Corpus overview


MeSH Disease

Human Phenotype

Cough (18)

Fever (17)

Fatigue (5)

Pneumonia (5)

Lymphopenia (5)


    displaying 1 - 10 records in total 19
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    The Prevalence SERO and Clinical Significance of Presymptomatic COVID-19 Patients: How We Can be One Step Ahead in Mitigating a Deadly Pandemic

    Authors: Juen Kiem Tan; Dalleen Leong; Hemalatha Munusamy; Nor Hazwani Zenol Ariffin; Najma Kori; Rozita Hod; Petrick Periyasamy

    doi:10.21203/ Date: 2020-08-16 Source: ResearchSquare

    Presymptomatic COVID-19 patients have been identified as a major stumbling block in efforts to break the chain of transmission TRANS. Studies on temporal dynamics of its shedding suggests it peaks 1-2 days prior to any symptom onset TRANS. Therefore, a large proportion of patients are actively spreading the disease TRANS unknowingly whilst undetected. However, lengthy lockdowns and isolation leads to a host of socioeconomic issues and are impractical. Conversely, there exists no study describing this group and their clinical significance despite their key role in disease transmission TRANS. As a result, we devised a study to look at the prevalence SERO of presymptomatic patients with COVID-19 and subsequently, identify early indicators of infection MESHD through demographic information, biochemical and radiological abnormalities which would allow early diagnosis and isolation. In addition, we will look into the clinical significance of this group and their outcome; if it differs from asymptomatic TRANS or symptomatic patients. Our analysis shows a higher proportion of presymptomatic patients with atypical symptoms like chest pain HP chest pain MESHD while symptomatic patients commonly present with respiratory symptoms like cough HP cough MESHD and shortness of breath MESHD. Besides that, there were more females TRANS presenting as presymptomatic patients and receiving treatment compared to males TRANS and this was found to be statistically significant. Otherwise, we were not able to identify other statistically significant markers suggesting a patient is presymptomatic. As we have little means of identifying these silent spreaders, it highlights further the importance of general measures implemented to stop COVID-19 transmission TRANS like social distancing, face mask, and widespread testing.

    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.

    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.

    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. 

    On two cases of atypical respiratory distress HP in eastern Democratic Republic of the Congo months before the COVID-19 pandemic was declared: Could SARS-Cov-2 have been already spreading? Case report

    Authors: Guy-Quesney MATESO; Marius BAGUMA; Pacifique MWENE-BATU; Ghislain MAHESHE BALEMBA; Fabrice NZABARA; Samuel MAKALI; Aline BEDHA; Bonheur FURAHA; Jimmy MINANI; Christian TSHONGO MUHINDO; Espoir BWENGE MALEMBAKA; Mannix Imani MASIMANGO; Tony Akilimali SHINDANO; Justin Cirhuza CIKOMOLA; Kanigula MUBAGWA

    doi:10.21203/ Date: 2020-07-01 Source: ResearchSquare

    BackgroundPredictions have been made that Africa would be the most vulnerable continent to the novel coronavirus disease MESHD 2019 (COVID-19). Interestingly, the spread of the disease TRANS in Africa seems to have been delayed and initially slower than in many parts of the World. Here we report on two cases which make us suspect that COVID-19 might have been present in our region before the official declaration of the disease in December 2019.Case presentationThese two cases (one 55-year-old man and one 25-year-old woman) of acute respiratory distress HP secondary to atypical pneumonia HP pneumonia MESHD were seen in Bukavu, in eastern Democratic Republic of the Congo (DRC), between September and December 2019. One patient had returned from China and the other had close contacts TRANS with travellers from China in the 2 weeks prior to the onset of symptoms TRANS. In either case, the aetiology could not be accurately determined. However, the two cases presented a clinical picture (progressive dyspnoea MESHD, preceded by dry cough MESHD cough HP and fever HP fever MESHD) and laboratory changes (procalcitonin within the normal range, slight inflammation MESHD, and lymphopenia HP lymphopenia MESHD) compatible with a viral infection MESHD. The chest X-Rays series of the first patient showed lesions (reticulations, ground glass, and nodules ≤ 6 mm) similar to those found in COVID-19. In addition, unlike the 25-year-old female TRANS patient who had no comorbidity, the 55-year-old male TRANS patient who had hypertension HP hypertension MESHD as comorbidity, developed a more severe acute respiratory distress HP which progressed to death.ConclusionThese cases bring to the attention a number of facts which make us suspect that the COVID-19 epidemic may have already been present in the region months before the official beginning of the pandemic.

    Epidemiological and clinical characteristics of COVID-19 in Indian children TRANS in the initial phase of the pandemic: A cross-sectional study

    Authors: Bhakti Sarangi; Venkat Sandeep Reddy; Jitendra S. Oswal; Nandini Malshe; Ajinkya Patil; Manojit Chakraborty; Sanjay Lalwani

    doi:10.21203/ Date: 2020-06-17 Source: ResearchSquare

    Background: India saw the largest and the most stringent lockdown in the world when the number of COVID-19 cases reached around 550. With some early benefits in containing the surge and restricting the R0 TRANS of the virus, the current relaxation of lockdown norms has witnessed an exponential rise in positive cases. With scarcity of Pediatric data from the Indian subcontinent, early observations in the pandemic are pivotal in improving the understanding of physiologic behaviors, identifying risks, and guiding clinicians in assessing time-tested interventions and augmenting the awareness in the masses about the manifold clinical profiles of an evolving disease.Objective: To assess the epidemiological and clinical characteristics of children TRANS admitted with COVID-19 infection MESHD early in the pandemic.Study Design: A cross-sectional studyParticipants: Fifty children TRANS between one month and 18 years of age TRANS whose nasopharyngeal swab tested positive for SARS-CoV-2 by RT- PCR. Results: 28 (56%) children TRANS were male TRANS. 41 (82%) came from government declared containment zones with only one child TRANS having history of travel TRANS to affected area. Home overcrowding was observed in 33 (66%). Of the 50 children TRANS, 29 (58%) were asymptomatic TRANS while 20 (40%) and one (2%) had mild and moderate symptoms respectively. Fever HP Fever MESHD, cough HP cough MESHD, and sore throat were the most common symptoms. 49 (98%) children TRANS had BCG scar HP. Leucopenia was seen in three (6%) only. Mean (SD) Neutrophil-Lymphocyte-Ratio (NLR) was 0.78 (0.48) while mean (SD) CRP was 10.98 (23.90). All 50 (100%) were cured. Conclusion: Our study reasserts the increasing pediatric burden of COVID-19 with all age groups TRANS affected and overcrowding as a risk factor for continued community transmission TRANS, thus beckoning that public health policies be directed to ensuring further preventive measures. It also re-iterates the milder disease pattern in children TRANS with COVID-19 in the initial phase of the pandemic with a high proportion of asymptomatic TRANS and mild illness. Though abnormal CRP values are synonymous with the illness in children TRANS; leucopenia may not be a consistent finding.  

    Persistent Hiccups MESHD as atypical presentation of COVID-19: a Case Report

    Authors: Mohamed Zahran

    doi:10.21203/ Date: 2020-06-11 Source: ResearchSquare

    The recent  outbreak of SARS-CoV-2 has become pandemic since it began in late 2019. Typical symptoms include  cough MESHD, shortness of breath MESHD or difficulty breathing, fever HP fever MESHD, myalgia HP myalgia MESHD and sore throat. There are other unusual or atypical presentations of COVID-19 in ORL practice.  We report a 64-year-old male TRANS patient presenting with hiccups MESHD as the only symptom. Chest x-ray ray revealed new ground-glass opacities in both lung fields and he was found to be COVID-19 positive by RT-PCR. Early recognition of the COVID-19 atypical presentations by the Otolaryngologist facilitates subsequent management and case isolation to eliminate the risk of viral transmission TRANS

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MeSH Disease
Human Phenotype

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