medRxiv

    Background: The COVID-19 affected millions of people, and the patients present a constellation of symptoms and comorbidities. We aimed to chronicle the prevalence SERO and correlations of symptoms and comorbidities, and associated covariates among the patients. Methods: We performed a systematic review and meta-analysis [PROSPERO registration: CRD42020182677]. Databases [PubMed, SCOPUS, EMBASE, WHO, Semantic Scholar, and COVID-19 Primer] were searched for clinical studies published in English from January 1 to April 20, 2020. The pooled prevalence SERO of symptoms and comorbidities were identified using the random effect model, and sub-groups analysis of patients age TRANS and locations were investigated. A multivariable factor analysis was also performed to show the correlation among symptoms, comorbidities and age TRANS of the COVID-19 patients. Findings: Twenty-nine articles [China (24); Outside of China (5)], with 4,884 COVID-19 patients were included in this systematic review. The meta-analysis investigated 33 symptoms, where fever HP fever MESHD [84%], cough HP cough MESHD/dry cough HP [61%], and fatigue HP fatigue MESHD/weakness [42%] were found frequent. Out of 43 comorbidities investigated, acute respiratory distress syndrome MESHD respiratory distress HP syndrome ( ARDS MESHD) [61%] was a common condition, followed by hypertension HP hypertension MESHD [23%] and diabetes MESHD [12%]. According to the patients age TRANS, the prevalence SERO of symptoms like fatigue HP fatigue MESHD/weakness, dyspnea HP dyspnea MESHD/shortness of breath, and anorexia HP anorexia MESHD were highly prevalent in older adults TRANS [[≥]50 years] than younger adults TRANS [<50 years]. Diabetes MESHD, hypertension HP hypertension MESHD, coronary heart disease MESHD, and COPD MESHD/ lung disease MESHD were more prevalent comorbidities in older adults TRANS than younger adults TRANS. The patients from outside of China had significantly higher prevalence SERO [p<0.005] of diarrhea HP diarrhea MESHD, fatigue HP fatigue MESHD, nausea HP nausea MESHD, sore throat, and dyspnea HP dyspnea MESHD, and the prevalent comorbidities in that region were diabetes MESHD, hypertension HP hypertension MESHD, coronary heart disease MESHD, and ARDS MESHD. The multivariable factor analysis showed positive association between a group of symptoms and comorbidities, and with the patients age TRANS. Interpretation: Epitomizing the correlation of symptoms of COVID-19 with comorbidities and patients age TRANS would help clinicians effectively manage the patients.

    Robust, reproducible clinical patterns in hospitalised patients with COVID-19

    Authors: Jonathan E Millar; Lucile Neyton; Sohan Seth; Jake Dunning; Laura Merson; Srinivas Murthy; Clark D Russell; Sean Keating; Maaike Swets; Carole H Sudre; Timothy D Spector; Sebastien Ourselin; Claire J Steves; Jonathan Wolf; - ISARIC4C Investigators; Annemarie B Docherty; Ewen M Harrison; Peter JM Openshaw; Malcolm G Semple; J Kenneth Baillie

    doi:10.1101/2020.08.14.20168088 Date: 2020-08-16 Source: medRxiv

    Severe COVID-19 is characterised by fever HP fever MESHD, cough HP cough MESHD, and dyspnoea MESHD. Symptoms affecting other organ systems have been reported. The clinical associations of different patterns of symptoms can influence diagnostic and therapeutic decision-making: for example, significant differential therapeutic effects in sub-groups of patients with different severities of respiratory failure HP respiratory failure MESHD have already been reported for the only treatment so far shown to reduce mortality in COVID-19, dexamethasone. We obtained structured clinical data on 68914 patients in the UK (the ISARIC Coronavirus Clinical Characterisation Consortium, 4C) and used a principled, unsupervised clustering approach to partition the first 33468 cases according to symptoms reported at recruitment. We validated our findings in a second group of 35446 cases recruited to ISARIC-4C, and in separate cohort of community cases. A core symptom set of fever HP fever MESHD, cough HP cough MESHD, and dyspnoea co MESHD-occurred with additional symptoms in three patterns: fatigue HP fatigue MESHD and confusion HP confusion MESHD, diarrhoea and vomiting MESHD vomiting HP, or productive cough HP. Presentations with a single reported symptom of dyspnoea MESHD or confusion HP confusion MESHD were common, and a subgroup of patients reported few or no symptoms. Patients presenting with gastrointestinal symptoms MESHD were more commonly female TRANS, had a longer duration of symptoms before presentation, and had lower 30-day mortality. Patients presenting with confusion HP confusion MESHD, with or without core symptoms, were older and had a higher unadjusted mortality. Symptom clusters were highly consistent in replication analysis using a further 35446 individuals subsequently recruited to ISARIC-4C. Similar patterns were externally verified in 4445 patients from a study of self-reported symptoms of mild disease. The large scale of ISARIC-4C study enabled robust, granular discovery and replication of patient clusters. Clinical interpretation is necessary to determine which of these observations have practical utility. We propose that four patterns are usefully distinct from the core symptom groups: gastro-intestinal disease MESHD, productive cough HP, confusion HP confusion MESHD, and pauci-symptomatic presentations. Importantly, each is associated with an in-hospital mortality which differs from that of patients with core symptoms. These observations deepen our understanding of COVID-19 and will influence clinical diagnosis, risk prediction, and future mechanistic and clinical studies.

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MeSH Disease
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