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HGNC Genes

SARS-CoV-2 proteins

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    Factors Associated with Disease Severity and Mortality among Patients with Coronavirus Disease 2019 MESHD: A Systematic Review and Meta-Analysis

    Authors: Vignesh Chidambaram; Nyan Lynn Tun; Waqas Haque; Marie Gilbert Majella; Ranjith Kumar Sivakumar; Amudha Kumar; Angela Ting-Wei Hsu; Izza Ishak; Aqsha Nur; Samuel Ayeh; Emmanuella Salia; Ahsan Zil-E-Ali; Muhammad Saeed; Ayu Sarena; Bhavna Seth; Muzzammil Ahmadzada; Eman Haque; Pranita Neupane; Kuang-Heng Wang; Tzu-Miao Pu; Syed Ali; Muhammad Arshad; Lin Wang; Sheriza Baksh; Petros Karakousis; Panagis Galiatsatos

    doi:10.1101/2020.08.07.20166868 Date: 2020-08-13 Source: medRxiv

    Background: Understanding the factors associated with disease severity and mortality in Coronavirus disease MESHD ( COVID19 MESHD) is imperative to effectively triage patients. We performed a systematic review to determine the demographic, clinical, laboratory and radiological factors associated with severity and mortality in COVID-19 MESHD. Methods: We searched PubMed, Embase and WHO database for English language articles from inception until May 8, 2020. We included Observational studies with direct comparison of clinical characteristics between a) patients who died and those who survived or b) patients with severe disease and those without severe disease. Data extraction and quality assessment were performed by two authors independently. Results: Among 15680 articles from the literature search, 109 articles were included in the analysis. The risk of mortality was higher in patients with increasing age, male gender ( RR 1 HGNC.45; 95%CI 1.23,1.71), dyspnea MESHD ( RR 2 HGNC.55; 95%CI 1.88,2.46), diabetes MESHD ( RR 1 HGNC.59; 95%CI 1.41,1.78), hypertension MESHD ( RR 1 HGNC.90; 95%CI 1.69,2.15). Congestive heart failure MESHD (OR 4.76; 95%CI 1.34,16.97), hilar lymphadenopathy MESHD (OR 8.34; 95%CI 2.57,27.08), bilateral lung involvement (OR 4.86; 95%CI 3.19,7.39) and reticular pattern (OR 5.54; 95%CI 1.24,24.67) were associated with severe disease. Clinically relevant cut-offs for leukocytosis MESHD(>10.0 x109/L), lymphopenia MESHD(< 1.1 x109/L), elevated C-reactive protein HGNC(>100mg/L), LDH(>250U/L) and D-dimer(>1mg/L) had higher odds of severe disease and greater risk of mortality. Conclusion: Knowledge of the factors associated of disease severity and mortality identified in our study may assist in clinical decision-making and critical-care resource allocation for patients with COVID-19 MESHD.

    Sex-specificity of mortality risk factors among hospitalized COVID-19 MESHD patients in New York City: prospective cohort study

    Authors: Tomi Jun; Sharon Nirenberg; Patricia Kovatch; Kuan-lin Huang

    doi:10.1101/2020.07.29.20164640 Date: 2020-08-01 Source: medRxiv

    Objective: To identify sex-specific effects of risk factors for in-hospital mortality among COVID-19 MESHD patients admitted to a hospital system in New York City. Design: Prospective observational cohort study with in-hospital mortality as the primary outcome. Setting: Five acute care hospitals within a single academic medical system in New York City. Participants: 3,086 hospital inpatients with COVID-19 MESHD admitted on or before April 13, 2020 and followed through June 2, 2020. Follow-up till discharge or death MESHD was complete for 99.3% of the cohort. Results: The majority of the cohort was male (59.6%). Men were younger (median 64 vs. 70, p<0.001) and less likely to have comorbidities such as hypertension MESHD (32.5% vs. 39.9%, p<0.001), diabetes MESHD (22.6% vs. 26%, p=0.03), and obesity MESHD (6.9% vs. 9.8%, p=0.004) compared to women. Women had lower median values of laboratory markers associated with inflammation MESHD compared to men: white blood cells (5.95 vs. 6.8 K/uL, p<0.001), procalcitonin (0.14 vs 0.21 ng/mL, p<0.001), lactate dehydrogenase (375 vs. 428 U/L, p<0.001), C-reactive protein HGNC (87.7 vs. 123.2 mg/L, p<0.001). Unadjusted mortality was similar between men and women (28.8% vs. 28.5%, p=0.84), but more men required intensive care than women (25.2% vs. 19%, p<0.001). Male sex was an independent risk factor for mortality (OR 1.26, 95% 1.04-1.51) after adjustment for demographics, comorbidities, and baseline hypoxia MESHD. There were significant interactions between sex and coronary artery disease MESHD (p=0.038), obesity MESHD (p=0.01), baseline hypoxia MESHD (p<0.001), ferritin (p=0.002), lactate dehydrogenase (p=0.003), and procalcitonin (p=0.03). Except for procalcitonin, which had the opposite association, each of these factors was associated with disproportionately higher mortality among women. Conclusions: Male sex was an independent predictor of mortality, consistent with prior studies. Notably, there were significant sex-specific interactions which indicated a disproportionate increase in mortality among women with coronary artery disease MESHD, obesity MESHD, and hypoxia MESHD. These new findings highlight patient subgroups for further study and help explain the recognized sex differences in COVID-19 MESHD outcomes.

    A Comprehensive Evaluation of Early Predictors of Disease Progression in Patients with COVID-19 MESHD: A Case Control Study

    Authors: Qiang Tang; Yanwei Liu; Yingfeng Fu; Ziyang Di; Kailiang Xu; Bo Tang; Hui Wu; Maojun Di

    doi:10.21203/rs.3.rs-50527/v1 Date: 2020-07-29 Source: ResearchSquare

    Background: The 2019 coronavirus disease MESHD ( COVID-19 MESHD) has become an unprecedented public health crisis with nearly 16 million confirmed cases and 630,000 deaths worldwide. Methods: We retrospectively investigated the demographic, clinical, laboratory, radiological and treatment data of COVID-19 MESHD patients consecutively enrolled from January 18 to May 15, 2020, in Taihe and Jinzhou central hospital. Results: Of all 197 patients, the median age was 66.5 years (IQR 7-76), and 120 (60.9%) patients were males. We identified 88 (44.7%) of 197 COVID-19 MESHD patients as the disease progression (aggravation) cases. The aggravation cases tend to have more medical comorbidity: hypertension MESHD (34.1%), diabetes MESHD (30.7%), and presented with dyspnea MESHD (34.1%), neutrophilia (60.2%), and lymphocytopenia MESHD (73.9%), compared with those without. And the patients with disease progression showed significantly higher level of Fibrinogen HGNC (Fbg), D-dimer, IL-6 HGNC, C-reactive protein HGNC ( CRP HGNC), procalcitonin (PCT), and serum ferritin, and were more prone to develop organ damage in the liver, kidney, and heart (P<0.05). Multivariable regression showed that advanced age, comorbidities, lymphopenia MESHD, and elevated level of Fbg, lactate dehydrogenase (LDH), Cardiac troponin ( CTnI HGNC), IL-6 HGNC, serum ferritin were the significant predictors of disease progression. Further, we investigated antibody responses to SARS-CoV-2 and found that the levels of IgM and IgG were significantly higher in the disease progression cases compared to non-progression cases from 3 weeks after symptom onset. In addition, the disease progression group tended to peak later and has a more vigorous IgM/IgG response against SARS-CoV-2. Further, we performed Kaplan-Meier analysis and found that 61.6% of patients had not experienced ICU transfer or survival from hospital within 25 days from admission.Conclusions: Investigating the potential factors of advanced age, comorbidities and elevated level of IL-6 HGNC, serum ferritin and Kaplan-Meier analysis enables early identification and management of patients with poor prognosis. Detection of the dynamic antibody may offer vital clinical information during the course of SARS-CoV-2 and provide prognostic value for patients infection.  

    Patient characteristics and predictors of mortality in 470 adults admitted to a district general hospital in England with Covid-19 MESHD

    Authors: Joseph V Thompson; Nevan Meghani; Bethan M Powell; Ian Newell; Roanna Craven; Gemma Skilton; Lydia J Bagg; Irha Yaqoob; Michael J Dixon; Eleanor J Evans; Belina Kambele; Asif Rehman; Georges Ng Man Kwong

    doi:10.1101/2020.07.21.20153650 Date: 2020-07-27 Source: medRxiv

    Background Understanding risk factors for death MESHD in Covid 19 is key to providing good quality clinical care. Due to a paucity of robust evidence, we sought to assess the presenting characteristics of patients with Covid 19 and investigate factors associated with death MESHD. Methods Retrospective analysis of adults admitted with Covid 19 to Royal Oldham Hospital, UK. Logistic regression modelling was utilised to explore factors predicting death. Results 470 patients were admitted, of whom 169 (36%) died. The median age was 71 years (IQR 57 to 82), and 255 (54.3%) were men. The most common comorbidities were hypertension MESHD (n=218, 46.4%), diabetes MESHD (n=143, 30.4%) and chronic neurological disease MESHD (n=123, 26.1%). The most frequent complications were acute kidney injury MESHD (n=157, 33.4%) and myocardial injury MESHD (n=21, 4.5%). Forty three (9.1%) patients required intubation and ventilation, and 39 (8.3%) received non-invasive ventilation Independent risk factors for death MESHD were increasing age (OR per 10 year increase above 40 years 1.87, 95% CI 1.57 to 2.27), hypertension MESHD (OR 1.72, 1.10 to 2.70), cancer MESHD (OR 2.20, 1.27 to 3.81), platelets <150x103/microlitre (OR 1.93, 1.13 to 3.30), C-reactive protein HGNC >100 micrograms/mL (OR 1.68, 1.05 to 2.68), >50% chest radiograph infiltrates, (OR 2.09, 1.16 to 3.77) and acute kidney injury MESHD (OR 2.60, 1.64 to 4.13). There was no independent association between death MESHD and gender, ethnicity, deprivation level, fever MESHD, SpO2/FiO2 (oxygen saturation index), lymphopenia MESHD or other comorbidities. Conclusions We characterised the first wave of patients with Covid 19 in one of Englands highest incidence areas, determining which factors predict death. These findings will inform clinical and shared decision making, including the use of respiratory support and therapeutic agents.

    Changes in lipid metabolism in patients with severe COVID-19 MESHD

    Authors: Yi Li; Yan Zhang; Minhui Dai; Minxue Shen; Jianchu Zhang; Yanhui Cui; Ben Liu; Fengyu Lin; Lingli Chen; Duoduo Han; Yifei Fan; Yanjun Zeng; Wen Li; Sha Li; Xiang Chen; Pinhua Pan

    doi:10.21203/rs.3.rs-43521/v1 Date: 2020-07-15 Source: ResearchSquare

    Background: Dyslipidemia MESHD plays an important role in the pathogenesis and evolution of critical illness MESHD, but limited information exists regarding the lipid metabolism of severe coronavirus disease 2019 MESHD ( COVID-19 MESHD) patients. The aim of this study was to investigate role of dyslipidemia MESHD in patients with severe COVID-19 MESHDMethods: We retrospectively reviewed 216 severe COVID-19 MESHD patients with clarified outcomes (discharged or deceased), admitted to the West Court of Union Hospital in Wuhan, China, between February 1 and March 31, 2020. The dynamic changes of lipid profiles and their relationships with disease severity and clinical outcomes were analyzed.Results: A total of 216 severe COVID-19 MESHD patients, including 24 non-survivors and 192 survivors, were included in the final analyses. The levels of high-density lipoprotein cholesterol ( HDL-C) and apolipoprotein AI HGNC ( Apo-AI HGNC) on admission were significantly lower in non-survivors compared to survivors. During hospitalization, low-density lipoprotein cholesterol (LDL-C), total cholesterol(TC), HDL-C and Apo-AI HGNC were shown an increasing trend in survivors, but maintained lower levels or shown downward trend in non-survivors. The serum levels of HDL-C and Apo-AI HGNC were inversely correlated with C-reactive protein HGNC ( CRP HGNC), length of hospital stay of survivors and disease severity. The receiver operating characteristic (ROC) curve analysis identified a CRP HGNC/ HDL-C ratio cut-off value of 62.54 as the predictor for in-hospital mortality (AUC=0.823, Sensitivity=83.3%, Specificity=70.8%). Logistic regression analysis demonstrated that hypertension MESHD, neutrophils-to-lymphocytes ratio(NLR), platelet count and high CRP HGNC/ HDL-C ratio (>62.54) were independent factors to predict in-hospital mortality.Conclusions: The results demonstrated that dyslipidemia MESHD was associated with the inflammatory response, disease severity and poor prognosis of COVID-19 MESHD. High CRP HGNC/ HDL-C ratio may serve as an independently potential predictor for hospital mortality among patients with severe COVID-19 MESHD.

    Clinical Characteristics of SARS-CoV-2 pneumonia diagnosed in a primary care practice in Madrid (Spain)

    Authors: Marina Guisado-Clavero; Ana Herrero Gil; Marta Pérez Álvarez; Marta Castelo Jurado; Ana Herrera Marinas; Vanesa Aguilar Ruiz; Ileana Gefaell Iarrondo; Miguel Menéndez; Sara Ares-Blanco

    doi:10.21203/rs.3.rs-42357/v2 Date: 2020-07-13 Source: ResearchSquare

    Background: Possible cases of SARS-CoV-2 infection MESHD were diagnosed in primary care in Madrid, some of these cases had pneumonia MESHD. Most of the SARS-CoV-2 pneumonia MESHD published data came from hospitalised patients. This study set out to describe clinical characteristics of patients with SARS-CoV-2 pneumonia MESHD diagnosed in primary care across age groups and type of pneumonia MESHD.Methods: Observational retrospective study obtaining clinical data from the electronic health records of patients who were followed-up by SARS-CoV-2 possible infection in a primary care practice in Madrid. All the cases were collected by in-person or remote consultation during the 10th March to the 7th of April. Exposure: Diagnosis of SARS-CoV-2 pneumonia MESHD by chest X-ray ordered by the GP. Main outcomes and measures: Symptoms of SARS-CoV-2 pneumonia MESHD, physical examination and diagnostic tests as a blood test, nasopharyngeal swab results for RT-PCR (Reverse transcriptase-polymerase chain reaction) and chest X-ray results. Results: The overall SARS-CoV-2 pneumonias MESHD collected were 172 (female 87 [50.6%], mean age 60.5 years (standard deviation [SD] 17.0). Comorbidities were body mass index ≥25 kg/m 2 (90 [52.3%]), hypertension MESHD 83 [48.3%]), dyslipidaemia (68 [39.5%]) and diabetes MESHD (33 [19.2%]). The sample was stratified by age groups (<50 years, 50-75 years and ≥75 years). Clinical manifestations at onset were fever MESHD (144 [83.7%]), cough (140 [81.4%]), dyspnoea MESHD (103 [59.9%]) and gastrointestinal disturbances MESHD (72 [41.9%]). Day 7.8 (SD:4.1) from clinical onset was the mean day of pneumonia MESHD diagnosis. Bilateral pneumonia MESHD was more prevalent than unilateral (126 [73.3%]) and 46 [26.7%]). Patients with unilateral pneumonia MESHD were prone to higher pulse oximetry (96% vs 94%, p <0.001). We found differences between unilateral and bilateral cases in C-reactive protein HGNC (29.6 vs 81.5mg/L, p <0.001), and lymphocytes (1400.0 vs 1000.0E3/ml, p<0.001). Complications were registered: 42 (100%) of patients ≥75 years were admitted into hospital; pulmonary embolism MESHD was only present at bilateral pneumonia MESHD (7 patients [5.6%]) and death MESHD occurred in 1 patient with unilateral pneumonia MESHD (2.2%) vs 10 patients (7.9%) with bilateral pneumonia MESHD ( p 0.170).Conclusion: Clinical manifestations of SARS-CoV-2 pneumonia MESHD were fever MESHD, cough and dyspnoea MESHD; this was especially clear in the elderly. We described different characteristics between unilateral and bilateral pneumonia MESHD.

    Clinical characteristics and outcomes in diabetes patients admitted with COVID-19 MESHD in Dubai: a cross-sectional single centre study.

    Authors: Rahila Bhatti; Amar Omer; Samara Khattib; Seemin Shiraz; Glenn Matfin

    doi:10.1101/2020.07.08.20149096 Date: 2020-07-10 Source: medRxiv

    Aim: To describe the clinical characteristics and outcomes of hospitalised Coronavirus Disease 2019 MESHD ( COVID-19 MESHD) patients with diabetes MESHD. Methods: A cross-sectional observational study was conducted in patients with diabetes MESHD admitted with COVID-19 MESHD to Mediclinic Parkview Hospital in Dubai, United Arab Emirates (UAE) from 30th March to 7th June 2020. They had laboratory and/or radiologically confirmed severe acute respiratory syndrome-coronavirus-2 MESHD (SARS-CoV-2), known as COVID-19 MESHD. Variation in characteristics, length of stay in hospital, diabetes MESHD status, comorbidities and outcomes were examined. Results: A total of 103 patients with confirmed COVID-19 MESHD presentations had diabetes MESHD. During the same timeframe, 410 patients overall were admitted with COVID-19 MESHD infection. This gives a total proportion of persons admitted with COVID-19 MESHD infection and coexistent diabetes MESHD/prediabetes of 25%. 67% (n=69) of the COVID-19 MESHD diabetes MESHD cohort were male. Patients admitted with COVID-19 MESHD and diabetes MESHD represented 17 different ethnicities. Of these, 59.2% (n=61) were Asians and 35% (n=36) were from Arab countries. Mean age (SD) was 54 (12.5) years. 85.4% (n=88) were known to have diabetes MESHD prior to admission, while 14.6% (n=15) were newly diagnosed with either diabetes MESHD or prediabetes MESHD during admission. Most patients in the study cohort had type 2 diabetes MESHD or prediabetes MESHD, with only 3% overall having type 1 diabetes MESHD (n=3). 46.9% of patients had evidence of good glycaemic control of their diabetes MESHD during the preceding 4-12 weeks prior to admission as defined arbitrarily by admission HbA1 HGNCc <7.5%. 73.8% (n=76) had other comorbidities including hypertension MESHD, ischaemic heart disease MESHD, and dyslipidaemia. Laboratory data Mean(SD) on admission for those who needed ward-based care versus those needing intensive care unit (ICU) care: Fibrinogen HGNC 462.75 (125.16) mg/dl vs 660 (187.58) mg/dl ; D-dimer 0.66 (0.55) mcg/ml vs 2.3 (3.48) mcg/ml; Ferritin 358.08 (442.05) mg/dl vs 1762.38 (2586.38) mg/dl; and CRP HGNC 33.9 (38.62) mg/L vs 137 (111.72) mg/L were all statistically significantly higher for the ICU cohort (p<0.05). Average length of stay in hospital was 14.55 days. 28.2% of patients needed ICU admission. 4.9% (n=5) overall died during hospitalisation (all in ICU). Conclusions: In this single-centre study in Dubai, 25% of patients admitted with COVID-19 MESHD also had diabetes MESHD/ prediabetes MESHD. Most diabetes MESHD patients admitted to hospital with COVID-19 MESHD disease were males of Asian origin. 14.6% had new diagnosis of diabetes MESHD/prediabetes on admission. The majority of patients with diabetes MESHD/ prediabetes MESHD and COVID-19 MESHD infection had other important comorbidities (n=76; 73.8%). Only 4 patients had negative COVID-19 MESHD RT-PCR but had pathognomonic changes of COVID-19 MESHD radiologically. Our comprehensive laboratory analysis revealed distinct abnormal patterns of biomarkers that are associated with poor prognosis: Fibrinogen HGNC, D-dimer, Ferritin and CRP HGNC levels were all statistically significantly higher (p<0.05) at presentation in patients who subsequently needed ICU care compared with those patients who remained ward-based. 28.2% overall needed ICU admission, out of which 5 patients died. More studies with larger sample sizes are needed to compare data of COVID-19 MESHD patients admitted with and without diabetes MESHD within the UAE region.

    Epidemiologic and Clinical Characteristics of 186 Hospitalized Patients with Covid-19 MESHD in Tehran, Iran: A Retrospective, Single-Center Case Series

    Authors: Saher Papizadeh; Pouya Moradi; Maysam Havasi Mehr; Saman Amerkani; Reza Farhadi Nezhad; Hassan Saadati; Toran Shahani; Masoud Mohammadian; Nilufar Sadooghi; Shahin Bahari; Ali Ghorbani; Maryam Mehrabi; Rana Farzi; Reza Ranjbar; Saied Ghorbani

    id:202007.0060/v1 Date: 2020-07-05 Source: Preprints.org

    Background: The information on the difference in clinical characteristics between severe and non-severe cases is limited in some countries including Iran. The objective of this case series is to compare the clinical characteristics, radiologic features, and laboratory findings between COVID-19 MESHD severe cases who received the intensive care unit (ICU) care with non-severe cases who did not receive ICU care. Methods: In this retrospective cohort study, 186 laboratory-confirmed patients with COVID-19 MESHD diagnosed from 1 March 2020 to 30 March 2020 were investigated. Results: This study population included 186 hospitalized patients with confirmed COVID-19 MESHD. The median age was 47 years, and 88 (47.31%) were female. Of these patients, 48 were admitted and transferred to ICU. Of 186 patients, 44.62% had medical comorbidities including hypertension MESHD and diabetes MESHD. The most common clinical manifestation were shortness of breath MESHD 86.56%, myalgia MESHD 74.19%, and headache MESHD. Higher neutrophil counts, CRP HGNC, and LDH as well as the lower levels of lymphocytes were the most important laboratory finding among COVID-19 MESHD patients. As of April 15, 2020, 33 were still hospitalized. A total of 116 patients (62.70 %) had been discharged, and 36 patients (19.94 %) had died. Of the 48 patients admitted to the ICU, 33.33% have died. Conclusion: In the present study, shortness of breath MESHD was the most common clinical symptom, and the mortality rate in patients admitted to the ICU was about 33%, indicating that about one-third of patients with severe illness who admitted to the ICU section died.

    COVID-19 MESHD related deaths in an urban academic medical center in Brooklyn – A descriptive case series

    Authors: James Andrew McCracken; Mohamed Nakeshbandi; Jeffrey Arace; Wayne J Riley; Roopali Sharma

    doi:10.21203/rs.3.rs-37896/v2 Date: 2020-06-25 Source: ResearchSquare

    Background Available studies are lacking in analysis of baseline demographics and hospital presentation of patients at risk of expiring due to coronavirus disease 2019 MESHD ( COVID-19 MESHD), particularly Black American patients. We conducted a retrospective chart review to determine similarities in demographics and hospital presentation among patients who expired due to COVID-19 MESHD at an academic medical center in Brooklyn, New York. Study design and methods This is a retrospective observational study of 200 patients who expired due to complications of COVID-19 MESHD. Patients were included in this study if they had laboratory-confirmed SARS-CoV-2 infection MESHD and expired during their admission. Data were collected on patients who expired between March 17 and April 16, 2020. Results A vast majority of patients were Black Americans (89%) with no history of international travel who had more than one comorbidity (81%), with the most common comorbidities being hypertension MESHD (84·5%), diabetes mellitus MESHD (57·5%), and obesity MESHD (41·5%). Fifty-five percent of our patient population had three or more comorbidities. Among patients with available data, C-reactive protein HGNC, lactate dehydrogenase, and ferritin values were elevated above normal limits at admission. Dyspnea MESHD was the most common presenting symptom (92·5%). Most (90·5%) presented within the first week of symptoms, with a median time of symptoms prior to expiration being 8·42 days (IQR 5·57 – 12·72). Interpretation Socioeconomic status and healthcare inequalities have greatly affected the Black population of Brooklyn, New York, and these disparities become even more apparent in COVID-19 MESHD infection. Patients presenting with numerous comorbidities and elevated inflammatory markers represent a population at high risk of in-hospital mortality.

    Low serum 25-hydroxyvitamin D (25D) levels in patients hospitalised with COVID-19 MESHD 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 2019 MESHD ( COVID-19 MESHD), including an assessment of the prevalence 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 MESHD-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 MESHD patients. Participants: One hundred thirty-four hospitalized patients with documented COVID-19 MESHD infection. Main outcome measures: Adherence to local investigation and treatment protocol; prevalence of VDD MESHD, and relationship of baseline serum 25(OH)D with markers of COVID-19 MESHD 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 of hypertension MESHD, and higher baseline respiratory rate, National Early Warning Score-2 and C-reactive protein HGNC level. While mean serum 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 MESHD infection in patients with VDD MESHD.

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MeSH Disease
HGNC Genes
SARS-CoV-2 Proteins


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