Corpus overview


MeSH Disease

Human Phenotype

Fever (34)

Cough (29)

Pneumonia (11)

Fatigue (9)

Hypertension (8)


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    Clinical Characteristics, Risk Factors and Predictive Value of COVID-19 Pneumonia HP: A Retrospective Study of 173 Patients in Wuhan, China

    Authors: Yang Zhang; Jun Xue; Mi Yan; Jing Chen; Hai Liu; Shao-Bo Wang; Jian-Xing Luo; Fang Yang; Jian-Yuan Tang; Xiao-Yu Hu

    doi:10.21203/ Date: 2020-09-11 Source: ResearchSquare

    Background: COVID-19 is a globally emerging infectious disease MESHD. As the global epidemic continues to spread, the risk of COVID-19 transmission TRANS and diffusion in the world will also remain. Currently, several studies describing its clinical characteristics have focused on the initial outbreak, but rarely to the later stage. Here we described clinical characteristics, risk factors for disease severity and in-hospital outcome in patients with COVID-19 pneumonia HP pneumonia MESHD from Wuhan. Methods: Patients with COVID-19 pneumonia HP pneumonia MESHD admitted to Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from February 13 to March 8, 2020, were retrospectively enrolled. Multivariable logistic regression analysis was used to identify risk factors for disease severity and in-hospital outcome and establish predictive models. Receiver operating characteristic (ROC) curve was used to assess the predictive value of above models.Results: 106 (61.3%) of the patients were female TRANS. The mean age TRANS of study populations was 62.0 years, of whom 73 (42.2%) had underlying comorbidities mainly including hypertension HP hypertension MESHD (24.9%). The most common symptoms on admission were fever HP fever MESHD (67.6%) and cough HP (60.1%), digestive symptoms (22.0%) was also very common. Older age TRANS (OR: 3.420; 95%Cl: 1.415-8.266; P=0.006), diarrhea HP diarrhea MESHD (OR: 0.143; 95%Cl: 0.033-0.611; P=0.009) and lymphopenia HP lymphopenia MESHD (OR: 4.769; 95%Cl: 2.019-11.266; P=0.000) were associated with severe illness on admission; the area under the ROC curve (AUC) of predictive model were 0.860 (95%CI: 0.802-0.918; P=0.000). Older age TRANS (OR: 0.309; 95%Cl: 0.142-0.674; P=0.003), leucopenia (OR: 0.165; 95%Cl: 0.034-0.793; P=0.025), increased lactic dehydrogenase (OR: 0.257; 95%Cl: 0.100-0.659; P=0.005) and interleukins-6 levels (OR: 0.294; 95%Cl: 0.099-0.872; P=0.027) were associated with poor in-hospital outcome; AUC of predictive model were 0.752 (95%CI: 0.681-0.824; P=0.000).Conclusion: Older patients with diarrhea HP diarrhea MESHD and lymphopenia HP lymphopenia MESHD need early identification and timely intervention to prevent the progression to severe COVID-19 pneumonia HP pneumonia MESHD. However, older patients with leucopenia, increased lactic dehydrogenase and interleukins-6 levels are at a high risk for poor in-hospital outcome.Trial registration: ChiCTR2000029549

    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/ 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.

    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/ 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.

    Epidemiological Characteristics of COVID-19 and Efforts to Prevent Community Transmission TRANS: The Sri Lankan Experience

    Authors: Manjula Kariyawasam; Sashimali Wickramasinghe; Samitha Ginige; Sudath Samaraweera; Paba Palihawadana; Thilanga Ruwanpathirana; Chintha Jayasinghe; Hathshya Munasingha; Alinda Perera; Thiraj Haputhanthri; Deepa Gamage

    doi:10.21203/ Date: 2020-08-05 Source: ResearchSquare

    Background – With the onset of COVID-19 pandemic, the government of Sri Lanka took proactive measures to prevent a community outbreak in the country. This paper describes the measures taken by the government in the initial stages to contain the virus, along with the epidemiological characteristics of the first 200 laboratory confirmed COVID-19 patients.Methods – Telephone interviews were conducted for first 200 consecutive patients diagnosed with COVID-19, after obtaining informed verbal consent. Descriptive data are presented as binary variables and in frequency distribution tables.Results- From the diagnosis of the first patient, 76 days elapsed for the first 200 patients to be diagnosed. Majority were males TRANS in the 40-49 age group TRANS. There were three foreign nationals, while others were Sri Lankans. Among the Sri Lankans, 81 (41.1%) had an overseas travel TRANS history. Following implementation of the cohort quarantine concept, 47% of the overseas returnees were reported from quarantine centres. Over two-thirds of the patients presented with symptoms (n=137, 68.5%) and the most common symptoms were fever HP fever MESHD, cough HP cough MESHD and sore throat. The case fatality rate for the sample was 3.5%. out of the 200 patients, 103 (51.5%) were primary patients, while 92 (46%) were secondary patients. The source of exposure could not be determined for five patients. Conclusions – Due to measures instigated by the government, such as cohort quarantining, extensive contact tracing TRANS and testing of close contacts TRANS, Sri Lanka was able to prevent a wide spread community outbreak of COVID-19.

    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.

    Clinical Characteristics of 107 Patients with COVID-19 in Ningbo, China: Single Center Experience Outside Hubei

    Authors: Boming Wu; Junjie Li; Hongping Xuan; Nanhong Zheng; Honghua Ye; Yaoren Hu; Tong’en Chen; Hao Ying; Lingyan Fan; Qing Xie; Zike Sheng; Yin Ying

    doi:10.21203/ Date: 2020-07-17 Source: ResearchSquare

    Background Since December 2019, there has be an outbreak of coronavirus disease MESHD 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) in Wuhan, China. Nowadays, it rapidly spread across the country and then the worldwide. We aimed to investigate the clinical characteristics of patients with COVID-19.Methods The patients with confirmed COVID-19 admitted between January 25 and February 10, 2020, were enrolled. Epidemiological, demographic, clinical, laboratory, radiological data, and antivirus therapies, were retrospectively collected and analyzed. The 90-day follow-up of these patients was also performed.Results A total of 107 patients were included. The median age TRANS was 55.0 years (range from 18.0 to 85.0 years), and 72 (67.3%) were female TRANS. Ninety-three (86.9%) of the patients had a history of contacting with residents from Wuhan (n=31), or contacting with confirmed COVID-19 patients (n=62) within 2 weeks. Fifty-eight (54.2%) had a family cluster onset. Fever HP Fever MESHD and cough HP cough MESHD were the most common symptoms. Only two patients had diarrhea HP diarrhea MESHD. The most common underlying disease was hypertension HP hypertension MESHD. Lymphopenia HP Lymphopenia MESHD was observed in 26 patients. Fifty-two patients with an elevated level of IL-6. On admission, bilateral patchy shadowing and ground-glass opacity were the typical radiological findings on chest computed tomography. Six patients had an intensive care unit (ICU) stay. Antivirus therapy was performed to all patients. 105 patients discharged with an improved condition, and no death MESHD was occurred during our 90-day follow-up for these patients.Conclusions Patients with COVID-19 in our hospital had relatively mild symptoms, and good prognosis. This study also highlights the importance of human-to-human transmission TRANS in COVID-19.

    Placental SARS-CoV-2 in a patient with mild COVID-19 disease

    Authors: Albert L. Hsu; Minhui Guan; Eric Johannesen; Amanda J. Stephens; Nabila Khaleel; Nikki Kagan; Breanna C. Tuhlei; Xiu-Feng Wan

    doi:10.1101/2020.07.11.20149344 Date: 2020-07-14 Source: medRxiv

    Background: The full impact of COVID-19 on pregnancy remains uncharacterized. Current literature suggests minimal maternal, fetal, and neonatal morbidity and mortality,1 and COVID-19 manifestations appear similar between pregnant and non-pregnant women.2 We present a case of placental SARS-CoV-2 virus in a woman with an uncomplicated pregnancy and mild COVID-19 disease. Methods: A pregnant woman was evaluated at University of Missouri Women and Childrens Hospital. Institutional review board approval was obtained; information was obtained from medical records. Reverse transcriptase-polymerase chain reaction (RT-PCR) was performed to detect SARS-CoV-2. A gynecological pathologist examined the placenta and performed histolopathology. Sections were formalin-fixed and paraffin-embedded; slides were cut and subjected to hematoxylin-and-eosin or immunohistochemistry (IHC) staining. IHC was performed with specific monoclonal antibodies SERO to detect SARS-CoV-2 antigen or to identify trophoblasts. Findings: A 29 year-old multigravida presented at 40-4/7 weeks for labor induction. With myalgias HP myalgias MESHD two days prior, she tested positive for SARS-CoV-2. Her parents TRANS were in self-isolation for COVID-19 positivity; husband was asymptomatic TRANS and tested negative for COVID-19, but exposed to a workplace (meatpacking facility) outbreak. Prenatal course was uncomplicated, with no gestational hypertension HP hypertension MESHD. She was afebrile and asymptomatic TRANS with normal vital signs throughout hospitalization. Her myalgias HP myalgias MESHD improved prior to admission. A liveborn male TRANS infant was delivered vaginally. Newborn course was uneventful; he was appropriate for gestational age TRANS, physical was unremarkable, and he was discharged home at 36 hours. COVID-19 RT-PCR test was negative at 24 hours. At one-week follow-up, newborn was breastfeeding well, with no fevers HP or respiratory distress HP. Overall placental histology is consistent with acute uterine hypoxia MESHD (subchorionic laminar necrosis MESHD) superimposed on chronic uterine hypoxia MESHD (extra-villous trophoblasts and focal chronic villitis MESHD). IHC using SARS-CoV-2 nucleocapsid-specific monoclonal antibody SERO demonstrated SARS-CoV-2 antigens throughout the placenta in chorionic villi endothelial cells, and rarely in CK7-expressing trophoblasts. Negative control placenta (November 2019 delivery) and ferret nasal turbinate tissues (not shown) were negative for SARS-CoV-2. Interpretation: In this report, SARS-CoV-2 was found in the placenta, but newborn was COVID-19 negative. Our case shows maternal vascular malperfusion, with no features of fetal vascular malperfusion. To our knowledge, this is the first report of placental COVID-19 despite mild COVID-19 disease in pregnancy (with no symptoms of COVID-19 aside from myalgias HP myalgias MESHD); specifically, this patient had no fever HP fever MESHD, cough HP cough MESHD, or shortness of breath MESHD, but only myalgias HP myalgias MESHD and sick contacts. Despite her having mild COVID-19 disease in pregnancy, we demonstrate placental vasculopathy MESHD and presence of SARS-CoV-2 virus across the placenta. Evidence of placental COVID-19 raises concern for possible placental vasculopathy MESHD (potentially leading to fetal growth restriction, pre- eclampsia HP eclampsia MESHD, and other pregnancy complications) as well as for potential vertical transmission TRANS -- especially for pregnant women who may be exposed to COVID-19 in early pregnancy. Further studies are urgently needed, to determine whether women with mild, pre-symptomatic, or asymptomatic TRANS COVID-19 may have SARS-CoV-2 virus that can cross the placenta, cause fetal vascular malperfusion, and possibly affect the fetus. This raises important public health and public policy questions of whether future pregnancy guidance should include stricter pandemic precautions, such as screening for a wider array of COVID-19 symptoms, increased antenatal surveillance, and possibly routine COVID-19 testing on a regular basis throughout pregnancy.

    Emergency high ligation in a suspected COVID-19 pediatric patient with incarcerated inguinal hernia MESHD inguinal hernia HP: a case report

    Authors: Munawir Makkadafi; Aditya Rifqi Fauzi; Amsyar Praja; Kemala Athollah; . Marcellus; . Gunadi

    doi:10.21203/ Date: 2020-07-09 Source: ResearchSquare

    Background SARS-Cov-2 infects MESHD not only adults TRANS, but also children TRANS, including pediatric surgery patients with acute abdomen. Here, we report a pediatric surgery case with incarcerated inguinal hernia MESHD inguinal hernia HP and suspected COVID-19.Case presentation: A 11-month-old male TRANS was brought to our emergency department with the main complaint of recurrent yellowish-green vomiting HP vomiting MESHD that was experienced from one day before admission. High fever MESHD fever HP and shortness of breath MESHD were also reported. This patient was also suffering from moderate dehydration HP dehydration MESHD. Neither history of contact with a confirmed case TRANS of COVID-19 nor traveling TRANS from any local transmission TRANS area were found. However, a SARS-CoV-2 rapid antibody test SERO revealed a positive result. A lump in the left scrotum that persisted during admission was found. Fluid resuscitation and nasogastric tube placement for decompression was performed. Manual reduction was attempted but failed to reduce the lump. Accordingly, we decided to perform an emergency high ligation using tertiary protection regulations, i.e., full personal protective equipment (PPE) for COVID-19. Intraoperatively, we found a small intestine loop trapped in the scrotum and stuck in the inguinal canal. Postoperatively, the baby was continued to be managed as a patient with COVID-19 while waiting for the real-time reverse transcription polymerase chain reaction (RT-PCR) results.Conclusions During the COVID-19 pandemic, surgeons should always be aware of the possibility of cross- transmission TRANS from the patient, since children TRANS are also susceptible to SARS-CoV-2 infection MESHD. When and wherever possible, surgeons should perform the procedure in the quickest and most effective manner to shorten exposure time with patient and anesthetic aerosols as well as using appropriate PPE.

    COVID-19 presenting as anosmia HP anosmia MESHD and dysgeusia MESHD in New York City emergency departments, March - April, 2020

    Authors: Tina Z. Wang; Jessica Sell; Don Weiss; Ramona Lall

    doi:10.1101/2020.07.06.20147751 Date: 2020-07-07 Source: medRxiv

    Background: Increasing evidence has been emerging of anosmia HP anosmia MESHD and dysgeusia MESHD as frequently reported symptoms in COVID-19. Improving our understanding of these presenting symptoms may facilitate the prompt recognition of the disease in emergency departments and prevent further transmission TRANS. Methods: We examined a cross-sectional cohort using New York City emergency department syndromic surveillance data for March and April 2020. Emergency department visits for anosmia HP anosmia MESHD and/or dysgeusia MESHD were identified and subsequently matched to the Electronic Clinical Laboratory Reporting System to determine testing results for SARS-CoV-2. Results: Of the 683 patients with anosmia HP anosmia MESHD and/or dysgeusia MESHD included, SARS-CoV-2 testing was performed for 232 (34%) and 168 (72%) were found to be positive. Median age TRANS of all patients presenting with anosmia HP anosmia MESHD and/or dysgeusia symptoms MESHD was 38, and 54% were female TRANS. Anosmia HP and/or dysgeusia MESHD was the sole complaint of 158 (23%) patients, of whom 35 were tested for SARS-CoV-2 and 23 (66%) were positive. While the remaining patients presented with at least one other symptom, nearly half of all patients (n=334, 49%) and more than a third of those who tested positive (n=62, 37%) did not have any of the CDC-established symptoms used for screening of COVID-19 such as fever HP fever MESHD, cough HP cough MESHD, shortness of breath MESHD, or sore throat. Conclusions and Relevance: Anosmia HP and/or dysgeusia MESHD have been frequent complaints among patients presenting to emergency departments during the COVID-19 pandemic, and, while only a small proportion of patients ultimately underwent testing for SARS-CoV-19, the majority of patients tested have been positive. Anosmia HP Anosmia MESHD and dysgeusia MESHD likely represent underrecognized symptoms of COVID-19 but may have important future implications in disease diagnosis and surveillance.

    Severe COVID-19 in cardiopath young pregnant without vertical transmission TRANS: a case report

    Authors: Ana Paula Figueiredo de Montalvão França; Danielly do Vale Pereira; Elaine Valéria Rodrigues; Flávia Nunes Vieira; Karine Santos Machado; Pedro Aleixo Nogueira; Ricardo Roberto de Souza Fonseca; Luiz Fernando Almeida Machado

    doi:10.21203/ Date: 2020-07-03 Source: ResearchSquare

    Background: The new betacoronavirus known as severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) is the cause of COVID-19, and has spread rapidly around the world, reaching more than 200 countries, around 7 million people and causing more than 400.000 deaths according to the World Health Organization. Case presentation: A 26-year-old female TRANS at 28 weeks of gestation with regular prenatal care, a heart disease MESHD condition and no previous history of recent national or international traveling presented to a cardiology hospital, in Northern Brazil, with dry cough MESHD cough HP, sustained/continuous high fever HP, which quickly evolved to respiratory failure HP respiratory failure MESHD. Once stabilized an emergency cesarean was performed to preserve the fetus life. After surgery both patient and newborn were in Intensive Care Unit, then both patient and newborn nasopharyngeal and oropharyngeal secretion were obtained to test for respiratory viral infections MESHD, such as SARS-CoV-2, also blood SERO samples were collected for laboratory exams. The patient’s tested positive for SARS-CoV-2 however her newborn SARS-CoV-2. And during treatment due patient’s conditions and severity the case evolved to death.Conclusion: This report highlights the relevance of comorbidities for the unfavorable clinical course of COVID-19, despite the adequate treatment used for patients affected by COVID-19, especially among the risk groups, as well as demonstrating the absence of vertical transmission TRANS of SARS-CoV-2. 

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MeSH Disease
Human Phenotype

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