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Overview

MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    Investigational treatments for COVID-19 may increase ventricular arrhythmia HP ventricular arrhythmia MESHD risk through drug interactions

    Authors: Meera Varshneya; Itziar Irurzun-Arana; Chiara Campana; Rafael Dariolli; Amy Gutierrez; Taylor K Pullinger; Eric A Sobie

    doi:10.1101/2020.05.21.20109397 Date: 2020-05-26 Source: medRxiv

    Many drugs that have been proposed for treatment of COVID-19 are reported to cause cardiac adverse events, including ventricular arrhythmias HP ventricular arrhythmias MESHD. In order to properly weigh risks against potential benefits, particularly when decisions must be made quickly, mathematical modeling of both drug disposition and drug action can be useful for predicting patient response and making informed decisions. Here we explored the potential effects on cardiac electrophysiology of 4 drugs proposed to treat COVID-19: lopinavir, ritonavir, chloroquine, and azithromycin, as well as combination therapy involving these drugs. Our study combined simulations of pharmacokinetics (PK) with quantitative systems pharmacology (QSP) modeling of ventricular myocytes to predict potential cardiac adverse events caused by these treatments. Simulation results predicted that drug combinations can lead to greater cellular action potential prolongation, analogous to QT prolongation MESHD, compared with drugs given in isolation. The combination effect can result from both pharmacokinetic and pharmacodynamic drug interactions. Importantly, simulations of different patient groups predicted that females TRANS with pre-existing heart disease MESHD are especially susceptible to drug-induced arrhythmias HP arrhythmias MESHD, compared males TRANS with disease or healthy individuals of either sex. Overall, the results illustrate how PK and QSP modeling may be combined to more precisely predict cardiac risks of COVID-19 therapies.

    Characteristics and outcomes of a cohort of SARS-CoV-2 patients in the Province of Reggio Emilia, Italy

    Authors: Paolo Giorgi Rossi; Massimiliano Marino; Debora Formisano; Francesco Venturelli; Massimo Vicentini; Roberto Grilli; - The Reggio Emilia COVID-19 Working Group

    doi:10.1101/2020.04.13.20063545 Date: 2020-04-16 Source: medRxiv

    Objectives. To describe the age TRANS- and sex-specific prevalence SERO of SARS-CoV-2 disease MESHD (COVID-19) and its prognostic factors. Design. Population-based prospective cohort study on archive data. Setting. Preventive services and hospital care in the province of Reggio Emilia, Northern Italy. Participants. All 2653 symptomatic patients who tested positive for SARS-CoV-2 from February 27 to April 2, 2020 in the province of Reggio Emilia. Main outcome measures. Hospitalization and death up to April 2, 2020. Results. Females TRANS had higher prevalence SERO of infection MESHD than males TRANS below age TRANS 50 (2.61 vs. 1.84 per 1000), but lower in older ages TRANS (16.49 vs. 20.86 per 1000 over age TRANS 80). Case fatality rate reached 20.7% (22/106) in cases with more than 4 weeks follow up. After adjusting for age TRANS and comorbidities, men had a higher risk of hospitalization (hazard ratio (HR) 1.4 95% confidence interval (95% CI) 1.2 to 1.6) and of death (HR 1.6, 95% CI 1.2 to 2.1). Patients over age TRANS 80 compared to < age TRANS 50 had HR 7.1 (95% CI 5.4 to 9.3) and HR 27.8 (95% CI 12.5 to 61.7) for hospitalization and death MESHD, respectively. Immigrants had a higher risk of hospitalization (HR 1.3, 95% CI 0.99 to 1.81) than Italians and a similar risk of death MESHD. Risk of hospitalization and of death MESHD were higher in patients with heart failure MESHD (HR 1.6, 95% CI 1.2 to 2.1and HR 2.3, 95% CI 1.6 to 3.2, respectively), arrhythmia HP arrhythmia MESHD (HR 1.5, 95% CI 1.2 to 1.9 and HR 1.8, 95% CI 1.3 to 2.5, respectively), dementia HP dementia MESHD (HR 1.2, 95% CI 0.9 to 1.8 and HR 1.8, 95% CI 1.1 to 2.8, respectively), ischemic MESHD heart disease MESHD (HR 1.3, 95% CI 1.0 to 1.7 and HR 1.7, 95% CI 1.2 to 2.5, respectively), diabetes MESHD (HR 1.5, 95% CI 1.3 to 1.9 and HR 1.6, 95% CI 1.1 to 2.2, respectively), and hypertensions HP hypertensions MESHD(HR 1.4, 95% CI 1.2 to 2.6 and HR 1.6, 95% CI 1.2 to 2.1, respectively), while COPD increased the risk of hospitalization (HR 1.9, 95% CI 1.4 to 2.5) but not of death MESHD (HR 1.1, 95% CI 0.7 to 1.7). Previous use of ACE inhibitors has no effect on risk of death (HR 0.97, 95% CI 0.69 to 1.34) Conclusions. The mechanisms underlying these associations are mostly unknown. A deeper understanding of the causal chain from infection MESHD, disease onset, and immune response to outcomes may explain how these prognostic factors act.

    Clinical features of critically ill MESHD patients with COVID-19 infection MESHD in China

    Authors: Bo Hu; Dawei Wang; Chang Hu; Ming Hu; Fangfang Zhu; Hui Xiang; Beilei Zhao; Xiaoyi Zhang; Kianoush B. Kashani; Zhiyong Peng

    doi:10.21203/rs.3.rs-16250/v1 Date: 2020-03-02 Source: ResearchSquare

    Importance: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections MESHD outbreak in China is now a global issue. There is only a limited understanding of the clinical characteristics of patients with SARS-CoV-2 infections MESHD is available.Objective:To describe the characteristics, management strategies, and outcomes of critically ill MESHD patients with SARS-CoV-2 infection MESHD.Design, Setting, and Patients: This is aretrospective, multi-center case series of 50 critically ill MESHD patients with confirmed SARS-CoV-2 infection MESHD who were admitted at Zhongnan Hospital of Wuhan University and Wuhan Pulmonary Hospital in Wuhan, China, from January 8 to February 9, 2020.Exposures:Documented Corona Virus Disease MESHD, 2019 (COVID-19).Main Outcome Measures: Demographic, clinical, laboratory, imaging data were collected along with management strategies, complications and outcomes of enrolled individuals. Results Fifty critically ill MESHD patients with SARS-CoV-2 infections MESHD were enrolled. Their median age TRANS was 62 (range, 29-92) [IQR,49.5-69.0] years, 68% were male TRANS, and 28 (56%) patients had comorbidities, the most common being hypertension HP hypertension MESHD. In this cohort, 20(40%) patients survived ,16(32%) patients died, and the rest remained hospitalized. The invasive mechanical ventilator was used in 36(72%) patients with 15(30%) of them requiring prone positioning, and 17(34%) switched to ECMO. The compliance scores of lungs (Cstat)on the day of ICU admission among survivors were higher than those in non-survivors [42.0(18.0-47.0), vs. 19.5(14.0-24.2), p=0.038].The blood SERO IL-6 levels and neutrophils counts at the first day of ICU admission were significantly higher in non-survivors compared to survivors [123.7(85.3-228.8), vs. 20.2(6.8-67.2) ng/ml, p=0.025 for IL-6, and 20.2(6.8-67.2) vs. 4.01(1.99-7.05) × 10⁹/L, p=0.02 for neutrophils counts].The heart rates, PaCO2, lung injury MESHD scale (LIS), and positive end-expiratory pressure levels were constantly higher for 10 days in non-survivors than those who survived (p<0.05). The frequency of vasopressor uses and neuromuscular blockers was higher in non-survivors from day 1 to day 10 compared to survivors (p<0.05). In the whole cohort, the most common complications were ARDS (97%), shock HP shock MESHD (44%), arrhythmia HP arrhythmia MESHD (38%), acute cardiac injury MESHD (26%), and acute kidney injury HP acute kidney injury MESHD (22%). A secondary bacterial infection MESHD was noted in 17(34%) patients. Univariate analysis indicated that lower lung complianceand higher neutrophil counts at the day of ICU admission were related to higher mortality (p-0.03, and 0.04, respectively)ConclusionWe demonstrated that SARS-CoV-2 infection MESHD-related critical illness predominantly affected old individuals with comorbidities and characterized by severe hypoxemic respiratory failure MESHD respiratory failure HP, often requiring prolonged mechanical ventilation and rescue therapies. Low lung compliance and persistently elevated PaCO2 indicated poor outcomes.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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