Corpus overview


Overview

MeSH Disease

Human Phenotype

Hypertension (30)

Pneumonia (6)

Fever (6)

Cough (5)

Obesity (4)


Transmission

Seroprevalence
    displaying 1 - 10 records in total 30
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    Clinical Characteristics of Severe Covid Pneumonia HP: Exploring New Trends in ICU

    Authors: Aftab Akhtar; Sheher Bano; Ahtesham Iqbal; Moazma Ramzan; Aayesha Qadeer; Syed Waqar Hussain; Anam Saleem; Omair-ul-Haq Lodhi; Sana Zubair; Abdul Hameed kiani

    doi:10.21203/rs.3.rs-69224/v1 Date: 2020-08-31 Source: ResearchSquare

    Background: In late December 2019, Covid-19 emerged as clusters of pneumonia HP pneumonia MESHD of unknown cause in a province of china, Wuhan. Etiological agent was identified as novel coronavirus that resembles severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East Respiratory syndrome coronavirus (MERS-CoV) MESHD and has zoonotic transmission TRANS. Covid pneumonia HP can remain asymptomatic TRANS, present as mild infection, severe HP infection, severe MESHD pneumonia HP pneumonia MESHD or respiratory failure HP respiratory failure MESHD. Diagnosis is based on rRT-PCR carried out on respiratory secretions. Covid related mortality exceeds 50% once patient requires ICU admission. Objective: To study the characteristics of ICU population admitted to ICU of Shifa International hospital.Results: we prospectively analysed 74 patients which included 43.3% females TRANS and 56.7% males TRANS. Commonest symptoms were shortness of breath MESHD (94.5%), fever HP fever MESHD (74.3%) and cough HP (74.3%). Most of our study population consisted of non-smokers (79.7%) and had hypertension HP hypertension MESHD (59.4%) followed by diabetes MESHD (47.2%). Hydroxychloroquine (HCQ) and azithromycin combination is superior to hydroxychloroquine and doxycycline in reducing mortality (p=0.023) whereas Doxycycline alone resulted in increased mortality (p=0.009). Those who did not require antibiotics or required only narrow spectrum antibiotics had increased survival and reduced requirement of invasive mechanical ventilation (p=< 0.0001). in our study population, (44.9%) developed acute kidney injury HP acute kidney injury MESHD, 2.7% needed re-intubations 10.8% developed surgical emphysema HP emphysema MESHD and 2.7 % thromboembolic MESHD events despite full anticoagulation. ICU mortality was 41.8% and was higher in females TRANS (59.4%, p=0.008), those who had SOFA score > 3.5 at time of admission, raised D-Dimers > 931 ng/ml, NLR > 9.2. It was further high in those who required invasive mechanical ventilation and vasopressor support (58.1% mortality p=< 0.001). ICU stay was more prolonged in those requiring invasive mechanical ventilation as compared to those who did not. (23 days vs 6 days, p=0.001). Mean plateau pressure was 19.6 ± 7.6; mean Driving pressures 14.4 ± 4.6; mean PaO2/FiO2 150.7 ± 73.9; mean SPO2/FiO2 173.9 ± 106.9; mean PEEP was 8.2 ±4.33.Conclusion: We concluded that severe covid pneumonia HP pneumonia MESHD is common amongst males TRANS, non-smokers those who had comorbid. HCQ and azithromycin combination is superior to combination of HCQ and doxycycline or doxycycline alone and QT prolongation MESHD is a rare complication. Baseline NLR, APACHI II, SOFA, SAPS II, NUTRIC scores, D-Dimers, invasive ventilation and vasopressor support are important tools to predict ICU mortality. Invasive mechanical ventilation carries higher mortality and associated with more prolonged ICU stay. AKI is most common complication followed by shock HP and surgical emphysema HP emphysema MESHD. CRP, Ferritin levels has no impact on outcome.

    Observational Study on Clinical Features, Treatment and Outcome of COVID 19 in a tertiary care Centre in India- a retrospective case series

    Authors: Raja Bhattacharya; Rohini Ghosh; Manish Kulshrestha; Sampurna Chowdhury; Rishav Mukherjee; Indranil Ray; Lionel Tim Ee Cheng; Lynette Lin Ean Oon; Min Han Tan; Kian Sing Chan; Li Yang Hsu; Ramgyan Yadav; Ashish Timalsina; Chetan Nidhi Wagle; Brij Kumar Das; Ramesh Kunwar; Binaya Chalise; Deepak Raj Bhatta; Mukesh Adhikari; Michael Gale; Daniel J Campbell; David Rawlings; Marion Pepper

    doi:10.1101/2020.08.12.20170282 Date: 2020-08-14 Source: medRxiv

    ABSTRACT Objective: This study will attempt to explore the demographic profile and outcome in the patients receiving multidisciplinary, personalised approach including use of Broad Spectrum Antivirals - Ivermectin, anti-inflammatory and antioxidants roles of Statins and N-acetyl-cysteine along with Standard of Care (SOC) in hospitalised COVID19 patients in a tertiary care centre. Setting: Inpatient department Participants: 191 COVID-19 patients with laboratory confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections MESHD in the year 2020 between June 14- 28, 2020 Main outcome measures: The outcome of Interests are : Studying the demographic profile of COVID 19 cases Study the treatment outcomes in terms of death MESHD or discharge in patients receiving Ivermectin+N-acetyl-cysteine+Statin along with Standard of care. Results: 148 patients were included in the study. All of them had confirmed COVID19 infection MESHD by the rtPCR method. Average age TRANS of the patients was 57.57 years ( Range = 17 - 88), 49% were male TRANS, 51% female TRANS. 81% of the patients had at least one or more comorbidities. Most common comorbidities included diabetes MESHD( 32%), Hypertension HP Hypertension MESHD (27%), Ischaemic Heart Disease MESHD (8%). More comorbidities. The in hospital, Case Fatality Rate was therefore, 1.35 %. The remaining 144 were discharged from the facility after an average 12 days duration of stay. Conclusions: Triple therapy with ivermectin + atorvastatin + N-acetylcysteine can be an useful adjunct to standard of care. Keywords: SARS-CoV-2, COVID-19, outpatients, treatment, zinc, hydroxychloroquine, azithromycin

    Characteristics of COVID-19 fatality cases in East Kalimantan, Indonesia

    Authors: Swandari Paramita; Ronny Isnuwardana; Krispinus Duma; Rahmat Bakhtiar; Muhammad Khairul Nuryanto; Riries Choiru Pramulia Yudia; Evi Fitriany; Meiliati Aminyoto

    doi:10.1101/2020.08.01.20166470 Date: 2020-08-04 Source: medRxiv

    Introduction. Coronavirus Disease MESHD (COVID-19) is caused by SARS-CoV-2 infection MESHD. On March 2, 2020, Indonesia announced the first confirmed cases TRANS of COVID-19 infection MESHD. East Kalimantan will play an important role as the new capital of Indonesia. There is attention to the preparedness of East Kalimantan to respond to COVID-19. We report the characteristics of COVID-19 fatality cases in here. Methods. We retrospectively analyzed the fatality cases of COVID-19 patients from the East Kalimantan Health Office information system. All patients were confirmed COVID-19 by RT-PCR examination. Results. By July 31, 2020, 31 fatality cases of patients had been identified as having confirmed COVID-19 in East Kalimantan. The mean age TRANS of the patients was 55.1 + 9.2 years. Most of the patients were men (22 [71.0%]) with age TRANS more than 60 years old (14 [45.2%]). Balikpapan has the highest number of COVID-19 fatality cases from all regencies. Hypertension HP Hypertension MESHD was the most comorbidities in the fatality cases of COVID-19 patients in East Kalimantan. Discussion. Older age TRANS and comorbidities still contributed to the fatality cases of COVID-19 patients in East Kalimantan, Indonesia. Hypertension HP Hypertension MESHD, diabetes MESHD, cardiovascular disease MESHD, and cerebrovascular disease MESHD were underlying conditions for increasing the risk of COVID-19 getting into a serious condition. Conclusion. Active surveillance for people older than 60 years old and having underlying diseases is needed for reducing the case fatality rate of COVID-19 in East Kalimantan. Keywords. Comorbidity, fatality cases, COVID-19, Indonesia.

    A Comprehensive Evaluation of Early Predictors of Disease MESHD Progression in Patients with COVID-19: A Case Control Study

    Authors: Qiang Tang; Yanwei Liu; Yingfeng Fu; Ziyang Di; Kailiang Xu; Bo Tang; Hui Wu; Maojun Di

    doi:10.21203/rs.3.rs-50527/v1 Date: 2020-07-29 Source: ResearchSquare

    Background: The 2019 coronavirus disease MESHD (COVID-19) has become an unprecedented public health crisis with nearly 16 million confirmed cases TRANS and 630,000 deaths worldwide. Methods: We retrospectively investigated the demographic, clinical, laboratory, radiological and treatment data of COVID-19 patients consecutively enrolled from January 18 to May 15, 2020, in Taihe and Jinzhou central hospital. Results: Of all 197 patients, the median age TRANS was 66.5 years (IQR 7-76), and 120 (60.9%) patients were males TRANS. We identified 88 (44.7%) of 197 COVID-19 patients as the disease progression (aggravation) cases. The aggravation cases tend to have more medical comorbidity: hypertension HP hypertension MESHD (34.1%), diabetes MESHD (30.7%), and presented with dyspnea HP dyspnea MESHD (34.1%), neutrophilia HP (60.2%), and lymphocytopenia MESHD (73.9%), compared with those without. And the patients with disease progression showed significantly higher level of Fibrinogen (Fbg), D-dimer, IL-6, C-reactive protein (CRP), procalcitonin (PCT), and serum SERO ferritin, and were more prone to develop organ damage in the liver, kidney, and heart (P<0.05). Multivariable regression showed that advanced age TRANS, comorbidities, lymphopenia HP lymphopenia MESHD, and elevated level of Fbg, lactate dehydrogenase (LDH), Cardiac troponin (CTnI), IL-6, serum SERO ferritin were the significant predictors of disease progression. Further, we investigated antibody SERO responses to SARS-CoV-2 and found that the levels of IgM and IgG were significantly higher in the disease progression cases compared to non-progression cases from 3 weeks after symptom onset TRANS. In addition, the disease progression group tended to peak later and has a more vigorous IgM/IgG response against SARS-CoV-2. Further, we performed Kaplan-Meier analysis and found that 61.6% of patients had not experienced ICU transfer or survival from hospital within 25 days from admission.Conclusions: Investigating the potential factors of advanced age TRANS, comorbidities and elevated level of IL-6, serum SERO ferritin and Kaplan-Meier analysis enables early identification and management of patients with poor prognosis. Detection of the dynamic antibody SERO may offer vital clinical information during the course of SARS-CoV-2 and provide prognostic value for patients infection MESHD.  

    A severe coronavirus disease MESHD 2019 patient with high-risk predisposing factors died from massive gastrointestinal bleeding MESHD: a case report

    Authors: Taojiang Chen; Qin Yang; Hongyu Duan

    doi:10.21203/rs.3.rs-45116/v1 Date: 2020-07-17 Source: ResearchSquare

    Background: SARS-CoV-2 is highly infectious and has been a significant public health threat. Despite typical manifestations of illness are dominated by respiratory symptom, some patients have concurrent gastrointestinal manifestations, including   nausea MESHD, diarrhea HP diarrhea MESHD, and vomiting HP vomiting MESHD. Massive gastrointestinal bleeding MESHD, however, has rarely been reported. Case presentation: We herein describe a case of severe SARS-CoV-2 infected MESHD patient with several risk factors for poor prognosis, including male TRANS, hypertension HP hypertension MESHD, old age TRANS, mixed bacterial infection MESHD and multilobular infiltration on radiological imaging. After improvement of respiratory status, the onset of gastrointestinal bleeding MESHD occurred, probably resulting from direct viral invasion as evidenced by the positive findings for SARS-CoV-2 in the repeat stool specimens. Although aggressive resuscitation was administered, hematochezia HP hematochezia MESHD was uncontrolled. The patient rapidly deteriorated, suffered cardiac arrest HP cardiac arrest MESHD, and expired. Conclusions: Digestive symptoms could be severe in SARS-CoV-2 infected MESHD patients, especially for the high-risk individuals with predisposing conditions. A more thorough protocol for preventing cross-infection MESHD through faecal-oral transmission TRANS should be implemented in the process of patient care and infection MESHD control.

    Clinical, Behavioral and Social Factors Associated with Racial Disparities in Hospitalized and Ambulatory COVID-19 Patients from an Integrated Health Care System in Georgia

    Authors: Felipe Lobelo; Alan X Bienvenida; Serena Leung; Armand N Mbanya; Elizabeth J. Leslie; Kate E Koplan; S. Ryan Shin

    doi:10.1101/2020.07.08.20148973 Date: 2020-07-10 Source: medRxiv

    Introduction: Racial and ethnic minorities have shouldered a disproportioned burden of coronavirus disease MESHD 2019 (COVID-19) infection MESHD to date in the US, but data on the various drivers of these disparities is limited. Objectives: To describe the characteristics and outcomes of COVID-19 patients and explore factors associated with hospitalization risk by race. Methods: Case series of 448 consecutive patients with confirmed COVID-19 seen at Kaiser Permanente Georgia (KPGA), an integrated health care system serving the Atlanta metropolitan area, from March 3 to May 12, 2020. KPGA members with laboratory-confirmed COVID-19. Multivariable analyses for hospitalization risk also included an additional 3489 persons under investigation (PUI) with suspected infection MESHD. COVID-19 treatment and outcomes, underlying comorbidities and quality of care management metrics, socio-demographic and other individual and community-level social determinants of health (SDOH) indicators. Results: Of 448 COVID-19 positive members, 68,3% was non-Hispanic Black (n=306), 18% non-Hispanic White (n=81) and 13,7% Other race (n=61). Median age TRANS was 54 [IQR 43-63) years. Overall, 224 patients were hospitalized, median age TRANS 60 (50-69) years. Black race was a significant factor in the Confirmed + PUI, female TRANS and male TRANS models (ORs from 1.98 to 2.19). Obesity HP was associated with higher hospitalization odds in the confirmed, confirmed + PUI, Black and male TRANS models (ORs from 1.78 to 2.77). Chronic disease MESHD control metrics ( diabetes MESHD, hypertension HP hypertension MESHD, hyperlipidemia HP hyperlipidemia MESHD) were associated with lower odds of hospitalization ranging from 48% to 35% in the confirmed + PUI and Black models. Self-reported physical inactivity was associated with 50% higher hospitalization odds in the Black and Female TRANS models. Residence in the Northeast region of Atlanta was associated with lower hospitalization odds in the Confirmed + PUI, White and female TRANS models (ORs from 0.22 to 0.64) Conclusions: We found that non-Hispanic Black KPGA members had a disproportionately higher risk of infection TRANS risk of infection TRANS infection MESHD and, after adjusting for covariates, twice the risk of hospitalization compared to other race groups. We found no significant differences in clinical outcomes or mortality across race/ethnicity groups. In addition to age TRANS, sex and comorbidity burden, pre-pandemic self-reported exercise, metrics on quality of care and control of underlying cardio-metabolic diseases MESHD, and location of residence in Atlanta were significantly associated with hospitalization risk by race groups. Beyond well-known physiologic and clinical factors, individual and community-level social indicators and health behaviors must be considered as interventions designed to reduce COVID-19 disparities and the systemic effects of racism are implemented.

    Clinical characteristics and outcomes in diabetes MESHD patients admitted with COVID-19 in Dubai: a cross-sectional single centre study.

    Authors: Rahila Bhatti; Amar Omer; Samara Khattib; Seemin Shiraz; Glenn Matfin

    doi:10.1101/2020.07.08.20149096 Date: 2020-07-10 Source: medRxiv

    Aim: To describe the clinical characteristics and outcomes of hospitalised Coronavirus Disease MESHD 2019 (COVID-19) patients with diabetes MESHD. Methods: A cross-sectional observational study was conducted in patients with diabetes MESHD admitted with COVID-19 to Mediclinic Parkview Hospital in Dubai, United Arab Emirates (UAE) from 30th March to 7th June 2020. They had laboratory and/or radiologically confirmed severe acute respiratory syndrome-coronavirus-2 MESHD (SARS-CoV-2), known as COVID-19. Variation in characteristics, length of stay in hospital, diabetes MESHD status, comorbidities and outcomes were examined. Results: A total of 103 patients with confirmed COVID-19 presentations had diabetes MESHD. During the same timeframe, 410 patients overall were admitted with COVID-19 infection MESHD. This gives a total proportion of persons admitted with COVID-19 infection MESHD and coexistent diabetes MESHD/prediabetes of 25%. 67% (n=69) of the COVID-19 diabetes MESHD cohort were male TRANS. Patients admitted with COVID-19 and diabetes MESHD represented 17 different ethnicities. Of these, 59.2% (n=61) were Asians and 35% (n=36) were from Arab countries. Mean age TRANS (SD) was 54 (12.5) years. 85.4% (n=88) were known to have diabetes MESHD prior to admission, while 14.6% (n=15) were newly diagnosed with either diabetes MESHD or prediabetes MESHD during admission. Most patients in the study cohort had type 2 diabetes MESHD or prediabetes MESHD, with only 3% overall having type 1 diabetes MESHD (n=3). 46.9% of patients had evidence of good glycaemic control of their diabetes MESHD during the preceding 4-12 weeks prior to admission as defined arbitrarily by admission HbA1c <7.5%. 73.8% (n=76) had other comorbidities including hypertension HP hypertension MESHD, ischaemic heart disease MESHD, and dyslipidaemia. Laboratory data Mean(SD) on admission for those who needed ward-based care versus those needing intensive care unit (ICU) care: Fibrinogen 462.75 (125.16) mg/dl vs 660 (187.58) mg/dl ; D-dimer 0.66 (0.55) mcg/ml vs 2.3 (3.48) mcg/ml; Ferritin 358.08 (442.05) mg/dl vs 1762.38 (2586.38) mg/dl; and CRP 33.9 (38.62) mg/L vs 137 (111.72) mg/L were all statistically significantly higher for the ICU cohort (p<0.05). Average length of stay in hospital was 14.55 days. 28.2% of patients needed ICU admission. 4.9% (n=5) overall died during hospitalisation (all in ICU). Conclusions: In this single-centre study in Dubai, 25% of patients admitted with COVID-19 also had diabetes MESHD/ prediabetes MESHD. Most diabetes MESHD patients admitted to hospital with COVID-19 disease were males TRANS of Asian origin. 14.6% had new diagnosis of diabetes MESHD/prediabetes on admission. The majority of patients with diabetes MESHD/ prediabetes MESHD and COVID-19 infection had other important comorbidities (n=76; 73.8%). Only 4 patients had negative COVID-19 RT-PCR but had pathognomonic changes of COVID-19 radiologically. Our comprehensive laboratory analysis revealed distinct abnormal patterns of biomarkers that are associated with poor prognosis: Fibrinogen, D-dimer, Ferritin and CRP levels were all statistically significantly higher (p<0.05) at presentation in patients who subsequently needed ICU care compared with those patients who remained ward-based. 28.2% overall needed ICU admission, out of which 5 patients died. More studies with larger sample sizes are needed to compare data of COVID-19 patients admitted with and without diabetes MESHD within the UAE region.

    COVID-19 related deaths in an urban academic medical center in Brooklyn – A descriptive case series

    Authors: James Andrew McCracken; Mohamed Nakeshbandi; Jeffrey Arace; Wayne J Riley; Roopali Sharma

    doi:10.21203/rs.3.rs-37896/v2 Date: 2020-06-25 Source: ResearchSquare

    Background Available studies are lacking in analysis of baseline demographics and hospital presentation of patients at risk of expiring due to coronavirus disease MESHD 2019 (COVID-19), particularly Black American patients. We conducted a retrospective chart review to determine similarities in demographics and hospital presentation among patients who expired due to COVID-19 at an academic medical center in Brooklyn, New York. Study design and methods This is a retrospective observational study of 200 patients who expired due to complications of COVID-19. Patients were included in this study if they had laboratory-confirmed SARS-CoV-2 infection MESHD and expired during their admission. Data were collected on patients who expired between March 17 and April 16, 2020. Results A vast majority of patients were Black Americans (89%) with no history of international travel TRANS who had more than one comorbidity (81%), with the most common comorbidities being hypertension HP hypertension MESHD (84·5%), diabetes mellitus HP diabetes mellitus MESHD (57·5%), and obesity HP obesity MESHD (41·5%). Fifty-five percent of our patient population had three or more comorbidities. Among patients with available data, C-reactive protein, lactate dehydrogenase, and ferritin values were elevated above normal limits at admission. Dyspnea HP Dyspnea MESHD was the most common presenting symptom (92·5%). Most (90·5%) presented within the first week of symptoms, with a median time of symptoms prior to expiration being 8·42 days (IQR 5·57 – 12·72). Interpretation Socioeconomic status and healthcare inequalities have greatly affected the Black population of Brooklyn, New York, and these disparities become even more apparent in COVID-19 infection MESHD. Patients presenting with numerous comorbidities and elevated inflammatory markers represent a population at high risk of in-hospital mortality.

    Low serum SERO 25-hydroxyvitamin D (25D) levels in patients hospitalised with COVID-19 are associated with greater disease severity: results of a local audit of practice.

    Authors: Grigorios Panagiotou; Su Ann Tee; Yasir Ihsan; Waseem Athar; Gabriella Marchitelli; Donna Kelly; Christopher S. Boot; Nadia Stock; Jim Macfarlane; Adrian R. Martineau; Graham Paul Burns; Richard Quinton

    doi:10.1101/2020.06.21.20136903 Date: 2020-06-23 Source: medRxiv

    Objectives: To audit implementation of a local protocol for the treatment of vitamin D deficiency MESHD ( VDD MESHD) among patients hospitalized for Coronavirus Disease MESHD 2019 (COVID-19), including an assessment of the prevalence SERO of VDD MESHD in these patients, and of potential associations with disease severity and fatality. Design: This was not a study or clinical trial, but rather a retrospective interim audit (Newcastle-upon-Tyne Hospitals Registration No. 10075) of a local clinical care pathway for hospitalized patients with COVID-19-related illness. The Information (Caldicott) Guardian permitted these data to be shared beyond the confines of our institution. Setting: A large tertiary academic NHS Foundation Trust in the North East of England, UK, providing care to COVID-19 patients. Participants: One hundred thirty-four hospitalized patients with documented COVID-19 infection MESHD. Main outcome measures: Adherence to local investigation and treatment protocol; prevalence SERO of VDD MESHD, and relationship of baseline serum SERO 25(OH)D with markers of COVID-19 severity and inpatient fatality versus recovery. Results: 55.8% of eligible patients received Colecalciferol replacement, albeit not always loaded as rapidly as our protocol suggested, and no cases of new hypercalcaemia MESHD occurred following treatment. Patients admitted to ITU were younger than those managed on medical wards (61.1 years +/- 11.8 vs. 76.4 years +/- 14.9, p<0.001), with greater prevalence SERO of hypertension HP hypertension MESHD, and higher baseline respiratory rate, National Early Warning Score-2 and C-reactive protein level. While mean serum SERO 25(OH)D levels were comparable [i.e. ITU: 33.5 nmol/L +/- 16.8 vs. Non-ITU: 48.1 nmol/L +/- 38.2, mean difference for Ln-transformed-25(OH)D: 0.14, 95% Confidence Interval (CI) (-0.15, 0.41), p=0.3], only 19% of ITU patients had 25(OH)D levels greater than 50 nmol/L vs. 60.9% of non-ITU patients (p=0.02). However, we found no association with fatality, potentially due to small sample size, limitations of no-trial data and, potentially, the prompt diagnosis and treatment of VDD MESHD. Conclusions: Subject to the inherent limitations of observational (non-trial) audit data, analysed retrospectively, we found that patients requiring ITU admission were more frequently vitamin D deficient than those managed on medical wards, despite being significantly younger. Larger prospective studies and/or clinical trials are needed to elucidate the role of vitamin D as a preventive and/or therapeutic strategy for mitigating the effects of COVID-19 infection MESHD in patients with VDD MESHD.

    COVID-19 infections MESHD and outcomes in patients with multiple myeloma HP multiple myeloma MESHD in New York City: a cohort study from five academic centers

    Authors: Malin Hultcrantz; Joshua Richter; Cara Rosenbaum; Dhwani Patel; Eric Smith; Neha Korde; Sydney Lu; Sham Mailankody; Urvi Shah; Alexander Lesokhin; Hani Hassoun; Carlyn Tan; Francesco Maura; Andriy Derkach; Benjamin Diamond; Adriana Rossi; Roger N Pearse; Deppu Madduri; Ajai Chari; David Kaminetzky; Marc Braunstein; Christian Gordillo; Faith Davies; Sundar Jagannath; Ruben Niesvizky; Suzanne Lentzsch; Gareth Morgan; Ola Landgren

    doi:10.1101/2020.06.09.20126516 Date: 2020-06-11 Source: medRxiv

    Importance: New York City is a global epicenter for the SARS-CoV-2 outbreak with a significant number of individuals infected by the virus. Patients with multiple myeloma HP multiple myeloma MESHD have a compromised immune system, due to both the disease and anti- myeloma MESHD therapies, and may therefore be particularly susceptible to coronavirus disease MESHD 2019 (COVID-19); however, there is limited information to guide clinical management. Objective: To assess risk factors and outcomes of COVID-19 in patients with multiple myeloma HP multiple myeloma MESHD. Design: Case-series. Setting: Five large academic centers in New York City. Participants: Patients with multiple myeloma HP multiple myeloma MESHD and related plasma SERO cell disorders who were diagnosed with COVID-19 between March 10th, 2020 and April 30th, 2020. Exposures: Clinical features and risk factors were analyzed in relation to severity of COVID-19. Main Outcomes and Measures: Descriptive statistics as well as logistic regression were used to estimate disease severity reflected in hospital admissions, intensive care unit (ICU) admission, need for mechanical ventilation, or death MESHD. Results: Of 100 multiple myeloma HP multiple myeloma MESHD patients ( male TRANS 58%; median age TRANS 68, range 41-91) diagnosed with COVID-19, 74 (74%) were admitted; of these 13 (18%) patients were placed on mechanical ventilation, and 18 patients (24%) expired. None of the studied risk factors were significantly associated (P>0.05) with adverse outcomes (ICU-admission, mechanical ventilation, or death MESHD): hypertension HP hypertension MESHD (N=56) odds ratio (OR) 2.3 (95% confidence interval [CI] 0.9-5.9); diabetes MESHD (N=18) OR 1.1 (95% CI 0.3-3.2); age TRANS >65 years (N=63) OR 2.0 (95% CI 0.8-5.3); high dose melphalan with autologous stem cell transplant <12 months (N=7) OR 1.2 (95% CI 0.2-7.4), IgG<650 mg/dL (N=42) OR=1.2 (95% CI 0.4-3.1). In the entire series of 127 patients with plasma SERO cell disorders, hypertension HP hypertension MESHD was significantly associated with the combined end-point (OR 3.4, 95% CI 1.5-8.1). Conclusions and Relevance: Although multiple myeloma HP myeloma MESHD patients have a compromised immune system due to both the disease and therapy; in this largest disease specific cohort to date of patients with multiple myeloma HP multiple myeloma MESHD and COVID-19, compared to the general population, we found risk factors for adverse outcome to be shared and mortality rates to be within the higher range of officially reported mortality rates.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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