Corpus overview


Overview

MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    Risk factors for SARS-CoV-2 infection MESHD, hospitalisation, and death in Catalonia MESHD, Spain: a population-based cross-sectional study

    Authors: Judit Villar-Garcia; Rosa Maria Vivanco-Hidalgo; Montserrat Cleries; Elisenda Martinez; David Monterde; Pol Perez-Sust; Luis Garcia-Eroles; Carol Sais; Montserrat Moharra; Emili Vela; Jochen Lennerz; Hetal Desai Marble; Lauren L. Ritterhouse; Julie Batten; N. Zeke Georgantas; Rebecca Pellerin; Sylvia Signorelli; Julia Thierauf; Molly Kemball; Christian Happi; Donald S. Grant; Daouda Ndiaye; Katherine J. Siddle; Samar B Mehta; Jason B. Harris; Edward T Ryan; Virginia M. Pierce; Regina C LaRocque; Jacob Lemieux; Pardis Sabeti; Eric Rosenberg; John Branda; Sarah E Turbett; Gail Carson; Malcolm G Semple; Janet T Scott

    doi:10.1101/2020.08.26.20182303 Date: 2020-09-01 Source: medRxiv

    OBJECTIVE To identify the different subpopulations that are susceptible for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection MESHD and hospitalisation or death MESHD due to coronavirus disease MESHD 2019 (COVID-19) in Catalonia, Spain. DESIGN Cross-sectional study. SETTING Data collected from the Catalan Health Surveillance System (CatSalut) in Catalonia, a region of Spain. PARTICIPANTS Using data collected between 1 March and 1 June 2020, we conducted the following comparative analyses: people infected by SARS-CoV-2 (328 892) vs Catalonia's entire population (7 699 568); COVID-19 cases who required hospitalisation (37 638) vs cases who did not require hospitalisation (291 254); and COVID-19 cases who died during the study period vs cases who did not die during the study period (12 287). MAIN OUTCOME MEASURES Three clinical outcomes related to COVID-19 ( infection MESHD, hospitalisation, or death MESHD). We analysed sociodemographic and environment variables (such as residing in a nursing home) and the presence of previous comorbidities. RESULTS A total of 328 892 cases were considered to be infected with SARS-CoV-2 (4.27% of total population). The main risk factors for the diagnostic were: female TRANS gender TRANS (risk ratio [RR] =1.49; 95% confidence interval [95% CI] =1.48-1.50), age TRANS (45-64 years old; RR=1.02; 95% CI=1.01-1.03), high comorbidity burden (GMA index) (RR=3.03; 95% CI=2.97-3.09), reside in a nursing home (RR=11.82; 95% CI=11.66-11.99), and smoking (RR=1.06; 95% CI=1.05-1.07). During the study period, there were 37 638 (11.4 %) hospitalisations due to COVID-19, and the risk factors were: male TRANS gender TRANS (RR=1.45; 95% CI=1.43-1.48), age TRANS > 65 (RR=2.38; 95% CI=2.28-2.48), very low individual income (RR=1.03; 95% CI=0.97-1.08), and high burden of comorbidities (GMA index) (RR=5.15; 95% CI=4.89-5.42). The individual comorbidities with higher burden were obesity HP obesity MESHD (RR=1.23; 95% CI=1.20-1.25), chronic obstructive pulmonary disease HP chronic obstructive pulmonary disease MESHD (RR=1.19; 95% CI=1.15-1.22), heart failure MESHD (RR=1.19; 95% CI=1.16-1.22), diabetes mellitus HP diabetes mellitus MESHD (RR=1.07; 95% CI=1.04-1.10), and neuro-psychiatric MESHD comorbidities (RR=1.06; 95% CI=1.03-1.10). A total of 12 287 deaths (3.73%) were attributed to COVID-19, and the main risk factors were: male TRANS gender TRANS (RR=1.73; 95% CI=1.67-1.81), age TRANS > 65 (RR=37.45; 95% CI=29.23-47.93), residing in a nursing home (RR=9.22; 95% CI=8.81-9.65), and high burden of comorbidities (GMA index) (RR=5.25; 95% CI=4.60-6.00). The individual comorbidities with higher burden were: heart failure MESHD (RR=1.21; 95% CI=1.16-1.22), chronic kidney disease HP chronic kidney disease MESHD (RR=1.17; 95% CI=1.13-1.22), and diabetes mellitus HP diabetes mellitus MESHD (RR=1.10; 95% CI=1.06-1.14). These results did not change significantly when we considered only PCR-positive patients. CONCLUSIONS Female TRANS gender TRANS, age TRANS between 45 to 64 years old, high burden of comorbidities, and factors related to environment (nursing home) play a relevant role in SARS-CoV-2 infection MESHD and transmission TRANS. In addition, we found risk factors for hospitalisation and death MESHD due to COVID-19 that had not been described to date, including comorbidity burden, neuro-psychiatric disorders MESHD, and very low individual income. This study supports interventions for transmission TRANS control beyond stratify-and-shield strategies focused only on protecting those at risk of death. Future COVID-19 studies should examine the role of gender TRANS, the burden of comorbidities, and socioeconomic status in disease transmission TRANS, and should determine its relationship to workplaces, especially healthcare centres and nursing homes.

    A world apart: levels and factors of excess mortality due to COVID-19 in care homes. The case of Wallonia - Belgium.

    Authors: Olivier J. Hardy; Dominique Dubourg; Mélanie Bourguignon; Simon Dellicour; Thierry Eggerickx; Marius Gilbert; Jean-Paul Sanderson; Aline Scohy; Eline Vandael; Jean-Michel Decroly; Josephine Soltani; Mehrsa Koukabi-Fradelizi; Jean Paul Beressi; Cecile Laureana; Jean Fran&ccedilois Prost; Livarek Bernard; Elisabet Leiva; Albert Ariza-Sole; Paolo D Dallaglio; Maria Quero; Antonio Soriano; Alberto Pasqualetto; Maylin Koo; Virginia Esteve; Arnau Antoli; Rafael Moreno; Sergi Yun; Pau Cerda; Mariona Llaberia; Francesc Formiga; Marta Fanlo; Abelardo Montero; David Chivite; Olga Capdevila; Ferran Bolao; Xavier Pinto; Josep Llop; Antoni Sabate; Jordi Guardiola; Josep M Cruzado; Josep Comin-Colet; Salud Santos; Ramon Jodar; Xavier Corbella

    doi:10.1101/2020.08.29.20183210 Date: 2020-09-01 Source: medRxiv

    COVID-19 became pandemic in 2020 and causes higher mortality in males TRANS (M) than females TRANS (F) and among older people. In some countries, like Belgium, more than half of COVID-19 confirmed or suspected deaths occurring in spring 2020 concerned residents of care homes. The high incidence in this population is certainly linked to its peculiar age TRANS structure but could also result from its poorer general health condition and/or from a higher contamination through the staff of care homes, while protection equipment and testing capacity were initially limited. To address these issues, we used data from Wallonia (Belgium) to characterize the distribution of death rates among care home institutions, to compare the dynamics of deaths in and outside care homes, and to analyse how age TRANS and sex affected COVID-19 death rates inside and outside care homes. We also used annual death rates as a proxy for the health condition of each population. We found that: (1) COVID-19 death rate per institution varied widely from 0{per thousand} to 340{per thousand} (mean 43{per thousand}) and increased both with the size of the institution (number of beds) and with the importance of medical care provided. (2) 65% of COVID-19 deaths in Wallonia MESHD concerned residents of care homes where the outbreak started after but at a faster pace than the outbreak seen in the external population. (3) The impact of age TRANS on both annual and COVID-19 mortality closely follows exponential laws (i.e. Gompertz law) but mortality was much higher for the population living in care homes where the age TRANS effect was lower (mortality rate doubling every 20 years of age TRANS increment in care homes, 6 years outside them). (4) Both within and outside care homes, the ratio of M/F death rates was 1.6 for annual mortality but reached 2.0 for COVID-19 mortality, a ratio consistent among both confirmed and suspected COVID-19 deaths. (5) When reported to the annual death rate per sex and age TRANS, the COVID-19 relative mortality was little affected by age TRANS and reached 24% (M) and 18% (F) of their respective annual rate in nursing homes, while these percentages reduced to 10% (M) and 9% (F) in homes for elderly TRANS people (with less medical assistance), and to 5% (M) and 4% (F) outside of care homes. In conclusion, a c. 130x higher COVID-19 mortality rate found in care homes compared to the outside population can be attributed to the near multiplicative combination of: (1) a 11x higher mortality due to the old age TRANS of its residents, (2) a 3.8x higher mortality due to the low average health condition of its residents, and (3) probably a 3.5x higher infection rate (1.6x in homes for elderly TRANS people) due to the transmission TRANS by its staff, a problem more acute in large institutions. Our results highlight that nursing home residents should be treated as a very specific population, both for epidemiological studies and to take preventive measures, due to their extreme vulnerability to COVID-19.

    Clinical features and inpatient trajectories of older inpatients with COVID-19: a retrospective observational study.

    Authors: Christopher N Osuafor; Catriona Davidson; Alistair J Mackett; Marie Goujon; Lelane Van Der Poel; Vince Taylor; Jacobus Preller; Robert J B Goudie; Victoria L Keevil

    doi:10.21203/rs.3.rs-61056/v1 Date: 2020-08-17 Source: ResearchSquare

    Background: A comprehensive description of the clinical characteristics, inpatient trajectory and relationship with frailty of older inpatients admitted with COVID-19 is essential in the management of older adults TRANS during the COVID-19 pandemic. The aim of this study was to describe the clinical features and inpatient trajectory of older inpatients with confirmed COVID -19.Methods: This was a retrospective observational study of hospitalised older adults TRANS. Subjects include unscheduled medical admissions of older inpatients to a University Hospital with laboratory and clinically confirmed COVID-19. The primary outcome was death MESHD during the inpatient stay or within 14 days of discharge after a maximum follow up time of 45 days. The characteristics of the cohort were described in detail as a whole and by frailty status.Results: 214 patients were included in this study with a mean length of stay of 11 days (Range 6 to 18 days), of whom 140 (65.4%) patients were discharged and 74 (34.6%) patients died in hospital. 142 (66.4%) patients were frail with median Clinical Frailty Scale (CFS) score of 6. Frail patients were more likely to present with atypical symptoms including new or worsening confusion HP confusion MESHD compared to non-frail patients (20.8% vs 45.1%, p<0.001) and were more likely to die in hospital or within 14 days of discharge (66% vs 16%, p=0.001). Older age TRANS, being male TRANS, presenting with high illness acuity and high frailty were all independently associated with higher risk of death MESHD and a dose response association between higher frailty and higher mortality was observed.Conclusions: Older adult TRANS inpatients with COVID-19 infection MESHD are likely to present with atypical symptoms, experience delirium HP delirium MESHD and have a high mortality, especially if they are also living with frailty. Clinicians should have a low threshold for testing for COVID-19 in older and frail patients presenting to hospital as an emergency during periods when there is community transmission TRANS of COVID-19 and, when diagnosed, this should prompt early advanced care planning with the patient and family. 

    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/rs.3.rs-44830/v1 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.

    The natural history of symptomatic COVID-19 in Catalonia, Spain: a multi-state model including 109,367 outpatient diagnoses, 18,019 hospitalisations, and 5,585 COVID-19 deaths among 5,627,520 people

    Authors: Edward Burn; Cristian Tebe; Sergio Fernandez-Bertolin; Maria Aragon; Martina Recalde; Elena Roel; Albert Prats-Uribe; Daniel Prieto-Alhambra; Talita Duarte-Salles

    doi:10.1101/2020.07.13.20152454 Date: 2020-07-14 Source: medRxiv

    Background The natural history of Coronavirus Disease MESHD 2019 (COVID-19) has yet to be fully described, with most previous reports focusing on hospitalised patients. Using linked patient-level data, we set out to describe the associations between age TRANS, gender TRANS, and comorbidities and the risk of outpatient COVID-19 diagnosis, hospitalisation, and/or related mortality. Methods A population-based cohort study including all individuals registered in Information System for Research in Primary Care (SIDIAP). SIDIAP includes primary care records covering > 80% of the population of Catalonia, Spain, and was linked to region-wide testing, hospital and mortality records. Outpatient diagnoses of COVID-19, hospitalisations with COVID-19, and deaths with COVID-19 were identified between 1st March and 6th May 2020. A multi-state model was used, with cause-specific Cox survival models estimated for each transition. Findings A total of 5,664,652 individuals were included. Of these, 109,367 had an outpatient diagnosis of COVID-19, 18,019 were hospitalised with COVID-19, and 5,585 died after either being diagnosed or hospitalised with COVID-19. Half of those who died were not admitted to hospital prior to their death. Risk of a diagnosis with COVID-19 peaked first in middle- age TRANS and then again for oldest ages TRANS, risk for hospitalisation after diagnosis peaked around 70 years old, with all other risks highest at oldest ages TRANS. Male TRANS gender TRANS was associated with an increased risk for all outcomes other than outpatient diagnosis. The comorbidities studied (autoimmune condition, chronic kidney disease HP chronic kidney disease MESHD, chronic obstructive pulmonary disease HP chronic obstructive pulmonary disease MESHD, dementia HP dementia MESHD, heart disease MESHD, hyperlipidemia HP hyperlipidemia MESHD, hypertension HP hypertension MESHD, malignant neoplasm HP neoplasm MESHD, obesity HP obesity MESHD, and type 2 diabetes MESHD) were all associated with worse outcomes. Interpretation There is a continued need to protect those at high risk of poor outcomes, particularly the elderly TRANS, from COVID-19 and provide appropriate care for those who develop symptomatic disease. While risks of hospitalisation and death MESHD are lower for younger populations, there is a need to limit their role in community transmission TRANS. These findings should inform public health strategies, including future vaccination campaigns.

    Mortality Analysis of COVID-19 Confirmed cases TRANS in Pakistan

    Authors: Ambreen Chaudhry; Aamer Ikram; Mirza Amir Baig; Muhammad Salman; Tamkeen Ghafoor; Zakir Hussain; Mumtaz Ali Khan; Jamil Ahmad Ansari; Asif Syed; Wasif Javed; Ehsan Larik; Muhammad Mohsan Wattoo; Naveed Masood; zeeshan Iqbal Baig; Khurram Akram

    doi:10.1101/2020.06.07.20121939 Date: 2020-06-09 Source: medRxiv

    Introduction: COVID-19, a novel disease, appeared in December 2019 in China and rapidly spread across the world. Till the second week of April 2020, high incidence (2.9/100,000) and cases fatality rates (1.7%) were observed in Pakistan. This study was conducted to determine the temporal and spatial distribution of the first 100 deaths attributed to COVID-19 in Pakistan and their associated demographic factors. Method: We conducted a descriptive epidemiological analysis of the first 100 deaths MESHD reported among RT-PCR confirmed COVID-19 cases. Demographic, epidemiological, and risk factors information was obtained associated comorbidities and clinical signs and symptoms were recorded and frequencies were determined. Results: A total of 100 mortalities with overall Case Fatality Rate 1.67% (CFR) were analysed. Median age TRANS of patients was 64.5 years (IQR: 54-70) with 75% (n=75) Males TRANS. Among all deaths MESHD reported, 71 (71%) cases had one or more documented comorbidities at the time of diagnosis. Most frequently reported co-morbidities were; hypertension HP hypertension MESHD (67 %), followed by Diabetes Mellitus HP Diabetes Mellitus MESHD 945%) and Ischemic Heart Diseases MESHD (27%). First death MESHD was reported on 18 March 2020 and the most frequent presenting symptoms were shortness of breath MESHD (87%) and fever HP fever MESHD (79%). Median duration of illness was eight days (IQR: 4-11 days), the median delay reaching hospital to seek health care was three days (IQR: 0-6 days) while median duration of hospital stay was also three days (IQR: 1-7 days). Among all reported deaths MESHD, 62% were attributed to local transmission TRANS as these cases had no history of international travel TRANS. The most affected age group TRANS was 60-69 years while no death reported in age group TRANS below 20 years. Conclusion: High CFR among old age group TRANS and its association with co-morbidities (chronic disease) suggests targeted interventions such as social distancing and strict quarantine measure for elderly TRANS and morbid people. Comparative studies among deaths MESHD and recovered patients are recommended to explore further disease dynamics. Key words: COVID-19, Cases Fatality Rates, Co-morbidities, Epidemiology, Pakistan, Co-morbidities

    Cross-sectional study on awareness and knowledge of COVID-19 among senior pharmacy students.

    Authors: Marwa Samir Hamza; Osama Ahmed Badary; Mohamed Mohey Elmazar

    doi:10.21203/rs.3.rs-33352/v1 Date: 2020-06-04 Source: ResearchSquare

    Extraordinary actions have been implemented in an effort to control the rapid spread of the ongoing COVID-19 epidemic in Egypt. People’s adherence to control measures is influenced by their knowledge, attitudes and practices towards the disease. Therefore, in the present study we assessed pharmacy senior students’ knowledge, attitudes and practices towards the COVID-19 pandemic. An online questionnaire was created and it consisted of 12 questions testing their knowledge about COVID-19nclinical characteristics, transmission TRANS routes and prevention and control steps. Among senior pharmacy students (n=238), 70% were females TRANS and 63% were living in greater Cairo. Their main source of information included social media (70%), published articles (48%) and television (48%). The overall correct knowledge score was 83%. Most of the students displayed a good COVID-19 knowledge level (72.5% of the students). The students were least informed when trying to answer questions about hyper-coagulation MESHD, as a major cause for death MESHD in patients with severe COVID-19, and about the timings on the necessity to wear masks practice. Assessment of students’ attitudes and practices towards COVID-19 reflected that 87% of them were confident that health care teams and scientists could win the fight against the virus. In addition, 72% of students agreed that COVID-19 will be controlled successfully. The greater the students’ knowledge, the more confident they felt that COVID-19 will be controlled successfully (OR = 2.2, 95% confidence interval [CI]: 1.03-4.72). Good behavioral practice towards COVID-19 control was confirmed when 87% of students answered that they didn’t go out to any crowded place. Females TRANS were 3.6 times (95% confidence interval [CI]: 1.03–3.11) more likely to avoid going out than males TRANS. Bad behavioral practice became evident when approximately 50% of students admitted that they did not wear masks when they left their house. Therefore, more efforts should be taken to protect future pharmacists from this pandemic.

    Practice and perception of Bangladeshi adults TRANS toward COVID-19: a cross-sectional study

    Authors: Md. Abdul Wadood; Lai Lee Lee; Md. Monimul Huq; ASMA Mamun; Suhaili Mohd; Md. Golam Hossain

    doi:10.21203/rs.3.rs-29364/v1 Date: 2020-05-15 Source: ResearchSquare

    Background: The coronavirus disease MESHD 2019 (COVID-19) has continued to spread across the world with increasing number of confirmed cases TRANS and death MESHD. Preventive measures have still been the only way of slowing down the transmission TRANS and prevention of the deadly disease. Practice of preventive guidelines and perception about the disease is important in this regard. We aimed to study on practice to prevent and perception toward COVID-19 among Bangladeshi adults TRANS during the rapid rise of the outbreak.Methods: For this cross-sectional study, we conducted an online survey to collect data from 320 Bangladeshi adults TRANS during the period of 10-20 April, 2020 with a self-developed questionnaire. For measuring their level of practice, a general question was asked to participants, “Are you properly following the guidelines recommended by WHO to avoid COVID-19? Four type of perceptions; (i) seriousness, (ii) susceptibility, (iii) efficacy, and (iv) carry out the measures of the disease were considered for measuring risk of perception. Frequency distribution, Chi-square (χ2) test and binary logistic regression model were utilized in this study.  Results: More than 71% of participants had good practice of always following the guidelines of the World Health Organization to prevent COVID-19. Logistic regression model demonstrated that people living in urban area (p<0.01), high education (p<0.01), rich (p<0.01) and joint family (p<0.01) had the most contributions to good practice. The average risk perception among participants was 3.05±0.75 (median, 3.00) (95% CI of mean: 2.96-3.13). More than 27% participants showed high risk perceptions. It was found that males TRANS (p<0.05), high educated (p<0.05), rich (p<0.01), service holders (0.05) and younger adults TRANS (p<0.05) had higher odds of high risk perception.Conclusions: The good practice of preventive guidelines and risk perception toward COVID-19 among Bangladeshi adults TRANS were satisfactory but not of the expected level. High socioeconomic status and education were significantly correlated with appropriate practice and perception during the peak time of the COVID-19 pandemic. Government should take step to increase the level of practice to avoid and perception toward COVID-19 among Bangladeshi people during the pandemic. 

    Immunosuppression is associated with a lower risk of moderate to severe acute respiratory distress syndrome MESHD respiratory distress HP syndrome in COVID-19.

    Authors: Enric Monreal; Susana Sainz de la Maza; Pedro Gullón; Elena Natera-Villalba; Juan Luis Chico-García; Álvaro Beltrán-Corbellini; Javier Martínez-Sanz; Nuria García-Barragán; Javier Buisán; Rafael Toledano; Araceli Alonso-Canovas; Paula Pérez-Torre; María Consuelo Matute-Lozano; Jose Luis López-Sendón; Guillermo García-Ribas; Íñigo Corral; Jesús Fortún; Beatriz Montero-Errasquín; Luis Manzano; Luis Máiz-Carro; Lucienne Costa-Frossard; Jaime Masjuan

    doi:10.21203/rs.3.rs-27095/v1 Date: 2020-05-04 Source: ResearchSquare

    BACKGROUND: Coronavirus disease 2019 (COVID-19) is an emerging infectious disease MESHD disease that has spread TRANS rapidly worldwide. The role of immunosuppression among COVID-19 patients has not been elucidated and management may be challenging.OBJECTIVE: To assess differences in severe outcomes of hospitalized patients with COVID-19 according to immune system state.DESIGN: Retrospective single-center observational study with confirmed COVID-19 patients admitted to Hospital Universitario Ramón y Cajal from March 18, 2020 to April 04, 2020. The final date of follow-up was April 09, 2020.PARTICIPANTS: Confirmed COVID-19 patients.MAIN MEASURES: The primary endpoint was development of moderate-severe acute respiratory distress syndrome MESHD respiratory distress HP syndrome ( ARDS MESHD). Time to moderate-severe ARDS MESHD, the need for mechanical or non-invasive ventilation (MV/NIV), death MESHD, and a composite of death MESHD or MV/NIV were secondary endpoints.KEY RESULTS: Of 138 patients included, 29 (21%) were immunocompromised (IC), with 95 (68.8%) male TRANS patients and a median (IQR) age TRANS of 68 (54 – 78) years. Among the baseline characteristics, no relevant or significant differences were observed between IC and non-immunocompromised (non-IC) patients. A significantly lower proportion of IC patients (24.1% [95% CI, 11.4 – 44.0%]) compared to non-IC patients (49.5% [95% CI, 40.1 – 59.0%]) developed moderate-severe ARDS MESHD, in both unadjusted (OR 0.32 [95% CI, 0.13 – 0.82], p=0.018) and adjusted (aOR 0.16 [95% CI, 0.05 – 0.52], p=0.003) analyses. A positive non-significant trend toward a longer time to moderate or severe ARDS MESHD, a lower need for MV/NIV, and a lower risk of death MESHD or MV/NIV were detected in IC. A trend toward a shorter- hospitalization in IC was observed.CONCLUSIONS: In our cohort of COVID-19 patients, immunosuppression was associated with a lower risk of moderate-severe ARDS MESHD. This suggests a potential protective effect from a hypothesized host hyper-inflammatory response and warrants reconsideration of drug discontinuation in IC patients.

    Non-severe immunosuppression might be associated with a lower risk of moderate-severe acute respiratory distress syndrome MESHD respiratory distress HP syndrome in COVID-19.

    Authors: Enric Monreal; Susana Sainz de la Maza; Pedro Gullón; Elena Natera-Villalba; Juan Luis Chico-García; Álvaro Beltrán-Corbellini; Javier Martínez-Sanz; Nuria García-Barragán; Javier Buisán; Rafael Toledano; Araceli Alonso-Canovas; Paula Pérez-Torre; María Consuelo Matute-Lozano; Jose Luis López-Sendón; Guillermo García-Ribas; Íñigo Corral; Jesús Fortún; Beatriz Montero-Errasquín; Luis Manzano; Luis Máiz-Carro; Lucienne Costa-Frossard; Jaime Masjuan

    doi:10.21203/rs.3.rs-27095/v2 Date: 2020-05-04 Source: ResearchSquare

    BACKGROUND: Coronavirus disease 2019 (COVID-19) is an emerging infectious disease MESHD disease that has spread TRANS rapidly worldwide. The role of immunosuppression among COVID-19 patients has not been elucidated and management may be challenging. OBJECTIVE: To assess differences in severe outcomes of hospitalized patients with COVID-19 according to immune system state. DESIGN: Retrospective single-center observational study with confirmed COVID-19 patients admitted to Hospital Universitario Ramón y Cajal from March 18, 2020 to April 04, 2020. The final date of follow-up was April 09, 2020.PARTICIPANTS: Confirmed COVID-19 patients. MAIN MEASURES: The primary endpoint was development of moderate-severe acute respiratory distress syndrome MESHD respiratory distress HP syndrome ( ARDS MESHD). Time to moderate-severe ARDS MESHD, the need for mechanical or non-invasive ventilation (MV/NIV), death MESHD, and a composite of death MESHD or MV/NIV were secondary endpoints. KEY RESULTS: Of 138 patients included, 27 (19.6%) were immunosuppressed (IS), with 95 (68.8%) male TRANS patients and a median (Q1, Q3) age TRANS of 68 (54–78) years. Among the baseline characteristics, no relevant or significant differences were observed between IS and non-immunosuppressed (non-IS) patients, detecting a non-severe immunosupression among IS. A significantly lower proportion of IS patients (22.2% [95%CI, 9.8–43.0%]) compared to non-IS patients (49.5% [95%CI, 40.2–58.9%]) developed moderate-severe ARDS MESHD, in both unadjusted (OR 0.29 [95%CI, 0.11–0.76], p=0.014) and adjusted (aOR 0.16 [95%CI, 0.05–0.55], p=0.004) analyses. After stratifying by pathologies, only IS autoimmune diseases remained significant (aOR 0.12 [95%CI, 0.03–0.57], p=0.007). Non-significant trends toward a longer time to moderate or severe ARDS MESHD, a lower need for MV/NIV, and a lower risk of death MESHD or MV/NIV were detected in IS. CONCLUSIONS: In our cohort of COVID-19 patients, non-severe immunosuppression was associated with a lower risk of moderate-severe ARDS MESHD, especially among AD MESHD. This suggests a potential protective effect from a hypothesized host hyper-inflammatory response and warrants reconsideration of management of IS patients.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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