Corpus overview


Overview

MeSH Disease

Fatigue (57)

Fever (54)

Cough (31)

Coronavirus Infections (27)

Dyspnea (23)


Human Phenotype

Cough (62)

Fatigue (62)

Fever (58)

Pneumonia (19)

Hypertension (18)


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.

    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.

    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.

    A case report of moderate COVID-19 with an extremely long-term viral shedding period in China

    Authors: yonghong wang; chaoyuan liu; qinghui meng; shuang gui; yu wu; pengjiang cheng; peng wang; xiuyong liao

    doi:10.21203/rs.3.rs-59700/v1 Date: 2020-08-14 Source: ResearchSquare

    BackgroundAn ongoing outbreak of novel coronavirus disease MESHD 2019 (COVID-19) from Wuhan, China, is currently recognized as a global public health emergency, which has subsequently spread to the rest of China and other countries. The WHO raised the COVID-19 alert to the highest level. The virus is a new highly contagious via human-to-human transmission TRANS. The median duration of viral shedding is 20.0 days. We report that the longest duration of viral shedding was 32.0 days from illness onset in a patient with moderate COVID-19 admitted to QianJiang Central Hospital.Case presentationA 37-year-old male TRANS sought medical advice while suffering from fever HP fever MESHD, dry cough MESHD cough HP, fatigue HP fatigue MESHD, dizziness MESHD, runny nose and diarrhoea MESHD. Five days before the visit, he had a history of travel TRANS from affected geographic areas. The patient had a positive RT-PCR test, and chest CT images showed multiple nodules and mixed ground-glass opacification with consolidation in both lungs. Laboratory findings showed that his lymphocyte and CD4+ counts were below the normal range. The patient was given antiviral treatment, including arbidol, lopinavir, IFN-α, and traditional Chinese medicine, and other necessary support care. All clinical symptoms and CT imaging manifestation abnormalities resolved during the course of therapy.ConclusionAlthough the positive RT-PCR tests were verified in consecutive upper respiratory specimens, the clinical symptoms, CT imaging findings, CD4 + lymphocyte counts, and IgG antibody SERO levels had obviously improved. Positive tests may be detecting pieces of inactive viruses, which would not be transmissible in individual cases.

    Clinical Characteristics of COVID-19 Patients with Recurrent PCR Positivity After Hospital Discharge

    Authors: Kaige Wang; Panwen Tian

    doi:10.21203/rs.3.rs-54709/v1 Date: 2020-08-06 Source: ResearchSquare

    Objective: This study aimed to investigate the clinical characteristics of COVID-19 patients with recurrent SARS-CoV-2 positivity after hospital discharge. Methods: This retrospective study included COVID-19 patients who were readmitted for recurrence of positive SARS-CoV-2 RNA. Univariate and multivariate analyses were performed to assess the risk factors associated to the duration of recurrent RNA positivity.Results: Among the 287 discharged COVID-19 patients, 33 (11.5%) patients with recurrent PCR positivity were included. Among these patients, 21 (63.7%) patients were female TRANS, their mean age TRANS was 48.7 (±19.7) years old. 22 (66.7%) patients were asymptomatic TRANS. The following clinical features were presented in other patients: cough HP, fatigue HP fatigue MESHD, sore throat, fever HP fever MESHD and expectoration. The chest CT findings revealed that 8 (24.2%) patients were characterized by deterioration compared to the previous results. The median duration of recurrent RNA positivity was 9.0 days (IQR, 6.0, 15.0). We found that increased serum SERO SARS-CoV-2-specific IgG antibody SERO titer, elevated serum creatinine HP serum SERO creatinine level, and female TRANS gender TRANS were the risk factors for the prolonged duration of recurrent RNA positivity.Conclusion: SARS-CoV-2 turned positive in a minority of discharged patients with COVID-19. Most patients experienced mild clinical course. Increased IgG antibody SERO titer, creatinine and female TRANS gender TRANS were correlated to the prolonged RNA clearance time.

    Examining Australian's beliefs, misconceptions, and sources of information for COVID-19: A national online survey

    Authors: Rae Thomas; Hannah Greenwood; Zoe A Michaleff; Eman Abukmail; Tammy Hoffmann; Kirsten J McCaffery; Leah Hardiman; Paul Glasziou

    doi:10.1101/2020.07.27.20163204 Date: 2020-07-29 Source: medRxiv

    Objective: Public cooperation to practice preventive health behaviours is essential to manage the transmission TRANS of infectious diseases MESHD such as COVID-19. We aimed to investigate beliefs about COVID-19 diagnosis, transmission TRANS and prevention that have the potential to impact the uptake of recommended public health strategies. Design: An online cross-sectional survey conducted May 8 to May 11 2020. Participants: A national sample of 1500 Australian adults TRANS with representative quotas for age TRANS and gender TRANS provided by online panel provider. Main outcome measure: Proportion of participants with correct/incorrect knowledge of COVID-19 preventive behaviours and reasons for misconceptions. Results: Of the 1802 potential participants contacted, 289 were excluded, 13 declined, and 1500 participated in the survey (response rate 83%). Most participants correctly identified washing your hands regularly with soap and water (92%) and staying at least 1.5m away from others (90%) could help prevent COVID-19. Over 40% (incorrectly) considered wearing gloves outside of the home would prevent them contracting COVID-19. Views about face masks were divided. Only 66% of participants correctly identified that regular use of antibiotics would not prevent COVID-19. Most participants (90%) identified fever HP fever MESHD, fatigue HP fatigue MESHD and cough HP as indicators of COVID-19. However, 42% of participants thought that being unable to hold your breath for 10 seconds without coughing HP was an indicator of having the virus. The most frequently reported sources of COVID-19 information were commercial television channels (56%), the Australian Broadcasting Corporation (43%), and the Australian Government COVID-19 information app (31%). Conclusions: Public messaging about hand hygiene and physical distancing to prevent transmission TRANS appear to have been effective. However, there are clear, identified barriers for many individuals that have the potential to impede uptake or maintenance of these behaviours in the long-term. Currently these non-drug interventions are our only effective strategy to combat this pandemic. Ensuring ongoing adherence to is critical.

    Older adults TRANS hospitalized with Covid-19: Clinical characteristics and early outcomes from a single center in Istanbul, Turkey 

    Authors: Alpay Medetalibeyoğlu; Naci Senkal; Murat Kose; Yunus Catma; Emine Bilge Caparali; Mustafa Erelel; Mustafa Oral Oncul; Gulistan Bahat; Tufan Tukek

    doi:10.21203/rs.3.rs-47728/v1 Date: 2020-07-22 Source: ResearchSquare

    Objective: Older adults TRANS have been continuously reported to be at higher risk for adverse outcomes of Covid-19. We aimed to describe clinical characteristics and early outcomes of the older Covid-19 patients hospitalized in our center comparatively with the younger patients, and also to analyze the triage factors that were related to the in-hospital mortality of older adults TRANS.Design: Retrospective; observational studySetting: Istanbul Faculty of Medicine hospital, TurkeyParticipants: 362 hospitalized patients with laboratory-confirmed Covid-19 from March 11 to May 11, 2020.Measurements: The demographic information; associated comorbidities; presenting clinical, laboratory, radiological characteristics on admission and outcomes from the electronic medical records were analyzed comparatively between the younger (<65 years) and older (≥65 years) adults TRANS. Factors associated with in-hospital mortality of the older adults TRANS were analyzed by multivariate regression analyses.Results: The median age TRANS was 56 years (interquartile range [IQR], 46-67), and 224 (61.9%) were male TRANS. There were 104 (28.7%) patients ≥65 years of age TRANS. More than half of the patients (58%) had one or more chronic comorbidity. The three most common presenting symptoms in the older patients were fatigue HP atigue/ MESHD myalgia HP yalgia MESHD(89.4%), d ry cough MESHD cough HP (72.1%), and fever HP ever MESHD(63.5%). Cough HP and fever HP ever MESHDwere significantly less prevalent in older adults TRANS compared to younger patients (p=0.001 and 0.008, respectively). Clinically severe pneumonia HP neumonia MESHDwas present in 31.5% of the study population being more common in older adults TRANS (49% vs. 24.4%) (p<0.001). The laboratory parameters that were significantly different between the older and younger adults TRANS were as follows: the older patients had significantly higher CRP, D-dimer, TnT, pro-BNP, procalcitonin levels, higher prevalence SERO of lymphopenia HP ymphopenia, MESHD neutrophilia HP, increased creatinine, and lower hemoglobin, ALT, albumin level (p<0.05). In the radiological evaluation, more than half of the patients (54.6%) had moderate-severe pneumonia HP neumonia, MESHD which was more prevalent in older patients (66% vs. 50%) (p=0.006). The adverse outcomes were significantly more prevalent in older adults TRANS compared to the younger patients (ICU admission, 28.8% vs. 8.9%; mortality, 23.1% vs. 4.3%, p<0.001).  Among the triage evaluation parameters, the only factor associated with higher mortality was the presence of clinically severe pneumonia HP neumonia MESHDon admission (Odds Ratio=12.3, 95% confidence interval=2.7-55.5, p=0.001).Conclusion: Older patients presented with more prevalent chronic comorbidities, less prevalent symptomatology but more severe respiratory signs and l aboratory abnormalities MESHDthan the younger patients. Among the triage assessment factors, the clinical evaluation of pulmonary involvement came in front to help clinicians to stratify the patients for mortality risk.

    Clinical Characteristics and Predictive Value of low CD4+T Count in Patients with Moderate and Severe COVID-19: A Multicenter Retrospective Study

    Authors: Xue-song Wen; Lei Gao; Dan Jiang; Xiao-cheng Cheng; Bin He; Yue Chen; Peng Lei; Wei-xiao Tan; Shu Qin; Guo-qiang Cai; dongying zhang

    doi:10.21203/rs.3.rs-46009/v1 Date: 2020-07-20 Source: ResearchSquare

    Background In December 2019, coronavirus disease MESHD 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) emerged in Wuhan, Hubei, China. And, it has become a global pandemic. Describe the patient's clinical symptoms in detail, finding markers that predict the prognosis of patients with COVID-19 are of great value.MethodsIn this multicenter, retrospective study, 476 patients with COVID-19 were recruited from a consecutive series. After screening, a total of 395 patients were included in this study. All-cause death MESHD was the primary endpoint. All patients were followed up from admission till discharge or death MESHD.ResultsThe dominant symptoms observed in the study included fever HP fever MESHD on admission, cough HP, fatigue HP fatigue MESHD and shortness of breath MESHD. The most frequent comorbidities were hypertension HP hypertension MESHD and diabetes MESHD. Compared with patients with higher CD4+T cells level, patients with lower CD4+T cells level were older and were more frequently male TRANS. In terms of laboratory findings, lymphocyte count, CD4+T cell count, CD8+T cell count were significantly lower in low group than in higher group. The case in-hospital death rate was significant higher in patients with lower CD4+T level. After adjusting for potential confounding factors, CD4+T count below the lower limit of normal showed independent prognostic value for all-cause in-hospital death MESHD in patients with COVID-19. Conclusions: Reductions in lymphocytes and lymphocyte subsets are common in COVID-19 patients, especially in severe cases. It is the CD8+T count, not the CD4+T count, that reflected the severity of the patient’s disease. Lower CD4+T count is independently associated with an increased rate of in-hospital death. Trial registration: Prognostic Factors of Patients With COVID-19, NCT04292964. Registered 03 March 2020. https://clinicaltrials.gov/ct2/show/NCT04292964.

    Clinical characteristics and Mortality risk factors among COVID-19 patients in Qom–Iran; The results of a Retrospective Cohort study

    Authors: Ahmad Hormati; SeyedYaser Foroghi Ghomi; masoudreza sohrabi; Ali Gholami; Saeede Jafari; Amir Jabbari; Reza AminNejad; Javad Khodadadi; Mansoureh shakeri; Alireza ShahHamzeh; Mahbobeh Afifian; Zohre Azad; Sajjad Ahmadpour; MohammadHadi Karbalai; MohammadReza Babaei; Parisa Karimzadeh; SeyedKamal Esshagh Hosseini

    doi:10.21203/rs.3.rs-42497/v1 Date: 2020-07-13 Source: ResearchSquare

    Background & AimCoronavirus 2019 (COVID-19) outbreak in the Middle East was initially reported in Qom-Iran. Clinical and epidemiologic and mortality risk factors details have not been already fully explained.MethodIn a retrospective study, the hospitalized adult TRANS patients with laboratory diagnosed COVID-19 between February 25 to March 20, 2020 were enrolled. A checklist including demographic, clinical, laboratorial, imaging, and treatment data was completed for each of the participant. The data were extracted from electronic medical records. In case of lack of information, a member of the research team contacted them via phone. All the dead patients and the first one hundred survived patients with these criteria were enrolled in the study. Outcome defined as death MESHD or discharge of patients.ResultsOf admitted patients, 200 patients who had been discharged or died were involved in this study. The majority of them were male TRANS (56%). The mean age TRANS of all patients was 62.63 ± 14.9. Co-morbidity was reported in 124 (62%) patients in which hypertension HP hypertension MESHD was the most common. The most frequent clinical presentations were dyspnea HP dyspnea MESHD in 169 (84.5%), cough HP cough MESHD in 150 (75%), and fatigue HP fatigue MESHD/weakness in 123 (61.5%) patients. The main complications were respiratory failure HP respiratory failure MESHD and acute respiratory distress syndrome MESHD respiratory distress HP syndrome with prevalence SERO of 143 (71.5%) and 105 (52.5%), accordingly. Multiple logistic models showed that decline of hemoglobin level (OR = 10.09), neutrophilia HP (OR = 3.48), high blood SERO urea nitrogen (OR = 4.29,), SpO2 ≤ 90% (OR = 3.38), and presence of patchy consolidation (OR = 6.81) were associated with poor outcome.ConclusionCOVID-19 disease has multiple aspects. CT scan findings, complete blood SERO count with differential, high blood SERO urea nitrogen and SpO2 are related to mortality. Hence needs to pay serious attention during admitting and surveillance, particularly among elderly TRANS patients and who with preexisting morbidities.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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