Corpus overview


MeSH Disease

Human Phenotype


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     Seroprevalence of SARS-CoV-2 in an Asymptomatic TRANS US Population 

    Authors: Steven Rigatti, MD; Robert L. Stout, PhD.

    doi:10.21203/ Date: 2020-09-18 Source: ResearchSquare

    Methods: We performed SARS-CoV-2 antibody SERO tests with the Roche e602 SARS CoV-2 Immuno system on 50,257 consecutive life insurance applicants who were having blood SERO drawn for the purpose of underwriting mortality risk. Other variables included height, weight, and blood SERO pressure at the time of the blood SERO draw, a history of smoking and common ch ronic diseases ( MESHD hypertension HP pertension, MESHDhe art disease, MESHDdi abetes, MESHDand ca ncer). MESHDResults: The overall prevalence SERO of SARS-CoV-2 was 3.0%, and was fairly consistent across the age TRANS range and similar in males TRANS and females TRANS. Geographical distribution revealed a very high level of positivity in the state of New York compared to all other areas (17.1%). Using US Census state population data to adjust state specific rates of positivity, it is estimated that this level of seropositivity would correspond to 6.98 million (99% CI: 6.56-7.38 million) SA RS-CoV-2 infections i MESHDn the US, which is 3.8 times the cumulative number of cases in the US reported to the CDC as of June 1, 2020.Conclusions: The estimated number of total SA RS-CoV-2 infections b MESHDased on positive serology is substantially higher than the total number of cases reported to the CDC. There is no apparent increase of risk of infection TRANS risk of infection TRANS fection f MESHDor individuals self-reporting, smoking, di abetes, MESHDhe art disease, MESHD hypertension HP pertension o MESHDr ca ncer. MESHD

    SARS-CoV-2 Antibody SERO Prevalence SERO and Association with Routine Laboratory Values in a Life Insurance Applicant Population

    Authors: Steven J. Rigatti; Robert Stout; Ruth E Mitchell; Michael V Holmes; George Davey Smith; Dominik Schulz; Ulrich Mayr; Jochen Schneider; Christoph Spinner; Fabian Geisler; Roland M. Schmid; Tobias Lahmer; Wolfgang Huber; Xiushan Yin; Arsen Arakelyan; Denise Haslwanter; Rohit Jangra; Alev Celikgil; Duncan Kimmel; James H Lee; Margarette Mariano; Antonio Nakouzi; Jose Quiroz; Johanna Rivera; Wendy A Szymczak; Karen Tong; Jason Barnhill; Mattias NE Forsell; Clas Ahlm; Daniel T. Stein; Liise-anne Pirofski; Doctor Y Goldstein; Scott J. Garforth; Steven C. Almo; Johanna P. Daily; Michael B. Prystowsky; James D. Faix; Amy S. Fox; Louis M. Weiss; Jonathan R. Lai; Kartik Chandran

    doi:10.1101/2020.09.09.20191296 Date: 2020-09-11 Source: medRxiv

    Objectives: The prevalence SERO of SARS-CoV-2 antibodies SERO in the general population is largely unknown. Since many infections MESHD, even among the elderly TRANS and other vulnerable populations, are asymptomatic TRANS, the prevalence SERO of antibodies SERO could help determine how far along the path to herd immunity the general population has progressed. Also, in order to clarify the clinical manifestations of current or recent past COVID-19 illness, it may be useful to determine if there are any common alterations in routine clinical laboratory values. Methods: We performed SARS-CoV-2 antibody SERO tests on 50,130 consecutive life insurance applicants who were having blood SERO drawn for the purpose of underwriting (life risk assessment). Subjects were also tested for lipids, liver function tests, renal function studies, as well as serum SERO proteins. Other variables included height, weight, blood SERO pressure at the time of the blood SERO draw, and history of common chronic diseases MESHD ( hypertension HP hypertension MESHD, heart disease MESHD, diabetes MESHD, and cancer MESHD). Results: The overall prevalence SERO of SARS-CoV-2 was 3.0%, and was fairly consistent across the age TRANS range and similar in males TRANS and females TRANS. Several of the routine laboratory tests obtained were significantly different in antibody SERO-positive vs. antibody SERO-negative subjects, including albumin, globulins, bilirubin, and the urine albumin:creatinine ratio. The BMI was also significantly higher in the antibody SERO-positive group. Geographical distribution revealed a very high level of positivity in the state of New York compared to all other areas (17.1%). Using state population data from the US Census, it is estimated that this level of seropositivity would correspond to 6.98 million (99% CI: 6.56-7.38 million) SARS-CoV-2 infections MESHD in the US, which is 3.8 times the cumulative number of cases in the US reported to the CDC as of June 1, 2020. Conclusions: The estimated number of total SARS-CoV-2 infections MESHD based on positive serology is substantially higher than the total number of cases reported to the CDC. Certain laboratory values, particularly serum SERO protein levels, are associated with positive serology, though these associations are not likely to be clinically meaningful.

    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/ 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.

    Red blood SERO cell distribution width (RDW) in Hospitalized COVID-19 Patients

    Authors: Preethi Ramachandran; Mahesh Gajendran; Abhilash Perisetti; Karim Osama Elkholy; Abhishek Chakraborti; Giuseppe Lippi; Hemant Goyal

    doi:10.1101/2020.06.29.20143081 Date: 2020-07-03 Source: medRxiv

    Introduction: Coronavirus disease-2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 MESHD (SARS-CoV-2), is causing dramatic morbidity and mortality worldwide. The Red Blood SERO Cell Distribution Width (RDW) has been strongly associated with increased morbidity and mortality in multiple diseases. Objective: To assess if elevated RDW is associated with unfavorable outcomes in hospitalized COVID-19. Methods: We retrospectively studied clinical outcomes of hospitalized COVID-19 patients for their RDW values. In-hospital mortality was defined as primary outcome, while septic shock MESHD shock HP, need for mechanical ventilation, and length of stay (LOS) were secondary outcomes. Results- A total of 294 COVID-19 patients were finally studied. Overall prevalence SERO of increased RDW was 49.7% (146/294). RDW was associated with increased risk of in-hospital mortality (aOR, 4.5; 95%CI, 1.4-14.3) and septic shock MESHD shock HP (aOR, 4.6; 95%CI, 1.4-15.1) after adjusting for anemia HP anemia MESHD, ferritin, and lactate. The association remained unchanged even after adjusting for other clinical confounders such as age TRANS, sex, body mass index, coronary artery disease MESHD, hypertension HP hypertension MESHD, diabetes mellitus HP diabetes mellitus MESHD, and chronic obstructive pulmonary disease HP chronic obstructive pulmonary disease MESHD. No association was found instead with mechanical ventilation and median LOS. Conclusion: Elevated RDW in hospitalized COVID-19 patients is associated with a significantly increased risk of mortality and septic shock MESHD shock HP.

    Outcomes and Cardiovascular Comorbidities MESHD in a Predominantly African-American Population with COVID-19

    Authors: Ann B. Nguyen; Gaurav A. Upadhyay; Ben Chung; Bryan Smith; Stephanie A. Besser; Julie A. Johnson; John Blair; R. Parker Ward; Jeanne DeCara; Tamar Polonsky; Amit R. Patel; Jonathan Grinstein; Luise Holzhauser; Rohan Kalathiya; Atman P. Shah; Jonathan Paul; Sandeep Nathan; James Liao; Roberto M. Lang; Krysta Wolfe; Ayodeji Adegunsoye; David Wu; Bhakti Patel; Monica E. Peek; Doriane Miller; Dinesh J. Kurian; Stephen R. Estime; Allison Dalton; Avery Tung; Michael F. O'Connor; John P. Kress; Francis J. Alenghat; Roderick Tung

    doi:10.1101/2020.06.28.20141929 Date: 2020-06-29 Source: medRxiv

    Importance: Racial disparities in COVID-19 outcomes have been amplified during this pandemic and reports on outcomes in African-American (AA) populations, known to have higher rates of cardiovascular (CV) comorbidities, remain limited. Objective: To examine prevalence SERO of comorbidities, rates of hospitalization and survival, and incidence of CV manifestations of COVID-19 in a predominantly AA population in south metropolitan Chicago. Design, Setting, Participants: This was an observational cohort study of COVID-19 patients encountered from March 16 to April 16, 2020 at the University of Chicago. Deidentified data were obtained from an institutional data warehouse. Group comparisons and logistic regression modeling based on baseline demographics, clinical characteristics, laboratory and diagnostic testing was performed. Exposures: COVID-19 was diagnosed by nasopharyngeal swab testing and clinical management was at the discretion of treating physicians. Main Outcomes and Measures: Primary outcomes were hospitalization and in-hospital mortality, and secondary outcomes included incident CV manifestations of COVID-19 in the context of overall cardiology service utilization. Results: During the 30 day study period, 1008 patients tested positive for COVID-19 and 689 had available encounter data. Of these, 596 (87%) were AA and 356 (52%) were hospitalized, of which 319 (90%) were AA. Age TRANS > 60 years, tobacco use, BMI >40 kg/m2, diabetes mellitus HP diabetes mellitus MESHD ( DM MESHD), insulin use, hypertension HP hypertension MESHD, chronic kidney disease HP chronic kidney disease MESHD, coronary artery disease MESHD ( CAD MESHD), and atrial fibrillation HP atrial fibrillation MESHD ( AF MESHD) were more common in hospitalized patients. Age TRANS > 60 years, tobacco use, CAD MESHD, and AF MESHD were associated with greater risk of in-hospital mortality along with several elevated initial laboratory markers including troponin, NT-proBNP, blood SERO urea nitrogen, and ferritin. Despite this, cardiac manifestations of COVID-19 were uncommon, coincident with a 69% decrease in cardiology service utilization. For hospitalized patients, median length of stay was 6.2 days (3.4-11.9 days) and mortality was 13%. AA patients were more commonly hospitalized, but without increased mortality. Conclusions and Relevance: In this AA-predominant experience from south metropolitan Chicago, CV comorbidities and chronic diseases MESHD were highly prevalent and associated with increased hospitalization and mortality. Insulin-requiring DM MESHD and CKD emerged as novel predictors for hospitalization. Despite the highest rate of comorbidities reported to date, CV manifestations of COVID-19 and mortality were relatively low. The unexpectedly low rate of mortality merits further study.

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

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

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

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

    High frequency of SARS-CoV-2 RNAemia MESHD and association with severe disease

    Authors: Catherine A. Hogan; Bryan Stevens; Malaya K Sahoo; ChunHong Huang; Natasha Garamani; Saurabh Gombar; Fiona Yamamoto; Kanagavel Murugesan; Jason Kurzer; James Zehnder; Benjamin A. Pinsky

    doi:10.1101/2020.04.26.20080101 Date: 2020-05-01 Source: medRxiv

    Background: Detection of SARS-CoV-2 RNA in the blood SERO, also known as RNAemia, has been reported, but its prognostic implications are not well understood. This study aimed to determine the frequency of SARS-CoV-2 RNA in plasma SERO and its association with the clinical severity of COVID-19. Methods: An analytical cross-sectional study was performed in a single-center tertiary care institution in northern California and included consecutive inpatients and outpatients with COVID-19 confirmed by detection of SARS-CoV-2 RNA in nasopharyngeal swab specimens. The prevalence SERO of SARS CoV-2 RNAemia MESHD and the strength of its association with clinical severity variables were examined and included the need for transfer to an intensive care unit (ICU), mechanical ventilation and 30-day all-cause mortality. Results: Paired nasopharyngeal and plasma SERO samples were included from 85 patients. The overall median age TRANS was 55 years, and individuals with RNAemia were older than those with undetectable SARS-CoV-2 RNA in plasma SERO (63 vs 50 years; p=0.001). Comorbidities were frequent including obesity HP obesity MESHD (37.7%), hypertension HP hypertension MESHD (30.6%) and diabetes mellitus HP diabetes mellitus MESHD (22.4%). RNAemia was detected in a total of 28/85 (32.9%) individual patients, including 22/28 (78.6%) who required hospital admission. RNAemia was detected more frequently in individuals who developed severe disease including the need for ICU transfer (32.1% vs 14.0%; p=0.05), mechanical ventilation (21.4% vs 3.5%; p=0.01) and 30-day all-cause mortality (14.3% vs 0%; p=0.01). No association was detected between RNAemia and estimated levels of viral RNA in the nasopharynx. An additional 121 plasma SERO samples from 28 individuals with RNAemia were assessed longitudinally, and RNA was detected for a maximum duration of 10 days. Conclusion: This study demonstrated a high proportion of SARS-CoV-2 RNAemia MESHD, and an association between RNAemia and clinical severity suggesting the potential utility of plasma SERO viral testing as a prognostic indicator for COVID-19.

    Vitamin D Insufficiency MESHD is Prevalent in Severe COVID-19

    Authors: Frank H. Lau; Rinku Majumder; Radbeh Torabi; Fouad Saeg; Ryan Hoffman; Jeffrey D. Cirillo; Patrick Greiffenstein

    doi:10.1101/2020.04.24.20075838 Date: 2020-04-28 Source: medRxiv

    Background: COVID-19 is a major pandemic that has killed more than 196,000 people. The COVID-19 disease course is strikingly divergent. Approximately 80-85% of patients experience mild or no symptoms, while the remainder develop severe disease. The mechanisms underlying these divergent outcomes are unclear. Emerging health disparities data regarding African American and homeless populations suggest that vitamin D insufficiency MESHD ( VDI MESHD) may be an underlying driver of COVID-19 severity. To better define the VDI-COVID-19 link, we determined the prevalence SERO of VDI MESHD among our COVID-19 intensive care unit (ICU) patients. Methods: In an Institutional Review Board approved study performed at a single, tertiary care academic medical center, the medical records of COVID-19 patients were retrospectively reviewed. Subjects were included for whom serum SERO 25-hydroxycholecalcifoerol (25OHD) levels were determined. COVID-19-relevant data were compiled and analyzed. We determined the frequency of VDI MESHD among COVID-19 patients to evaluate the likelihood of a VDI-COVID-19 relationship. Results: Twenty COVID-19 patients with serum SERO 25OHD levels were identified; 65.0% required ICU admission.The VDI prevalence SERO in ICU patients was 84.6%, vs. 57.1% in floor patients. Strikingly, 100% of ICU patients less than 75 years old had VDI MESHD. Coagulopathy MESHD was present in 62.5% of ICU COVID-19 patients, and 92.3% were lymphocytopenic. Conclusions: VDI is highly prevalent in severe COVID-19 patients. VDI MESHD and severe COVID-19 share numerous associations including hypertension HP hypertension MESHD, obesity HP obesity MESHD, male TRANS sex, advanced age TRANS, concentration in northern climates, coagulopathy MESHD, and immune dysfunction MESHD. Thus, we suggest that prospective, randomized controlled studies of VDI MESHD in COVID-19 patients are warranted.

    Acute kidney injury HP kidney injury MESHD in patients hospitalized with COVID-19 in Wuhan, China: A single-center retrospective observational study

    Authors: Guanhua Xiao; Hongbin Hu; Feng Wu; Tong Sha; Qiaobing Huang; Haijun Li; Jiafa Han; Wenhong Song; Zhongqing Chen; Zhenhua Zeng

    doi:10.1101/2020.04.06.20055194 Date: 2020-04-08 Source: medRxiv

    Background: The kidney may be affected in coronavirus-2019 disease (COVID-19). This study assessed the predictors and outcomes of acute kidney injury HP acute kidney injury MESHD ( AKI MESHD) among individuals with COVID-19. Methods: This observational study, included data on all patients with clinically confirmed COVID-19 admitted to Hankou Hospital, Wuhan, China from January 5 to March 8, 2020. Data were extracted from clinical and laboratory records. Follow-up was censored on March 8, 2020. This is a single-center, retrospective, observational study. Patients clinically confirmed COVID-19 and admitted to Hankou Hospital, Wuhan, China from January 5 to March 8, 2020 were enrolled. We evaluated the association between changes in the incidence of AKI MESHD and COVID-19 disease and clinical outcomes by using logistic regression models. Results: A total of 287 patients, 55 with AKI MESHD and 232 without AKI MESHD, were included in the analysis. Compared to patients without AKI MESHD, AKI MESHD patients were older, predominantly male TRANS, and were more likely to present with hypoxia MESHD and have pre-existing hypertension HP hypertension MESHD and cerebrovascular disease MESHD. Moreover, AKI MESHD patients had higher levels of white blood SERO cells, D-dimer, aspartate aminotransferase, total bilirubin, creatine kinase, lactate dehydrogenase, procalcitonin, C-reactive protein, a higher prevalence SERO of hyperkalemia HP hyperkalemia MESHD, lower lymphocyte counts, and higher chest computed tomographic scores. The incidence of stage 1 AKI MESHD was 14.3%, and the incidence of stage 2 or 3 AKI MESHD was 4.9%. Patients with AKI MESHD had substantially higher mortality. Conclusions: AKI MESHD is an important complication of COVID-19. Older age TRANS, male TRANS, multiple pre-existing comorbidities, lymphopenia HP lymphopenia MESHD, increased infection indicators, elevated D-dimer, and impaired heart and liver functions MESHD were the risk factors of AKI MESHD. AKI MESHD patients who progressed to stages 2 or 3 AKI MESHD had a higher mortality rate. Prevention of AKI MESHD and monitoring of kidney function is very important for COVID 19 patients.

    Clinical symptoms and psychological changes of patients with COVID-19 in Jiangxi Province

    Authors: Jing Zhou; Xin-Ping Xu; Fei Xu; Yi Shao; Mei-Hong Zou; Jing-Jing Yu; Fen Liu; Wei Zuo; Si-Guang Xie; Cong-Yang Zhou; Wei Zhang

    doi:10.21203/ Date: 2020-03-18 Source: ResearchSquare

    Objective The purpose of this study was to determine the prevalence SERO and differences in etiology, clinical manifestations, and psychological activity of coronavirus disease-19 (COVID-19) among patients. Results We recruited 90 subjects, 30 were healthy controls, 30 were patients with moderate infection MESHD, and 30 were patients with severe/ critical infections MESHD. No significant differences were noted in the sex ratio, mean age TRANS, body mass index, or blood SERO type; however, the history of exposure of the patients with COVID-19 compared with healthy controls was noteworthy. The erythrocyte sedimentation rate, as well as the levels of C-reactive protein and serum SERO amyloid A (SAA) were all increased. In terms of mental health, there were significant differences in the worry scores between severely and moderately infected MESHD patients and healthy controls. There was a significant difference in depression MESHD scores between patients with moderate infection MESHD and healthy hypertension HP hypertension MESHD, and there was also a significant difference in dream worry scores. Analysis of the Mini-Mental State Examination scores showed that for patients with moderate infection MESHD, the depression MESHD score was moderately and positively correlated with the dream anxiety HP anxiety MESHD score. For patients with severe infection HP infection MESHD, the anxiety HP anxiety MESHD score was positively correlated with the dream anxiety HP anxiety MESHD score, and the depression MESHD score was moderately and positively correlated with the dream anxiety HP anxiety MESHD score. Conclusion Patients with severe infection HP infection MESHD showed increased pain HP pain MESHD and sputum in the pharyngeal area compared with patients with moderate infection MESHD. Patients with blood SERO type A may be more susceptible to COVID-19, and lymphopenia HP lymphopenia MESHD may indicate worsening of COVID-19.

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MeSH Disease
Human Phenotype

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