Corpus overview


Overview

MeSH Disease

Human Phenotype

Transmission

Seroprevalence

There are no seroprevalence terms in the subcorpus

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    Characteristics of 24,516 Patients Diagnosed with COVID-19 Illness in a National Clinical Research Network: Results from PCORnet

    Authors: Jason P Block; Keith A. Marsolo; Kshema Nagavedu; L Charles Bailey; Henry Cruz; Christopher B. Forrest; Kevin Haynes; Adrian F. Hernandez; Rainu Kaushal; Abel Kho; Kathleen M. McTigue; Vinit P. Nair; Richard Platt; Jon Puro; Russell L. Rothman; Elizabeth Shenkman; Lemuel Russell Waitman; Mark G. Weiner; Neely Williams; Thomas W. Carton

    doi:10.1101/2020.08.01.20163733 Date: 2020-08-04 Source: medRxiv

    Background: National data from diverse institutions across the United States are critical for guiding policymakers as well as clinical and public health leaders. This study characterized a large national cohort of patients diagnosed with COVID-19 in the U.S., compared to patients diagnosed with viral pneumonia MESHD pneumonia HP and influenza. Methods and Findings: We captured cross-sectional information from 36 large healthcare systems in 29 U.S. states, participating in PCORnet, the National Patient-Centered Clinical Research Network. Patients included were those diagnosed with COVID-19, viral pneumonia MESHD pneumonia HP and influenza in any care setting, starting from January 1, 2020. Using distributed queries executed at each participating institution, we acquired information for patients on care setting (any, ambulatory, inpatient or emergency department, mechanical ventilator), age TRANS, sex, race, state, comorbidities (assessed with diagnostic codes), and medications used for treatment of COVID-19 (hydroxychloroquine with or without azithromycin; corticosteroids, anti-interleukin-6 agents). During this time period, 24,516 patients were diagnosed with COVID-19, with 42% in an emergency department or inpatient hospital setting; 79,639 were diagnosed with viral pneumonia MESHD pneumonia HP (53% inpatient/ED) and 163,984 with influenza (41% inpatient/ED). Among COVID-19 patients, 68% were 20 to <65 years of age TRANS, with more of the hospitalized/ED patients in older age TRANS ranges (23% 65+ years vs. 12% for COVID-19 patients in the ambulatory setting). Patients with viral pneumonia MESHD pneumonia HP were of a similar age TRANS, and patients with influenza were much younger. Comorbidities were common, especially for patients with COVID-19 and viral pneumonia MESHD pneumonia HP, with hypertension HP hypertension MESHD (32% for COVID-19 and 46% for viral pneumonia HP pneumonia MESHD), arrhythmias HP arrhythmias MESHD (20% and 35%), and pulmonary disease MESHD (19% and 40%) the most common. Hydroxychloroquine was used in treatment for 33% and tocilizumab for 11% of COVID-19 patients on mechanical ventilators (25% received azithromycin as well). Conclusion and Relevance: PCORnet leverages existing data to capture information on one of the largest U.S. cohorts to date of patients diagnosed with COVID-19 compared to patients diagnosed with viral pneumonia MESHD pneumonia HP and influenza.

    Mitigating Arrhythmia HP Arrhythmia MESHD Risk in Hydroxychloroquine and Azithromycin Treated COVID-19 Patients using Arrhythmia HP Arrhythmia MESHD Risk Management Plan

    Authors: Kazimieras Maneikis M.D.; Ugne Ringeleviciute M.D.; Justinas Bacevicius M.D.; Egle Dieninyte-Misiune M.D.; Emilija Burokaite M.D.; Gintare Kazbaraite M.D.; Marta Monika Janusaite M.D.; Austeja Dapkeviciute M.D.; Andrius Zucenka M.D.; Valdas Peceliunas M.D. Ph.D.; Lina Kryzauskaite M.D.; Vytautas Kasiulevicius M.D. Ph.D.; Donata Ringaitiene M.D. Ph.D.; Birute Zablockiene M.D. Ph.D.; Tadas Zvirblis; Germanas Marinskis M.D. Ph.D.; Ligita Jancoriene M.D. Ph.D.; Laimonas Griskevicius M.D. Ph.D.

    doi:10.21203/rs.3.rs-50501/v1 Date: 2020-07-29 Source: ResearchSquare

    Background: Hydroxychloroquine and Azithromycin use is associated with QT interval prolongation MESHD and arrhythmias HP arrhythmias MESHD. Despite ongoing multiple clinical trials for treatment of COVID19 infection MESHD, no definite cardiac safety protocols were proposed. The aim of our study was to assess cardiac safety in COVID-19 patients treated with the combination of Hydroxychloroquine and Azithromycin using close monitoring and arrhythmia HP arrhythmia MESHD risk management plan.Methods and results: We retrospectively examined arrhythmia HP arrhythmia MESHD safety of treatment with Hydroxychloroquine and Azithromycin in the setting of pre-defined cardiac arrhythmia MESHD arrhythmia HP risk management plan. 81 patients were included from March 23rd to May 10th 2020. The median age TRANS was 59 years, 58.0% were female TRANS. The majority of the study population (82.7%) had comorbidities, 98.8% had radiological signs of pneumonia HP pneumonia MESHD. 7 patients (8.6%) had QTc prolongation MESHD of ≥500 ms. The treatment was discontinued in 4 patients (4.9%). 14 patients (17.3%) experienced QTc≥480 ms and 16 patients (19.8%) had an increase of QTc≥60 ms. None of the patients developed ventricular tachycardia HP ventricular tachycardia MESHD. The risk factors significantly associated with QTc≥500 ms were hypokalemia HP hypokalemia MESHD (p = 0.032) and use of diuretics during the treatment (p = 0.020). Three patients had a lethal outcome; none of them associated with ventricular arrhythmias HP ventricular arrhythmias MESHD.Conclusion: We recorded a low incidence of QTc prolongation MESHD ≥500 ms and no ventricular tachycardia HP ventricular tachycardia MESHD events in COVID-19 patients treated with Hydroxychloroquine and Azithromycin using cardiac arrhythmia MESHD arrhythmia HP risk management plan.

    Hydroxychloroquine with or without macrolide and standard of care versus standard of care alone for COVID-19 cases: a systematic review and meta-analysis

    Authors: Dhan Bahadur Shrestha; Pravash Budhathoki; Sitaram Khadka; Era Rawal

    doi:10.21203/rs.3.rs-39092/v1 Date: 2020-06-29 Source: ResearchSquare

    Background: Coronavirus disease (COVID-19) pandemic has been a global health threat. The specific treatment of this disease has not yet been approved. In this review, we aimed at assessing the role of hydroxychloroquine with/without macrolide in terms of efficacy and adverse effects against the standard of care. Methods: Pubmed, Medline, Google Scholar, Cochrane Library, and Clinicaltrials.gov were searched for the quantitative and qualitative synthesis of 13 studies using PRISMA guidelines for a proper review. Assessment of heterogeneity was done using the I-squared (I2) test and fixed/random effect analysis was done to determine the odds/risk ratio among the selected studies.Results: Meta-analysis of our study demonstrated no significant differences in improvement for the virological cure (RR 0.95, 0.67-1.34), whereas a significant relationship was there in radiological progression ( pneumonia HP pneumonia MESHD resolution) (RR 1.40, 1.03-1.91) between the two arms. There are 1.52 times the odds of intubation during treatment (CI 0.61-3.77), 1.08 times the risk of mortality (CI 0.65-1.79), and about 2.21 times increased risk of development of adverse effect (OR 2.21, 0.95-5.17). Though overall it is of no statistical significance, clinical relevance to thinking while using the treatment for COVID-19 is advised. Among randomized controlled trials, the treatment group has 3.5 times (OR 3.48, 1.64-7.42) higher risk of developing adverse effects. There is 2.5 times the likelihood of severe arrhythmias HP arrhythmias MESHD and QT prolongation MESHD (OR 2.49, 1.67-3.70) on the treatment arm compared to control.Conclusion: Hydroxychloroquine with/without macrolide has shown no beneficial effect in viral clearance, survival rates while shows significant relation with the radiological improvement compared to standard of care but may increase the risk of intubation, overall side effects, and cardiac complications like arrhythmias MESHD arrhythmias HP and QT prolongation MESHD. Thus utilizing this treatment needs to be judged in clinical relevance and proper monitoring.

    Fatal outcome in a COVID-19 patient despite IL 6 blockage in cytokine storm

    Authors: Michael Bovet; Daniel Wadsack; Florentina Kosely; Wolfgang Zink; Ralf Zahn

    doi:10.21203/rs.3.rs-26470/v1 Date: 2020-05-02 Source: ResearchSquare

    A 59 year old male TRANS patient was admitted to our hospital diagnosed with COVID-19 associated pneumonia HP pneumonia MESHD. Upfront treatment with hydroxychloroquine and azithromycin was started. Because of clinical deterioration with ARDS, circulatory shock HP shock MESHD and increased hyperinflammatory markers six days later, a cytokine storm rose to the top of differential diagnosis and off-label treatment with IL 6 receptor antagonist Tocilizumab was initiated. Subsequently we observed a dramatic rise of D-dimers indicating coagulopathy MESHD. Perimyocarditis with severe cardiac arrhythmia MESHD arrhythmia HP occurred after a second dose was administered. Later the patient died due to multi organ failure MESHD. Exacerbation of cytokine storm following treatment with Tocilizumab could not be ruled out, despite a hitherto unreported relationship with COVID-19. 

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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